Case Study: Valerie
One factor that contributed to Valerie’s confusion about whether she had a “real” eating disorder was that a lot of girls she knew used purging to get ready for beach trips. In fact, she had first purged, when she was 13, before just such a trip. Her friends would take turns running to the pharmacy to pick up “supplies,” which generally included tanning lotion, diet pills, diuretics, and laxatives. No one hid the behavior, and everyone considered it a lark—nothing serious, shameful or concerning. Valerie clearly recalled her friend Diana’s stating matter-of-factly: “Well, I better get rid of this potbelly before I try to put on a bikini. Can I pick up some pills for you while I’m at the chemist’s?” Given that Diana was 5 feet 7 inches tall and weighed no more than 130 pounds, Valerie found herself thinking that if Diana viewed herself as having a potbelly, she must think that Valerie was a disgusting pig.
Valerie’s attitudes about her own eating disorder are influenced not only by her friends’ behaviors but also by how they talk about themselves. Knowing that her friends use purging to control their weight makes this behavior seem potentially normal to her, and hearing Diana’s derogatory comments about her own weight left Valerie feeling more insecure and worried about looking fat to others. While neither believing that purging was normative among her friends nor hearing fat talk may have contributed directly to the onset of Valerie’s eating disorder, both factors could have contributed to its maintenance over time.