Eating Disorders in the Orthodox Jewish Community

Having worked with several Orthodox clients and also having participated in a Chabad Orthodox congregation when my family lived in Shanghai, I was excited to join in on the Academy for Eating Disorders’ Tweetchat on Eating Disorders in the Orthodox Community last month. The chat was informative and the full transcript of the chat is available here. A summary of some of the information covered in the chat as well as from a review of other sources follows.  In addition, I received some feedback from Devorah Levinson of Relief Resources (a non-profit serving the Jewish community), which I’ve incorporated.

Eating disorders do not discriminate. They affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses. As such, they are found in the Orthodox Jewish community as well as every other religious community.

Eating disorders are caused by a combination of genetic and environmental factors. Among the environmental factors implicated in the development of eating disorders among Orthodox females is a pressure among young Orthodox women to be thin. Some believe this pressure stems from the culture surrounding dating and matchmaking in the Orthodox community. For women of marrying age (frequently around 18 or 19 years old), thinness is greatly preferred, so women feel pressured to be thin in order to be matched with a desirable husband.  However, Devorah Levinson of Relief Resources wrote this in a response to my initial post: “Unfortunately I am not a big believer in the orthodox dating process being a cause or large contributor to the development of eating disorders. The dating process or variations of it have been in place for hundreds of years. The only thing that has changed is the beauty ideal. A beautiful wife has always been an important item on ‘the checklist.’ What’s important for us to note is that our vision of beauty has changed. Years ago in the Orthodox world it was actually the heavier woman that was sought after because she exuded health and financial stability. Just like how Marylyn Monroe was the ideal woman with her curvaceous figure and now would be considered overweight – it is the media and secular society that is so strong it has managed to change even the most insular communities’ visions of beauty. So I disagree with that being a large factor. I actually think the internet and easier access to outside media within our community has brought the thin ideal so close to home.”

Stigma surrounding eating disorders is pervasive in the Orthodox Jewish community, which can make getting help very difficult for individuals and their families. Moreover, in the case of the ultra-orthodox, the social disgrace surrounding an eating disorder could harm a woman’s prospects of marriage. Still, guest @JudyKrasna explained that Jewish law values health and life above all else, so despite the stigma that exists in the community, individuals are not prevented from getting treatment for religious reasons.  Devorah wrote, “stigma is a big challenge and it was one of the main reasons Relief was established. We wanted to be able to help our community access appropriate care for all mental health issues.”

The cultural significance of food and fasting in the Orthodox Jewish community is also important to consider. Dietary laws for Orthodox Jews require that they keep to a kosher diet, which can limit food options for individuals in treatment. Moreover, certain celebrations and holy days involve fasting and/or feasting, which can be additional obstacles for those struggling with eating disorders.

Eating disorders are the same across races and religions. Therefore, members of the Orthodox community do not necessarily need to use Orthodox providers for treatment. Instead, members of the Orthodox Jewish community should seek the best treatment options available. When selecting a residential treatment center, however, it is important to consider a provider’s availability of kosher options. When faced with a lack of residential centers that provide kosher options, Family Based Treatment (FBT) may be an effective treatment strategy.

Devorah adds, “Regarding kosher food, I have tried very hard to encourage parents to not let that be a stumbling block or deciding factor in making a treatment decision. I try and help families find the best and most effective treatment facilities and then we work out the kosher food situation. Most facilities will accommodate to some extent. After that, because of the medical issues involved many Rabbis understand the severity of the situation and will give families dispensations to not be as meticulous with their observance of these laws for the time the patient is in the program. In general I have unfortunately not seen success with programs that were either created for Orthodox patients or even had an ‘orthodox track’.  My goal has always been to find the most effective evidence based treatment and then promote cultural sensitivity amongst the clinicians. I have traveled to several facilities and have always been welcomed with warmth and openness.”

For providers working with members of the Orthodox Jewish community, cultural competency is key. To build this competency, treatment centers and providers should familiarize themselves with available resources (see below), and should also ask patients directly about how to better address their specific needs. In addition, treatment centers should work to provide kosher options for Orthodox individuals. Even with these improved treatment options, the issue of stigma within the Orthodox Jewish community remains an obstacle. For this reason, it is especially important that we reach out to others outside the eating disorder field, especially rabbis and educators, to raise attention to the problem, and ultimately, to reduce the stigma surrounding eating disorders in the community.

Resources:

• Relief Resources is a non-profit organization that provides services for individuals who suffer from mental health disorders and caters to the needs of the Jewish community.
  • Relief Resources also has an Eating Disorder Hotline at (718)-431-9501 ext. 103.
  • Devorah Levinson, the referral specialist and Director of the Eating Disorder Division at Relief Resources, wrote this article for the parents of Jewish Orthodox Children with eating disorders.
• Suggestions for kosher dietary recovery is available in this article.
• To learn more about eating disorders in Orthodox Jewish communities, thorough articles are available from NEDA Psychology Today The Jerusalem Post, Gurze-Salucore, and The New York Times.
• Eating Disorders Recovery Today and TreatingEatingDisorders.com offer extensive background information about some of the vulnerabilities to eating disorders that exist in Orthodox Jewish communities.

• Orthodox Union recently released a short documentary, “Hungry to be Heard” covering the topic, which can be found at their website and it was designed to be presented to parents in schools and synagogues to raise awareness. 

• Temimah Zucker, a blogger for The Times of Israel, is a survivor of Anorexia and runs support groups geared towards the Jewish community. Her blogs cover a variety of topics related to Judaism and eating disorders, which can be found here.

• The Renfrew Center offers specialized programs and groups for observant Jewish individuals, and their residential programs offer kosher options for all meals.

Research Assistant, Erin Standen contributed to the preparation of this post.