Eating disorder at root
of Terri Schiavo case

What about the effects on women’s fertility?
Well, it's interesting that you bring that up. Terri Schiavo’s husband, Michael, said in a 2003 interview with CNN’s Larry King that he and Terri were trying to have a baby. But they were not achieving their goal.

It is very common for women with eating disorders not to menstruate. In fact, the reason why Terri Schiavo won a judgment against a fertility specialist was that Michael Schiavo alleged that the fertility specialist should have been able to notice that she was having an eating disorder and diagnose it before it became potentially damaging to her brain.

Fertility is definitely an issue with eating disorders. In fact, it’s more of an issue with anorexia because women that are so thin that their bodies are starving don’t menstruate. That is well known from famines and things like that.

Even though the Schiavo situation is an extreme case, how can it serve as a message about eating disorders?
It can serve as a message that this behavior that is often undertaken by women to control their body weight can often have horrific consequences. In this case, it was severe brain damage. She will probably end up dying basically because of an eating disorder. If it wasn’t for that, all of the rest of this wouldn’t have happened.

Her heart stopped beating and the paramedics got there, but by the time they revived her, it had been too long. Her brain had been deprived of oxygen for so long that it actually ended up being severely damaged.

It’s interesting in terms of the medical aspects of the Schiavo case. One of the things that a lot of neurologists will point out is that people are more likely to recover from an injury to the brain — like an automobile accident or a fall or something like that — than this kind of situation when oxygen is deprived to the brain for a long time, because that destroys the entire brain throughout. It is not just an injury to one part.

How are eating disorders treated?
It is a complicated business because there is a lot of shame and it is really difficult to treat eating disorders.

It is not as though you can say to someone, “Hey, knock it off.” People who are anorexic and are literally starving themselves to death will look at themselves in the mirror and think they are fat still. People who are bulimic are vomiting regularly. They will go and eat a large meal and then go off and vomit. It is quite humiliating.

It is a mental problem and, therefore, it can be very difficult to get over. It is not just caused by body image issues — there are a lot of other problems at hand.

So, there is no simple answer. There are Web sites and there is a lot of advice out there and a lot of people are treated for this. But it turns out that it is a difficult thing to treat the underlying psychological problems.

But, one of the things about the Schiavo case is that this is a wake-up call that this sort of thing can have very serious consequences.

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