It was Thanksgiving and the sight of sweet potatoes topped with gooey melted marshmallows made Linda begin to shake. She set aside the packaged diet food she had intended to eat instead of the traditional dishes that night and stuffed herself until she could barely breathe.
Another diet ruined. Or so it seemed, until Linda excused herself from the table and quietly threw up her Thanksgiving dinner. Linda, who doesn't want her real name used, has been a bulimic for almost a decade since that night.
At her peak, the 46-year-old former Jewish educator and mother of three was vomiting up to five times a day. She'd send her daughters to their rooms so she could binge alone, choking down a gallon of ice cream and a box of cookies, vomiting and then waiting for the familiar feeling of release and calm to wash over her.
"All those moments with my kids were lost," says Linda, who at 5-foot-5 weighs 185 pounds, is recently divorced and still struggling with bulimia.
"I couldn't fill myself. I was empty. I didn't even feel myself in my body anymore. My youngest daughter worries about me. When I cry she says, `Mommy, I'm afraid you're going to throw up.' That makes me sad."
Linda is near one end of an eating-disorder spectrum that ranges from mild body-image obsession to fatal starvation. According to the Anorexia/Bulimia Association, 1,000 American women die each year from anorexia nervosa.
The organization estimates that more than 5 million Americans suffer from eating disorders.
Some experts contend that Jewish women — overall, men constitute only 10 percent of anorexics, bulimics and compulsive overeaters — are at particular risk.
This month, the Bay Area Jewish community launched its first-ever large-scale eating-disorder treatment program, called Begin From Within. Workshops dealing with food and weight issues were organized through the S.F.-based Jewish Family and Children's Services at various locations in San Francisco, Marin and Palo Alto.
Since German Jewish immigrant and physician Hilde Bruch introduced anorexia into popular culture with her 1978 book "The Golden Cage," Jewish thinkers have been omnipresent in the world of eating-disorder research and treatment and commentary — from best-selling Santa Cruz author Geneen Roth (her latest in a trilogy on eating is "When Food is Love") to feminist Naomi Wolf, who explored eating disorders among college-age women in "The Beauty Myth."
In "My Sister's Bones," a new book for young adults by Cathi Hanauer, fictional teen Cassie Weinstein is a scholastic overachiever who is eventually institutionalized for anorexia.
While no statistics linking Jews with eating disorders are currently available, many close to the field say there is a strong correlation.
"There's a colloquialism going around: Food, weight and body image issues is Jewish alcoholism," says Joan Barnes Strauss, who founded Begin from Within through her Extend Our Happiness Endowment Fund.
Strauss, 49, was the president and CEO of Gymboree, a publicly traded chain of children's stores. She was also a bulimic for nearly 30 years, and has now dedicated her life to helping others who suffer from eating disorders.
"There's a lot of us Jewish people who overdo and have unhealthy relationships with food [rather] than other substances. In Jewish culture, it's eat, eat, eat. Food is love. If you don't eat it, you must not love me."
While raising two kids and running a successful company, Strauss became increasingly obsessed with her body, on a constant loop of bingeing and purging. Sometimes she used laxatives or vomiting to rid herself of excess calories. Other times she punished herself with three-to-four-hour daily workouts. Finally she was doing all three.
She describes the unraveling of her life and marriage as a "slow burn" that eventually landed her in a live-in treatment facility for eight months. "I was really very sick. I was trying to kill myself."
These days, she's five years into recovery, remarried and living in Sausalito.
"I feel far from my fear of food. I feel like a different person," says Strauss.
Like most people in recovery from eating disorders, she stresses that the syndrome is not really about food.
"It's bingeing on life, on not being able to get enough of what you need. Food is used to fill emotional longings. Crunchy food is anger, soft is nurturing, like a lover to go to bed with at night," Strauss explains.
Marsea Marcus, a counselor for Begin From Within and author of "Don't Diet — Live It! A JourneyBook for Recovery from Food and Weight Issues," says her own compulsive eating made her "nonfunctional" by age 25. She was depressed, living at home, able to work only at a local library where she wouldn't be terrified by the presence of food or embarrassed by the 70 pounds she couldn't seem to lose.
Her problems with food, she says, began with messages she received while growing up.
"Jewish people tend to calm and numb themselves with food. In my family, everybody stuffed themselves and complained about their weight," says the Santa Cruz author.
What's more, she adds, "hereditarily, Jewish women tend to be bigger and fleshier, softer, and there's this drive to fit into the American culture. It puts us in a terrible bind. We have our natural body that doesn't fit into magazines and this tendency to use food as nurturing.
"We have these fleshy soft bodies in a state of deprivation. We're hungry, physically and emotionally."
Add to that a cultural drive toward perfectionism, and, the counselor says, the Jewish psyche is a fertile field for eating disorders.
As a dancer, Lorie Bloustein began to hate her own body while still in her teens. A muscular 5-foot-3, she describes herself as "from Eastern European peasant stock." By age 24, she was a "garden-variety starver and binger." A year later, she went from being "a regular young woman concerned about the size of my hips to bingeing my brains out, obsessed with my body size."
Her binges came upon her like storms. She could feel her heart speeding up, adrenaline pumping through her veins and "nothing going on in my brain, just imagining where the next food is coming from. It's horrendous and terrible and stupefying.
"When it was over, I would be completely wasted, exhausted, washed up on the beach."
Now staying in Berkeley and performing and choreographing with her Paradox Dance Company throughout the world, Bloustein can discuss the storms of her past with a certain remove — and clarity. She realized that depriving herself of food was at the center of her eating disorder.
She promised herself she would never starve herself again, that there would be no "good foods" and "off-limits foods." For a bulimic, that was a leap of faith, she says.
"It meant going into some of my worst fears, that I would eat and never stop. We've been conditioned to have an enormous fear about what happens when we satisfy our hunger," Bloustein says.
Begin from Within workshops focus on helping clients determine what they are truly hungry for, helping them recognize the difference between physical hunger and unconscious feelings of anger, guilt, anxiety, loneliness and sadness that can trigger binges.
Still, eating disorders have been difficult to treat, with a recidivism rate estimated as high as 97 percent. Antidepressant drugs have been shown to decrease binges in 50 percent to 90 percent of bulimics, as well as helping anorexics and nonpurging binge eaters. But only a fraction of patients become totally free of eating disorders — even on high levels of Prozac and other drugs.
Insurance companies only pay for treatment in extreme cases, when years of starvation or vomiting and overeating have resulted in such problems as extreme obesity, slowed reflexes, a weakened heart, bluish hands and feet, swollen parotid glands ("chipmunk cheeks") and cardiac arrest.
Before such physical consequences become evident, eating disorders often wreak unspeakable and invisible havoc on the lives of those starving under baggy clothes, vomiting while the water runs loudly, running until their joints ache and ligaments tear.
"For people who haven't experienced it, it's a darkness they can't imagine. For people who have, it's a darkness that seems like it will never end," says Bloustein.
For Linda, a patch of the darkness may be dissolving.
She is seeing a counselor, attending meetings of the 12-step program Overeaters Anonymous in the South Bay, and at the time of her interview she could say she had just completed three consecutive binge-free days.
"I don't know what will happen tomorrow," she admits, crying as her best friend sits nearby for support. "Every time you go backward, it takes too much strength to go forward again. I hope tonight, when it's dinnertime, I can be healthy."