Posted: Monday, April 4, 2005 12:00 am
Perhaps out of a sense of decorum; perhaps because it was so long ago, the public debate over the life and lingering twilight death of Terri Schiavo has not focused long and hard enough on the reason why she suffered the heart attack in 1990 that stole her life but left her marginally alive.
Like four out of 100 women her age in the United States, Terri Schiavo suffered from bulimia, an eating disorder involving binge eating immediately followed by purging, usually by inducing vomiting. Bulimia last received widespread discussion when the late Princess Diana revealed her struggle with the disorder.
As a child, Terri Schiavo was plump and a little shy and self-conscious. Losing her chubbiness as a teenager brought her positive attention and, some suggest, the attention of the man who became her husband.
Our modern culture insists women, in particular, look a certain way to receive approval. Standards of physical perfection are especially harsh on the sunlit beaches of Florida.
But the biggest struggle in weight loss is keeping it off, and Terri Schiavo binged and then purged before the nutrients in the food she ate could be absorbed. Tragically, she didn't realize that one of those - potassium - is listed among the "essential nutrients" that the body requires to maintain vital organ function.
Those who practice this form of extreme weight control often hide it, and so the doctors' inability to diagnose her potassium deficiency may have been partly been due to the secretive nature of bulimia.
Since her death, editorial columns have been full of questions about how others managed Terri Schiavo's life after she became disabled. Debate rages anew about who has the right to make choices of life and death for the severely debilitated. Wanting to avoid a similar fate, many people are rushing to sign "living wills" to leave instructions in case they can't direct their own medical care.
Let's hope that Terri Schiavo's legacy includes renewed awareness of eating disorders, and the pressure to be physically perfect that fuels them.