Conditions such as anorexia and bulimia are a serious health issue in Western cultures. Alarming numbers of young people, especially women, are jeopardizing their health by using food in self-destructive ways (for example, by gorging on food, then vomiting or taking laxatives) or by denying food to themselves altogether. For some, it is a misguided attempt to gain control over their lives. For others, it is an obsession with weight gain, which is considered the greatest of all evils. In nearly all cases, low self-esteem is strongly evident. The table becomes the battleground, and food, whether it is the enemy or the only trusted ally, is the one thing that matters. Needless to say, when this kind of emotional war is being waged, considerations such as nutrition or real nourishment are rarely addressed.

Still another type of eating disorder is evidenced by nutrition addicts," who devote the greater part of their day's work to worrying about and planning the balancing of their foods. They can be found wandering the aisles of the health-food stores, diligently studying vitamin bottles; they then hurry home to administer to themselves some new intestinal cleanser. They are obsessed with "toxins" and fascinated by the consistency of their feces. This excessive concern may be temporarily necessary during certain critical periods, especially in treating serious illness, but as a way of life, it more likely indicates another obsession with food that fills time and may serve to discourage the cultivation of relationships with others and the creation of more dynamic and rewarding forms of self-expression.

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