WASHINGTON—When Faryn Hart settled into her seat at the weekly Shabbat table set for 20, she also settled into the role her grandmother expected her to play.
Yes–I will study medicine.
Yes–I will marry an engineer.
Yes–I got an A on my exam.
Inasmuch as these canned responses weren’t really her own, Hart reveled in the predictability of it all. The ballerina and popular Hebrew day school student effortlessly spit out the right answers, while her mind submerged into the torment she couldn’t control. As each food item came out, fried sole, fish cakes, salad oozing with mayonnaise, so did the triggers to binge and purge.
“I was not present,” a now 24-year-old Hart reflects on those moments as a teenager. “I was in the conversation but completely thinking about the food. It wasn’t about the ritual, it was about the ego. Perhaps it was a way to deal with the discomfort of a family that put so much pressure on me.”
Though Hart grew up in Johannesburg, the eating disorder she struggled with throughout high school and at the University of Florida, reflects an alarming trend that’s long taken hold among Orthodox Jewish women in the states. The statistics for this demographic are few, but eating disorder expert Dr. Ira Sacker found in 1996 that one in every 19 Brooklyn Orthodox Jewish teenage girls had an eating disorder, about 50 percent higher than the general population. The Renfrew Center, which treats patients with eating disorders at its nine U.S. locations, reported this year that 13 percent of its Florida and Philadelphia in-patients identify as Jewish. That’s 5 percentage points higher than it was in 2007. This year was also the first that Renfrew offered a track geared specifically for Orthodox Jewish patients. Something no other program has offered before.
“It could no longer be swept under the rug,” said Adrienne Ressler, Renfrew’s national training director, of the pressing need to intervene. “But we were not as aware of all that was involved in the treatment of this population.”
Such a program wasn’t available to Hart when she sought out recovery two years ago. So Hart constructed her own healing plan when she turned to the sustainable Hostel in the Forest in Brunswick, Ga. There, she works as a manager and directly with her food she helps to grow.
“It’s not this evil thing anymore,” Hart shared of her relationship with food. “When she toils in the garden’s acre of produce she often thinks, “this is what a zucchini looks like–it’s beautiful. It’s magical.”
Though Hart’s experience is hopeful, it’s also unusual, especially among members of a community who prefer to conceal any semblance of an emotional problem. Concerned with sufferers’ reluctance to come forward, the Orthodox Union reached out to Renfrew for help last January, just a few months after the organization released, “Hungry to be Heard.” The documentary profiles observant Jews who struggle with eating disorders and a community reluctant to acknowledge them.
The two organizations hosted its first joint conference and workshop on the topic in New York City last June. Renfrew held a similar conference—on its own—last month in Bethesda, Md.
“It took a lot of courage for the Orthodox Union to approach us,” said Ressler. “They wanted to help families get past the shame of admitting they have a problem. [A problem] that may reduce the chance of making a good marriage contract.”
The challenge to treat Orthodox Jewish patients is two-fold—there’s dealing with kosher food logistics and addressing the nuances of the culture that surface during recovery.
When Rocky Horwitz, 19, was admitted to Renfrew’s Coconut Creek, Fla. location two years ago, the facility didn’t yet have the accommodations to cook kosher food on site. Although the staff ordered in from a local kosher restaurant for her, the fact that Horwitz was served eggplant parmesan, while the rest of the patients ate bean fajitas, often piled on additional stress to an already fraught situation.
“I was freaking out that I was having more calories [than the other patients],” Horwitz remembered. “My plate looked different from everyone else’s. My portion looked bigger.”
But meal discrepancies typically caused anxiety for everyone at the table.
Julie Dorfman, nutritional director for Renfrew’s Philadelphia location, noted that tensions rose when the orthodox patients were served a cheese sandwich, for example, while the rest of the patients were given pizza.
“Pizza versus a cheese sandwich is not the same challenge,” Dorfman explained. “Some foods are categorized as ‘scary.’ The fat in a cheese sandwich is contained, not as visual. But the grease on the pizza is visible and there’s the temptation to blot it with a napkin.”
To foster a uniform rehabilitative experience for all patients, that is also conducive to orthodox rituals, Renfrew assembled a committee of mental health professionals and religious leaders. The kitchen practices have been overhauled in Florida and Philadelphia so that the staff could prepare kosher dairy and kosher vegetarian meals.
Dietitians and therapists were also taught how to discern a religious food ritual from an eating disordered ritual.
“In what sense is kosher not a pathology in the least?” asked David Hahn, a psychiatrist at Renfrew in Philadelphia. “The control of food that’s necessary in Judaism is very different than control of food around someone who has an eating disorder. It may look the same, but it’s not.”
A patient who keeps kosher will request to drink a dairy protein shake before a meat meal, for example. Such a regimen might seem like a common eating disorder practice such as, having to take three sips of water, after three bites of food. But because kosher law mandates waiting between three and six hours to eat a dairy food after a meat meal, the protein shake request is respected.
At the same time though, treatment professionals have to be wary of patients who actually do use their kosher observance as an untouchable exemption.
Becca Shrier, 27, often relied on her kosher practice–the fast days and restricting of breads on pasta on Passover, for example–to get away with limiting her caloric intake. She was also treated at Renfrew in Florida before its program for Orthodox Jewish patients was implemented.
“I used my religion as an excuse to engage in my eating disorder over and over again,” Shrier recounted.
But therapists and dietitians have also pushed beyond accommodating the tangible rituals in order to better understand what triggers these women to futilely pursue thinness as perfection.
They learned how a skinny early-20s bride is often idealized as the ultimate prize. So is her quick evolution into a mother of a large brood.
“I speak to boys who tell me they want someone who’s a size zero or size two,” remarked Frank Buchweitz, director of community services and special projects at the Orthodox Union.
Such endemic issues are now incorporated into group therapy sessions and Jewish-themed classes at Renfrew. The Hebrew text helps dispute an eating disorder’s fundamental code.
“When you look at “Eshet Chayil” [the prayer a husband sings on Shabbat], there’s many things your wife is supposed to be,” said Hahn, “gracious, kind and wise. Thin is not one of them.”