While the incidence of eating disorders among Jewish women may not be higher than in the general population, the ways to effectively treat those disorders can be uniquely tied to cultural and religious distinctions, according to experts from The Renfrew Center, a network of eating disorder clinics, which will be opening a facility in Pittsburgh this summer.
Factors such as Jewish holidays that emphasize food, the laws of kashrut and the pressure to be thin for matchmaking purposes, or shidduch, can all come into play, according to Sarah Bateman, The Renfrew Center’s liaison to the Jewish community.
“I’m not saying these factors are problematic, and I’m not blaming Jewish rituals,” said Bateman, who was raised Orthodox. “But they can help us figure out what can be triggering and problematic and help us learn how to turn it around.”
The Renfrew Center held a seminar last week for local social workers and other professionals who work with women suffering from eating disorders in advance of the opening of its Pittsburgh center, which will be its 18th facility.
The Pittsburgh center, which will be located in Oakland, will include day treatment, outpatient and group therapy and will specialize in the treatment of anorexia, bulimia, binge eating disorder and related mental illnesses. A residential center is located in Philadelphia.
“Eating disorder clients do recover and can recover completely,” said Adrienne Ressler, vice president of professional development of The Renfrew Center Foundation. “It will always be part of their history, but they can leave it behind.”
The Renfrew Center sites have seen a “spike in Jewish patients over the years, many of whom are Orthodox,” Bateman said. There have been, however, no studies conducted in the United States measuring the prevalence of eating disorders among adult Jewish women.
A study of Jewish women and eating disorders was conducted, however, in Israel.
Marjorie C. Feinson, professional development specialist for the Renfrew Center Foundation, directed the first community study of disordered eating and domestic abuse among women in Israel. What she found was that most Jewish women with eating disorders who were interviewed had suffered emotional abuse during childhood.
Feinson also found a strong correlation between binge eating and depression, anxiety and anger.
Being aware of cultural norms prevalent in the Jewish community can provide “context” for eating disorders among Jewish women and are salient for treatment, according to Feinson.
One factor is the “dominance and prominence of food” marking holidays and Jewish life cycle events, she said.
“Every holiday has its own special foods,” Feinson explained. “Even Yom Kippur, there is planning on what to eat before the fast and after the fast. There are 17 holidays that require special foods, and every Shabbat involves food, with the focus on foods for Shabbat beginning days before it starts.”
Another factor that can come into play when a Jewish woman has an eating disorder is the “ongoing responsibility for food preparation, even if that woman has a serious eating problem,” according to Feinson. “A woman is expected to engage in the preparation of foods, even those that trigger binge eating and bulimia. An alcoholic man would not be expected to prepare and serve drinks.”
Kashrut must also be understood when treating a Jewish woman, according to Bateman, as “the strict dietary laws can normalize the idea of restricting. It’s normal to not have, to wait, which can contribute to problematic food rituals for some people.”
Shabbat, with its restrictions on the use of electricity, can also be a challenge for the Orthodox Jewish woman struggling with an eating disorder because some of her coping mechanisms — like calling a friend or going online — are not available, according to Bateman.
Then there is the “shidduch problem,” Bateman said.
“Matchmakers keep a woman’s statistics on file, and they can be anything from the color tablecloth her family uses on Shabbat to the woman’s size and weight.”
The “number one question men are asking” matchmakers, Bateman said, is the woman’s size. And the pressure to be thin can extend to the mothers of those women seeking a match.
“There is a new wave of eating disorders where the mothers, who are middle age, are restricting because the men want to know the mother’s size so they can predict what the woman will look like after she has children,” Bateman said.
The “shidduch problem,” Bateman continued, “may contribute to an overwhelming pressure to be thin.”
Another factor coming into play can be “Jewish guilt,” she said, which
also is prevalent in other religious and ethnic groups.
“There is a rigidity in the Orthodox community that leads to an absence of options,” she said. “So, food becomes the good girl’s way to rebel.”
The Renfrew Center opened its first center in Philadelphia in 1985. Through its 17 centers across the nation, it has provided help to more that 75,000 adolescent girls and women.
“All of our staff is trained in working with Jewish women,” said Wendy Cramer, The Renfrew Center’s professional relations representative, adding that 13 percent of those whom it treats are Jewish. Kosher meals are provided to those requiring them.
Eating disorders are, in fact, “a relevant issue” in the Jewish community in Pittsburgh, according to Molly Geiger, who works in family resources at Jewish Family & Children Service in Pittsburgh, and who was present at the seminar.
Geiger declined to elaborate further, citing confidentiality concerns.
“People can be very secretive,” said Cramer. “People don’t want to talk about it.”
Toby Tabachnick can be reached at firstname.lastname@example.org.