Jane Blackwell can spot them in the audience when she goes to local high schools to speak. There's a certain look about them, she says. A strained look. Sometimes the glands under their jaws are swollen, so that even though their faces may be bony, they still look a little bit like chipmunks.

Blackwell, director of the Eating Disorders Unit at Wasatch Canyons Hospital, can spot bulimic students right away. But that doesn't mean she can always reach them.The war against eating disorders is far from won, says Blackwell, despite the fact that there is much more awareness of the problem today than there was three years ago.

In May 1986, Cottonwood High School student Kristin Haroldsen died after swallowing baking soda in an effort to purge herself of unwanted calories. Her death shocked the Salt Lake Valley and spurred efforts to increase awareness of eating disorders.

But three years later, says Blackwell, there are just as many - maybe even more - teenagers and adults suffering from anorexia and bulimia.

The Eating Disorders Unit is now seeing more men with eating disorders, she says, particularly men in their 30s who are "obsessed with thinness."

"There's a lot of work still to be done," she says. Much of that work involves American attitudes about weight.

"We need to be teaching kids that only 2 percent of people look like the models in magazines. Mothers need to stop complaining about their own bodies," argues Blackwell.

And, she adds, it would help if we didn't look for miracle diets. "I still think we're into magic, rather than good health," she notes.

During the past three years the Eating Disorders Unit, which recently moved to Wasatch Canyons Hospital from Cottonwood Hospital, has treated 250 to 300 patients. According to Blackwell, these patients "are more of a mixed group than we first believed."

Although it was originally thought that most people with eating disorders were perfectionist over-achievers, treatment facilities are now seeing a high incidence of anxiety and impulsivity among their patients. About 30 percent of them were sexually abused as children.

"The bottom line is that they don't like the way they are. And they assume that if they lose enough weight they will like themselves better."

On average, the people who finally end up at the Eating Disorders Unit have been anorexic or bulimic, or both, for at least two years before finally deciding to get help. "Some of them are 40 years old and have had eating disorders since they were 15."

What she has learned in the past three years, says Blackwell, is that "we have to change the way they think of themselves. And we have to teach them alternative ways to deal with stress."


(Additional story)

Signs of bulimia

These signs may indicate a person is suffering from bulimia, an eating disorder characterized by binging and purging:

-Eats excessive amounts but gets thinner

-Has swollen glands under the jaw, giving a chipmunk-like appearance

-Always excuses self after meal, disappears, then returns with bloodshot eyes

-Dentist reports pitting in tooth enamel and increased number of gum-line cavities (caused by stomach acid)