Anorexia and Professional Women

Can professional school or a high-powered career cause anorexia nervosa in women? Compelling anecdotal evidence suggests an association between advanced degrees and eating disorders, but that is no reason for giving up on your dreams.

What initially got me thinking about this subject was an article posted on one of the discussion boards on this topic page. It was written by Nicole Schlesinger, whose plans for medical school were thwarted by her anorexia. Her poignant story made me wonder whether there were many other young women like her.

“I see the increased pressure of professional school or professional life as a “trigger” that may exacerbate the ED,” observes Rebecca McCulloh in an email. McCulloh is a therapist in private practice with 15 years’ experience treating childhood sex abuse survivors with eating disorders. “It is my experience that the ED typically pre-exists entrance into a graduate program.”

A September 1995 article in The Monitor, a monthly publication of the Tulane School of Medicine, reported an interview with Susan Willard, associate professor of psychiatry and director of Tulane’s Eating Disorders Clinic. She is quoted as follows: “Our patients are generally high-functioning people who are very goal oriented… We see a number of professional women, college students, and graduate students.”

At first blush, it may seem incredible that such highly educated persons like doctors, lawyers, and senior executives could fall victim to anorexia nervosa and related disorders. Doctors have extensive medical training and fully understand the dire threat to health posed by these illnesses. Although other professions may not require scientific expertise, their pressures and responsibilities demand that a person take reasonably good care of her body.

How can this happen to such smart people? Perhaps the phenomenon is better understood when professionalism is considered a subcategory of perfectionism, which is a common characteristic among anorexics. Clearly, giving up one’s aspirations will not solve the problem. Instead, the key to overcoming the condition appears to involve balancing personal and professional life.

“While it is not surprising that high-achieving women in demanding professions (law, medicine, business) frequently develop eating disorders, I don’t believe that there is anything specific about these professions that is causative,” writes Paul Hamburg, M.D. in an email. Dr. Hamburg is a psychiatrist and an associate director of Massachusetts General Hospital’s Eating Disorders Program. “To the extent that eating disorders happen most often to high-achieving, ambitious, perfectionistic young women who feel defined by their accomplishments, but have not found ways to nurture themselves, these professions are natural destinations for them to choose. One might look at eating symptoms as the psychological glue that permits professional and academic accomplishment in the face of inner psychic fragmentation.

“Of course, once a woman has developed an eating disorder along with a professional career, there are a number of difficulties specific to the demands of these professions that affect treatment and recovery. While professional success might continue to be a vital cornerstone in self esteem, the requirement to meet the needs of patients, clients, or start-up businesses regularly interferes with learning to take care of one’s own body and soul.”