Eating disorders kill. Just ask Featherweight Inc.’s Debbie Begeny.

In a town known for hearty food such as wings, beef on weck, and frozen custard, there are many misconceptions about eating disorders. Eating disorders afflict between five and 10 million Americans; approximately one million of those afflicted are male.

Heather Begeny

Featherweight, Inc. was established to promote a healthy body image and educate the public about eating disorders. Founded by Debbie Begeny, an energetic woman who lost her only child Heather Begeny in 2003 to anorexia, the organization has worked in schools to inform parents, teachers and students about eating disorders. They also help with out-of-pocket expenses that one’s insurance may not cover, paying for prescriptions and therapy.

The mental disorder anorexia has the highest death rate of all the eating disorders: Between five and 20 percent of all anorexics will die from the disease.

Other eating disorders include bulimia and binge eating. Bulimics are often at normal weight or even slightly overweight. They may eat an entire cake or a gallon of ice cream, feel terrible about it, and then purge or starve themselves afterwards.

Binge eaters, unlike bulimics, do not purge. They may consume enormous quantities of food to the point of pain, then feel guilt, shame, anxiety ,and depression afterwards. This often leads to obesity, which ranks as the number one cause of death in industrial nations, beating out tobacco use.

Begeny says, “Anorexia is not just a disease of models, actors or celebrities. People think of Karen Carpenter.”

Steve Paradowski, director of Featherweight, adds, “The fashion world isn’t helping by promoting size 0 figures like Kate Moss.”

Pro-anorexia Web sites don’t help either. These sites glamorize anorexia. They offer tips and advice on how to purge and remain thin.

“For anorexics, putting food into their mouths is one way to control their lives. They know exactly how many calories they put in their mouths. It’s part of the compulsion. If they enjoy eating something they feel guilty,” says Paradowski.

“They’re proud to not eat and feel dizzy,” Begeny says. “They have a tremendous amount of willpower to not eat.

“It’s a disease that’s easy to dismiss as a phase. Many people go through diets during their lives, however a percentage of those will develop ED.”

“And there are people who are naturally slim that are not anorexic,” says Paradowski.

Psychiatric disorders traditionally have had a social stigma attached to them that physical disorders do not. More men are developing eating disorders, particularly bulimia, because of weight requirements in sports such as boxing or wrestling. They tend to follow a binge-and-purge cycle followed by bouts of intense exercising. Men who have bulimia tend to be especially ashamed because eating disorders are normally associated with women.

Eating disorders, though normally associated with adolescents, are also becoming more prevalent among older women. Women in their 40s who have career- and family-related stress are developing eating disorders, especially after pregnancy, when women feel pressured to lose the weight they’ve gained.

Eating disorders are often coupled with other destructive behaviors such as cutting, drug addiction, or alcohol abuse.

Heather Begeny first showed signs of developing anorexia at the age of 19 when she weighed 120 pounds. Debbie Begeny explains that Heather had been raped and that trauma became the underlying basis for her anorexia. When Heather died at the age of 22, she weighed only 62 pounds.

Heather had begun to severely restrict her diet, eating only apples and salads, ultimately paring down to a daily diet of a single banana, a jar of baby food, the occasional cup of soup, and lots of coffee. Large quantities of coffee gave her the runs, enabling her to eliminate what little food she’d eaten.

“The way she ate was highly ritualistic,” Debbie says. “People with eating disorders often have varying levels of OCD as well. She’d insist on eating with a certain spoon, cup or plate at a certain time. She’d slowly cut the banana in slices and then those slices into quarters. It would take her two hours to finish a cup of soup. I insisted we have meals together so I could make sure she ate. I didn’t know she was also purging.”

Heather died the night of March 9, 2003. The direct cause was cardiac arrhythmia, a result of lethally low electrolyte levels. A similar case was that of Terry Schiavo, whose husband contended she battled with bulimia and suffered brain damage due to dangerously low potassium levels.

“The day she died, we’d gone to the mall and I’d taken her out to Anderson’s,” Debbie says. “She’d had a lemon ice. But when they performed the autopsy on her, her stomach was empty. So sometime in the evening, she’d purged out whatever was in her.”

Heather had maintained a body weight of 80 pounds for some time. However, once she discovered she could purge on ipecac, she rapidly decreased to 62 pounds within just six weeks.

Ipecac has traditionally been used to induce vomiting in children when they’ve swallowed a toxic substance. However, Poison Control Centers and the American Pediatric Association no longer recommend its use as it only removes 10 to 30 percent of the poisons. Ipecac is now more often a substance abused by eating disorder sufferers.

Begeny is fighting to make ipecac an item that can only be purchased over the counter, like pseudoephedrine. State Assemblyman Sam Hoyt is currently proposing legislation to make it more difficult to purchase.

Eating disorder sufferers have body dysmorphia, which distorts how they view their bodies. When Heather was only 80 pounds, she’d declare how fat her thighs were. No matter how much she weighed, no number was ever good enough. When she had slimmed down to 90 pounds, she aimed for 80 pounds, then 70 pounds.

Debbie Begeny tried multiple times to have her daughter committed to a hospital for a psychiatric evaluation, but Heather didn’t qualify for 48-hour observation. Had Heather been underage, it would have been simpler. But she was an adult and Debbie was unable to force her to undergo treatment.

“When I took her to the doctor, all he did was tell her to eat,” Debbie says. “He gave her pamphlets on how to eat 1,000 calories a day. Most doctors unless they go into psychiatry don’t recognize the symptoms of eating disorders.”

Anorexics feel a tremendous amount of pressure to protect their disease. Some even think of ED as their friend, “Ed.” They go to great lengths to hide the disease. Skipping meals is one way. Because eating is a social phenomenon, many anorexics alienate themselves and withdraw from family and friends to avoid eating.

“Heather told me what I wanted to hear,” Debbie says. “It was not that she was lying out of maliciousness or spite; it was part of the disease process. She’d tell me she’d already eaten a big lunch or was going out with friends and they would eat out.”

Despite the anorexia, Heather maintained a façade of normalcy. At the time of her death, Heather was a junior in college studying art history. “She was functioning, her grades were good,” says Paradowski.

Begeny says, “This wasn’t suicide. She never intended to do this to herself.” Paradowski adds, “If she knew what was going to happen, she’d say, ‘This fucking sucks.’”

A year after Heather’s death, Begeny paid a visit to the family dentist and that’s when the hygienist told her that there had been signs that Heather was anorexic. Heather’s dental enamel was worn down, indicating that she was purging. When one vomits frequently, stomach acids come up and begin to dissolve tooth enamel. To avoid the loss of enamel, some purgers now wear mouthguards. Because Heather was an adult, confidentiality laws kept them from informing her mother.

Other symptoms of purging include calluses around the knuckles, where purg insert their hands in their throats to cause vomiting. Bloodshot eyes from broken capillaries caused by vomiting are another sign. Constant vomiting will also wear away the esophageal lining and lead to ulcers that destroy the esophagus. Malnourishment will cause a pot belly of the sort one sees in famine victims, which ironically induces eating disorder sufferers to restrict their calories even more to lose the bloated appearance.

In women, amenorrhea may develop. Loss of body fat reduces one’s ability to menstruate.

For bulimics, coffee enemas, OTC laxatives, and diuretics take a toll on the gastrointestinal tract, and many other diseases are caused by the repetitive cycle of binging, purging, and starving.

Things that parents can do for their children that the members of Featherweight, Inc. encourage are shopping and cooking in a healthy way, avoiding junk foods like potato chips and soda pop, which can cause obesity.

One promising development in recent years is Timothy’s Law, which mandates mental health parity: Mental health has to be covered by insurance in the same way as a physical disability.

“I don’t want to relive Heather’s death,” Bebbie Begeny says. “I don’t enjoy talking about it, but I feel I have an obligation. Nobody was there for me. I know what that felt like, I feel it’s necessary for parents to know what to look for. Eating disorders are very misunderstood. I knew nothing and I don’t think I would have done anything different although I feel a lot of guilt.

“We’re trying to teach people from an early age to be comfortable with their bodies, that you’re more than what you weigh.”

Moving Toward Awareness is a 5K walk hosted by Featherweight, Inc. on Saturday September 20 at 11am. Runners meet at the North Forest entrance to the Amherst Bike Path. For more information on eating disorders and treatment options, go to featherweightinc.com.