The real tragedy of Terri Schiavo

As I write these words, Terri Schiavo is being starved to death because she was once a chubby little girl.

Almost everyone has heard about how, 15 years ago, Schiavo’s heart stopped for several minutes, causing massive brain damage that left her severely disabled.

What very few people are aware of, because it has gone largely unreported, is that Terri’s heart stopped as a consequence of an eating disorder.

Terri was a chubby child, in a culture that tells children, and especially girls, that not being thin is both a disease and moral failing. And our children get the message: fully half of all 9-to-11-year-old girls either are or have been on a diet.

Terri was one of these children. She spent much of her childhood and adolescence dieting, in a desperate effort to deal with having the “wrong” kind of body. Like most dieters, her weight fluctuated a great deal, but she was unable to remain thin.

Eventually, according to evidence introduced at the trial following her collapse, she started forcing herself to vomit after meals. This, combined with a regimen of 15 glasses of iced tea per day, made her thin and “beautiful.” (More than 200 articles have commented on Terri’s beauty. Almost none of these mention her eating disorder).

On the night she collapsed Terri had just eaten dinner. She went into the bathroom and forced herself to vomit. Apparently, the chemical imbalance brought on by her bulimia stopped her heart.

Approximately 10 million Americans, 90 percent of them girls and women, suffer from eating disorders. Anorexia nervosa, the best-known eating disorder, has the highest fatality rate of any mental illness. Somewhere between 5 percent and 25 percent of anorexics die from their illness.

The fatality rate from other eating disorders is hard to determine, in part because they so often go undiagnosed. Indeed the civil judgment that has paid for Terri’s medical care was based on the failure of her doctors to diagnose her bulimia, despite what should have been obvious symptoms.

Such diagnostic failures are caused by the same factors that have led the media to largely ignore this tragic irony at the center of Terri’s story. After all, Terri was merely being a “good girl.” She was fat, and she made herself thin _ a transformation for which she surely received endless praise.

The day before Terri’s feeding tube was disconnected, an article appeared in the New England Journal of Medicine, claiming that, if there were only some way to convince all fat Americans to become thin, life expectancy would be improved by four to nine months (that’s right _ months).

Among the article’s many absurdities, one in particular, given the circumstances of the Schiavo tragedy, deserves comment: the authors don’t bother to specify how this life-enhancing weight loss is supposed to take place.

There is little doubt that increasing the prevalence of anorexia and bulimia would help reduce the number of fat people in America, both by making them thinner, and by killing a significant percentage of them. Of course those who advocate continuing to shame little girls about their bodies, as Terri Schiavo was shamed, are outraged when it’s suggested that what their obsession with thinness will actually produce is yet more eating disordered behavior.

Such people, naturally, believe they’re “helping” our “overweight” children. And how do these experts know a child is “overweight?” Answer: if she’s in the top 15 percent of body mass for children her age. The insanity of such a definition – one that ensures exactly 15 percent of our children will always be labeled “overweight” – is part of the same madness that is killing Terri Schiavo.

(Paul Campos is a law professor at the University of Colorado and can be reached at Paul.Campos(at)