At least 30 million people of all ages and genders suffer from an eating disorder in the United States. Every 62 minutes, at least one person dies as a direct result from an eating disorder. And eating disorders have the highest mortality rate of any mental illness, according to the National Association of Anorexia Nervosa and Related Disorders.

The Renfrew Center is the country’s first residential eating disorder center, with locations throughout the country, including one in Boston (870 Commonwealth Ave). The female-only facilities also offer a specialized track for Jewish women to focus on their unique needs as they pertain to religious traditions, Jewish identity, faith, perfectionism and more.


On May 7, they’ll host a Boston-area public seminar focusing on eating disorders in the Jewish community. JewishBoston talked to Sarah Bateman, LCSW, the center’s liaison to the Jewish community, about the particular impact of eating disorders on Jewish women. As an Orthodox Jew, she comes from a place of empathy and compassion.

How are eating disorders connected to Judaism?

I always start out by saying it’s not about blaming Judaism. We’re not saying there’s anything wrong with religious rituals. It’s about being sensitive to how Jewish rituals can be stressful and challenging for someone who is trying to make changes. I think the most important [connection] is the emphasis on food. We are in the middle of the Passover holiday. This time of year is so difficult for Jewish women who have eating disorders.

People of all levels of Judaism observe Passover, and Jewish women talk about how every single Sabbath is like a Thanksgiving meal. We struggle with what other women struggle with at the holidays, and also the changes in what we’re allowed to eat. For someone struggling or in recovery and coming up with a meal plan, trying to eat and nourish their bodies in a healthy way, it’s [hard] when those ways become unavailable when they have to follow a Passover meal plan. It can trigger them. [Loved ones] need to be aware to give extra support, extra help with meal planning, extra help with shopping and preparation to make it not as challenging.

How do you suggest loved ones help if there’s an issue or a suspected issue?

I would ask each individual, if a parent is dealing with a child, or a friend, “How can I support you? What would be helpful? How are you?” Don’t comment on appearance or on food. “How are you doing? What’s going on for you? Is there anything you’d like to talk about?” Give them a voice.

This could be awkward to bring up, though, especially for a friend. How do you ask without seeming accusatory?

My thinking is it’s better to ask than not to ask. Come from a place of concern, not judging, not making assumptions. Start by stating a fact. So, “Are you OK? I’ve noticed you look different. I don’t want to assume you’ve lost weight, but I’m wondering if you’re OK. Is anything going on?” Asking can be helpful. Let them know you care.

A lot of times, people won’t respond when you first ask. If they’re hiding it, let them know that you’re there if they do want to talk—and do it one on one. An eating disorder can become someone’s voice, so show them you’ll listen to their actual words, what they’re actually saying. Location, timing and setting are important. Sometimes the people who look healthy and normal can be struggling the most. Try to point out specific behaviors. Be concrete. Mention a fact, but not in a judgmental way.

Why does this issue manifest through food? What is the deeper problem?

It’s about the food but not about the food. Food becomes a replacement for whatever’s missing. Their body is the only thing they can control. There’s also a self-worth piece: “I don’t deserve to have the food everyone else is having.” Often, there’s a belief that they’re not lovable and not worthwhile. So give them that control: “I am not an expert, but I love you, and I care about you enough that I want to make sure you’re able to get treatment. How can I help you in that process?” Give them that control.

It’s a multi-faceted disorder with a lot of different issues. Depression, anxiety and obsessive-compulsive disorder can all be involved. Re-feeding has to come first, but it’s not the only focus.

Won’t people feel defensive?

In my experience, when I talk to people as an expert, they feel relieved that they can just be honest and say what’s going on. The way you approach people makes a difference. Most are relieved and happy. In the end, they’ll be happy their parents [or friends] noticed and saw them and insisted.

How can people seek help in a Jewish context given its food-oriented traditions and rituals?

I work with a lot of people who get stuck in the observance of Jewish rituals but would not consider changing them. They find comfort in their Judaism. Instead of focusing on how to manage the challenges of observance, I try to flip it around: How can it be helpful in their treatment? Where did it become problematic?

The first step is to figure out triggers and set concrete goals that make it easier to manage. If we talk about food, modify a meal plan. At Renfrew, the dietitian looks at how a person can get the nutrients and food groups they need in a day. A dietitian helps them break down the Sabbath meal, so instead of feeling extraneous, it can fit their meal plan—how can I break this up so it works for me? The challah can be part of their carb exchange. Chicken can be their protein.

Then, can you change the tradition so it’s in line with your observance and works for your needs? Let’s say going home for Passover is triggering and unhelpful. Maybe you can go to a friend’s house this year. If going to a friend’s isn’t an option and you have to go home, how is it triggering? Someone I work with felt like her parents never  made it a happy place when she was a kid. She had bad feelings about it. Instead of that resentment, she decided she would make the family table for her nieces and nephews. She came up with games and ideas to build into the seder that fit with the family’s traditions but made it fun and entertaining. It’s about creating happy memories.

How can parents avoid blaming themselves if their child has an eating disorder?

We call this narcissistic injury. Our children are images of ourselves. When they get sick, it’s normal to blame ourselves. It’s OK if a parent needs to get their own therapy and their own support. It’s not OK not to get treatment because they don’t want to admit they have a problem. It’s normal to have a hard time when kids are sick, but the way to deal with it is by being the parent and getting them treatment and working through their own feelings. If as a parent you feel your child has a problem, trust your instincts.

This interview has been edited and condensed. For more information about eating disorders and tips for parents, visit The Renfrew Center’s resources page.