Our practice of the Lord's Supper

I haven't linked to any columns I've written in the United Methodist Reporter recently. I'm in the middle of a column series on the means of grace, and I had planned to do one post that pointed to the whole series when I was finished with it.

Then I had to go and write about Holy Communion. It's a topic that gets me in trouble every time I take it up.

The column - which you can find here - is a call for reform of our Eucharistic practice in a number of ways. But a certain part near the end has caught some folks' attention (to, in my opinion, the neglect of the whole). It is my critique of that un-Scriptural, un-historical, un-ecumenical quasi-doctrine that so many Methodists just love: the "Open Table" practice of inviting anyone in earshot to receive the Lord's Supper with a "y'all come!" enthusiasm. The Open Table ethos as many pastors and congregations practice it today presents the Eucharist as a meal where anyone is welcome - Christians, non-Christians, confessed adherents of other religions, unbelievers, agnostics, and atheists.

That such an approach to the sacrament of our Lord's body and blood is an utter novelty in the history of the Christian Church, without any biblical foundation or support in Wesleyan theology or widespread support in the church catholic, does not seem to factor into the consideration of those who consider it to be amongst the fundamental marks of Methodism.

And so it is incumbent upon us to preach and defend the gospel. As the Church's shepherds, pastors and theologians are called to be faithful in their teaching and preaching regardless of the shifting temper of the times. As the Apostle Paul instructs Timothy and all presbyters of the Church,

"Preach the Word: be prepared in season and out of season; correct, rebuke and encourage - with great patience and careful instruction. For the time will come when men will not put up with sound doctrine. Instead, to suit their own desires, they will gather around them a great number of teachers to say what their itching ears want to hear. The will turn their ears away from the truth and turn aside to myths. But you, keep your head in all situations, endure hardship, do the work of an evangelist, discharge all the duties of your ministry" (2 Timothy 4:2-5, NIV).

Regardless of how well-meaning its advocates might be, the truth of the so-called Open Table is this: it is, in the true sense of the term, false teaching. The radical version of the Methodist practice of Open Table does violence to the institution of the most holy act of worship we have been given and disregards the salvation of the unbaptized. And there is not one word of the preceding sentence that is an exaggeration.

If this doesn't seem to make sense to you, then read on. To better explain, I'm going to edit and splice in a big chunk of a lengthy comment I left on John Meunier's blog when he posted about my column yesterday:

Whenever I write a column or put up a blog post on this issue, I inevitably take a lot of flack. Sometimes people act as if there is a deep arrogance at work in even engaging the issue of participation in Holy Communion, as if exercising a holy discipline over the sacrament were the equivalent of making a value judgment the intrinsic worth of persons. And sometimes people will act aghast that the Church would ever make a statement suggesting a standard of ministry or discipleship in anyway, because we are all supposed to bow at the altar of "inclusivism" - a concept that apparently means we never say 'no' to anyone, at anytime, for any reason.

Here's what I would offer in response: There are about 2 billion Christians in the world, and probably 1,980,000,000 of them have an understanding of Eucharistic practice that suggests one should be baptized before coming to the Supper of the Lord. Throughout the two millennia of Christian history, practically all Christians have had that understanding. That means there are, at present, a few million Methodists (and, I assume, probably a few million more sacramentally lackadaisical Protestants in other ecclesiastical communions) who do what we do.

Now I would ask this of anyone who happens to be reading this post: What in the world do we have to show as evidence to suggest that our doctrine is right and the ecumenical and historical consensus of the rest of the church catholic is wrong? A misquoted Wesley citation that gets regularly pulled out of context? Incoherent statements about 'prevenient grace' that get applied to the Eucharist in ways that could literally define the term, 'non-sequitur'? Fruits? Does our Eucharistic practice bring glory to God and serve as a means of grace such that those who partake are demonstrably affected in their journey of sanctification? In this last question (which is the type of thing liable to get indignant "of course it does!" replies), I would only say that, if we think we're being faithful to God and to Christ's institution of the sacrament in the shabby way we practice it now, I think we would be amazed at what the Holy Spirit would do with us if we committed ourselves to a greater faithfulness in our practice of it.

I like the way John Meunier poses the questions about the propriety of the Open Table in his post because I think he poses it as a question of doctrine. And indeed, as a doctrinal question, it should be engaged via rigorous theological examination. Charles Rivera, one of his respondents, points to the seriousness with which the Apostle Paul instructs the Church to practice Eucharist in 1 Corinthians. I'd suggest three other Scriptural images in addition: First, in the Great Commission (Matthew 28), Jesus' instruction to the disciples is to go into all the world to make disciples of every nation, and his single teaching to describe the way by which disciples are made is through baptism in the name of the triune God. Second, in the book of Acts, the apostles' response to converts who hear the Word of God and believe is "Repent and be baptized" (Acts 2:37-38). And third, throughout the NT epistles (e.g., Romans 6, Colossians 2, 1 Peter 3), it is clear time and time again that the manner of incorporation into the body of Christ is through the sacrament of baptism.

Moreover, in the early Church, new believers never received Holy Communion until they had been baptized. Actually, they weren't even admitted into the presence of the Eucharistic celebration until after baptism. And despite all the doctrinal differences that arose in later centuries over exactly what happens at Holy Communion, in the matter of what was requisite for participation in the Eucharist the divided Church was in agreement: baptism and repentance of sin.

Now one of John's respondents cited the This Holy Mystery doctrinal statement (passed by our General Conference and currently to be found in the Book of Resolutions), and on the whole, I think that is a fine piece of sacramental theology for our Church. But in the matter of which we are speaking, I can tell you that some on the study committee that developed it were vexed at the larger Church's attitudes over the radically "Open Table" ethos. Prof. Ed Phillips, who chaired that committee, recounts this in his article, "Open Tables and Closed Minds," in the journal Liturgy back in 2005. He writes (on p.28):

"What becomes curious to me is that attempts by some of us on the committee to do careful biblical and historical reflection (both from the perspective of the church catholic and the Wesleyan tradition) was often strongly discounted. Here is a typical response to my own attempt to explain to one individual why a totally open table is neither biblical nor Wesleyan: 

'Of course, we can go round and round about what Paul or the Gospel writers meant, . . . I just think one can make a strong theological case for an open table using prevenient grace (a primary theological contribution by Wesley via Augustine). I also think that . . . an open table appeals to our American sense of inclusive democracy.'

This is a significant key to what contemporary United Methodists in the West find so problematic about a disciplined table: it is undemocratic. It flies in the face of liberal freedom."

I'm well aware that advocates of the Open Table are sincere and well-meaning, and in most cases, they probably think that the Open Table stance is compassionate. The problem is that it isn't compassionate at all. Baptism and Eucharist are the difference between life and death. And when we ignore the clear teaching of the Scriptures and the tradition of the Church so that we can make either into whatever we want it to be, we are doing violence to the gospel entrusted to us. When we practice the Lord's Supper in as non-chalant a way as the Open Table implies, then we deny the saving gifts of God that should be at the heart of our evangelistic ministry. Salvation is not a series of isolated acts from which we can pick and choose at will; it is, rather, a reality into which God beckons us and is made manifest in our lives through our submission to the Holy Spirit in Christ's Holy Church. Baptism is the way we are initiated - no, incorporated - into that blessed reality.

I'm as serious as I can be when I say this: When we find ourselves to be in sin, the realization of that sin is a gift of the Holy Spirit, insofar as it is an invitation to repent and return to Christ in faithfulness. And that is exactly where the people called Methodists find themselves with their practice of the Lord's Supper.

John Meunier's post speaks of "shooing the unwashed from the Lord's table," but that's truly not what the orthodox practice of Eucharist does. Located within a form of ministry that embraces all the means of grace, it rather pursues the lost with an evangelical love, beckoning them to come to the living waters of baptism that they might die and be raised. And through those life-giving waters, it draws them toward the great feast that awaits, so that - once incorporated into the body of Christ and catechized through the preaching and teaching of Christ's holy word - they might then receive the body of Christ and know that it is the bread of heaven given to them for their salvation. We have all been offered the life that is a way of life, and there is a deep & profound logic to that journey.

Anything less than this is a commodification of the sacrament. That's something we could rightly do if we owned it, but we don't. Vicit agnus noster.

The Power of Holy Communion

How often should we celebrate the Lord's Supper?

Wesley Report's Shane Raynor recently wrote that he has received real spiritual benefit from weekly participation in Holy Communion. At my church, we celebrate monthly. But moving to that level of frequency after I arrived as pastor a year-and-a-half ago was a big change for my congregation. Previously, the church celebrated very infrequently.

At our chapel services at Duke Divinity School, there is at least one Eucharistic worship service per week. The Duke Chapel, right next door to the seminary, also has a mid-week celebration of Holy Communion every week. Those multiple celebrations of the sacrament mean that all members of the Duke community can receive the Lord's Supper every week if they so desire.

But what is the reason for coming to the Lord's table at all? And why should we do so frequently?

People with little experience in regular participation in the Lord's Supper (and often with little inclination to increase their frequency), sometimes say that the sacrament is "special" and should be celebrated infrequently lest it become too "common." But would we use that same argument with prayer? Or preaching? With those particular means of grace, don't we assume that increased frequency - matched with a willing heart - is a spiritual benefit to the Christian believer?

In the Wesleyan tradition, one of our best resources for looking at the importance of regular participation in Holy Communion is John Wesley's sermon on "The Duty of Constant Communion." In the sermon, Wesley points out that "Do this in remembrance of me," is a command Jesus gave to us at a pivotal moment in his life - right before he was arrested and killed. That it is a command shows its importance on one level; Jesus' timing of it only emphasizes that importance.

Wesley argues that, if the command were all we had, that should be enough to compel us to go the Lord's table at every opportunity. But the great joy we find is that there are other reasons as well - true spiritual benefits that we receive when we partake of the Lord's Supper with a willing heart. Assuming the liturgy of a Eucharistic worship where confession of sin and assurance of pardon would be made prior to the consecration of the elements, Wesley names these benefits as "the forgiveness of our past sins and the present strengthening and refreshing of our souls."

He goes on to speak of the "grace of God given herein," and says, "As our bodies are strengthened by bread and wine, so are our souls by these tokens of the body and blood of Christ. This is the food of our souls: this gives strength to perform our duty, and leads us on to perfection." Thus, he can conclude, "We must neglect no occasion which the good providence of God affords us for this purpose. This is the true rule - so often are we to receive as God gives us opportunity."

Also helpful for our thinking about Holy Communion is Wesley's sermon, "The Means of Grace." He believes that there are many ways God makes grace present to us in our lives, but in this sermon he focuses on the "chief means" of prayer, searching the Scriptures, and the Lord's Supper. Wesley makes a point in this sermon that is worth considering: He distinguishes the means of grace themselves as practices from the power that can be received through participation in them. That is, he points out the common error of some Christians in thinking that the means are actually ends - that simply participating in them earns "merit" in the eyes of God.

But that is not only false; it is dangerous. As Wesley writes, "[A]ll outward means whatever, if separate from the Spirit of God, cannot profit at all." He goes on: "We know that there is no inherent power in the words that are spoken in prayer, in the letter of Scripture read, the sound thereof heard, or the bread and wine received in the Lord's Supper; but that it is God alone who is the giver of every good gift, the author of all grace; that the whole power is of him, whereby through any of these there is any blessing conveyed to our soul."

So why are the means of grace in general (and Holy Communion in particular) so important? If the power we receive through them is really the power and presence of God in our lives, why can't we leave off the means and simply wait for the Holy Spirit to descend upon us?

Wesley's answer is that God has ordained the means as the "ordinary channels" through which we receive his grace. It's not that God couldn't do it another way if God so chose. But he didn't! He has chosen to give us his grace through these wonderful practices of the faith. And we come to know that truth as we commit to the means of grace and allow the life of discipleship we live to be patterned by them.

We come to know Jesus Christ more fully, and we find that the Holy Spirit draws us ever closer to the Father through the Son.

In short, we find ourselves transformed.

So while the command of Christ would be enough to convince us to receive at every opportunity (as Wesley says), we have so much more than just that. We have the possibility of a transformed existence, where we find ourselves - over time - being remade into Christlike children of God.

Holy Communion Online(?)

Here's a question: If you are sitting alone in your living room, with a cracker and a bottle of grape juice, listening to a recording of a pastor saying the Holy Communion liturgy over the Internet, and then you proceed to consume that cracker and grape juice, have you just received the sacrament?

Have you actually taken Holy Communion?

According to United Methodist doctrine, the answer is no. According to our church's sacramental teaching, as contained at various points in our Book of Discipline, Book of Resolutions (i.e., the "This Holy Mystery" statement), and the Book of Worship, that kind of exercise does not rise to the level of Eucharist.

I could sketch out the reasons why this is the case, but if you don't know them already, I would simply say to go to the relevant places in our doctrine and read them for yourselves. Our sacramental doctrine (like a lot of our church's doctrinal positions) could use some development. But what we've got is good, and it expresses a deep sense of the power of the grace of Jesus Christ active in the community of believers through the church's liturgy.

What we do not allow are interpretations of the sacrament of the Lord's Supper that are so far out of bounds that they do damage to the church's historic understanding of the sacramental meal and endanger the laity's reception of the gospel message of salvation.

Why am I stressing this so much? Well, a couple of weeks ago, my wife showed me this article in Newsweek, which highlights a new movement sometimes called "Virtual Communion." It involves pastors and churches inviting people to "celebrate" Holy Communion from the comfort of their couches, while viewing websites where Eucharistic worship services are shown or the liturgy is recited.

One of the Newsweek's articles featured websites is this one, which calls itself "A United Methodist Celebration of Holy Communion." In the name of inclusivity (the term always used to advocate for radical individualism in the church), the site provides web surfers the opportunity to receive the Lord's Supper with no other companion than a disembodied, previously recorded voice while they participate from their sofas.

I wrote a column in the United Methodist Reporter about this phenomenon last week, which you can read here. I hesitated to put my thoughts on paper, because the creator of the site (a retired UM local pastor) clearly believes he is doing the church a good service. But good intentions are simply not enough. This website represents something not just mistaken; it is dangerous. And in such a situation the Lord's Supper must be defended.

Not long ago, I posted a satire called "Winnie-the-Poohcharist" (in two installments, which you can read here and here) about the ridiculous attempts of some churches to make the sacrament more "relevant" by employing cheap gimmicks from pop culture. I now wonder if I should even have written that satire, because of the danger that it would be misunderstood (as, indeed, it was in some of the comments left on the blog posts).

So let me be clear: The sacrament of Holy Communion is the single most important act of worship in which we, as disciples of the Incarnate God, can engage. It should not be abused, maltreated, or deformed in its character. It requires sound teaching for it to be understood and celebrated with fidelity. The Eucharist is the very vehicle of God's salvation of us. It is difficult to over-exaggerate its importance. It is not to be changed to suit our consumerist tastes, but rather to be understood in the great mystery of grace that it offers us.

If you are interested in reading another interpretation of this same issue, check out Kevin Baker's blog here.

[Update: The website dealt with on this blog post and the linked UM Reporter column was also highlighted in the "Century Marks" section of the December 2, 2008, issue of The Christian Century. As of this update on January 11, 2009, the Holy Communion Online website was still deactivated.]

Winnie-the-Poohcharist: The sequel

This is the follow-up to the remarkable Winnie-the-Poohcharist worship experience I had at Amazing Grace UMC in Rockville, VA, not long ago. If you haven't read part one, you can scroll down to yesterday's blog post or just click here. And if you've never taken part in a Winnie-the-Poohcharist service, you're not going to believe this...

What I encountered after Associate Pastor Karen Teasely led me into the sanctuary almost defies explanation. The packed worship space had been decorated to look like the Hundred Acre Wood (think Vacation Bible School set on steroids). The "hymns" consisted of A.A. Milne's sing-song poetry straight out of the Pooh books, only set to music by a high school praise band. And let's just say that Rev. Teasely wasn't the only one wearing a costume.

The senior pastor (who would not go on record for this review) looked confused through most of the service, but he did get up and preach at the appropriate time. I noted that this seemed to be the least meaningful part of the service for the congregation, and many of the younger couples - "formerly unchurched" Karen later told me with a knowing expression - got up during the sermon to refresh their donuts and coffee with a quick trip to the Holy Grounds coffee bar.

The real celebration started when Karen herself went to the altar and uncovered piles of cinnamon rolls and little clay pots with "Hunny" written on the side. She sort of skimmed over the Prayer of Confession and went straight to a tailored Great Thanksgiving. It looked like this:

Celebrant: We don't much mind if it rains or snows,
'Cos we're gonna have some honey on our nice new nose!

People: Sing Ho! For the life of a Bear!
Sing Ho! For the life of a Bear!

Celebrant: We don't much care if it snows or thaws,
'Cos we're gonna have some honey on our nice clean paws!

People: Sing Ho! For a Bear!
Sing Ho! For a Pooh!

The lyrics seemed vaguely familiar, and I had to admit that the praise band played a nice tune to go with them. All the words were helpfully projected using PowerPoint, with scenes of Winnie and his friends juxtaposed against images of Jesus and the Twelve.

Jesus himself did make a brief appearance in the liturgy when the words of institution were said, and then Karen went on at length to talk about the sweetened elements in front of her: "Some churches use unleavened bread, and others use leavened," she said with a shrug. "Some use wine, and others use grape juice."

"When you come forward today, you'll receive a cinnamon roll and your own little pot of honey-sweetened juice. Here at Amazing Grace, we think the Spirit is what is important."

As I sat in my pew munching on my Poohcharist, I thought about how meaningful and relevant the whole service had seemed. Stodgy old traditionalists might quibble with some of the things Karen's church is doing, but the service had been packed with young people. And Amazing Grace is obviously not going to let outdated concepts like "tradition" or "orthodoxy" or "the Bible" stand in the way of a postmodern feast for the senses.

And besides, maybe we all need to sweeten up the sacrament a little bit. With hunny. Just think about it: Who can't relate to Winnie and the gang down at Pooh Corner? If other churches follow Amazing Grace's lead, all the poignant lessons we learned as children from philosophic Winnie and his ragtag group of friends can finally be put to use for the Grand Pooh-bah himself: Jesus Christ.

And maybe, just maybe, we also need somebody a little less cosmic than the Second Person of the Trinity for the sacrament to make sense in this day and age. Someone who can really help people think about what God's grace looks like in the world. A rock star? Perhaps. A Pooh Bear? Even better.

Winnie-the-Poohcharist: A liturgical review

I've got a remarkable story to tell:

Liturgical renewal in contemporary Protestantism is taking on a number of surprising forms: Emergent worship settings where weekly Eucharist comes in the form of mulled wine and sweet bread. Or U2charist services in formerly button-down Episcopal churches where the sacrament is received to the sounds of Bono's theologically-inspired vocals.

But neither of these comes close to matching what I saw during a recent trip to Amazing Grace United Methodist Church in suburban Rockville, Virginia.

After a friend told me about Amazing Grace UMC's own foray into Eucharistic renewal, it only took a quick phone call to put me in touch with the Rev. Karen Teasely, the church's Associate Pastor in charge of Innovation Ministries.

I could feel Karen beaming over the phone. "I heard that the Episcopalians came up with U2charist," she said. "Now Episcopalians are nice folks. But I wouldn't exactly call them cutting edge. But heck, 'cutting edge' is on our marquee!"

Karen invited me up for the following Sunday to see what the church was doing for myself. "Just come on up and worship with us," she said. "We've got something that'll knock your high church socks off."

The "something" is a liturgical experiement that the folks at Amazing Grace are calling "Winnie-the-Poohcharist." Aimed primarily at children, youth, and the unchurched, Winnie-the-Poohcharist combines the sacrament with poems and imagery from the popular A.A. Milne children's books to offer - according to Teasely - "a more relevant sacramental experience."

Intrigued, I drove up from my home in Durham, NC, to Rockville the next Sunday. Pulling into the parking lot, I saw that 'cutting edge' was, indeed, on the church's marquee (it reads "Amazing Grace - we worship on the cutting edge." In tiny letters at the bottom of the sign it reads, "A United Methodist congregation").

Karen was supposed to meet me before the regular morning service, but I didn't recognize her at the front door because of the Tigger costume she was wearing (think of a college team mascot). She spotted me right away and started bouncing in true imitation of Tigger himself. She was clearly eager to talk and, it seemed, a bit over-caffeinated. Amazing Grace has recently shut down its food pantry ("lack of volunteers," Karen explained) and transformed the space into a cutting edge coffee bar ministry called Holy Grounds. We headed there for a couple of venti-sized, double-shot espresso lattes with seasonal pumpkin spice and a conversation.

Once settled, Karen and I chatted about the pros and cons of Winnie-the-Poohcharist. "I admit we've gotten a little creative with the liturgy," Karen confessed. "But you should see what Winnie-the-Poohcharist has done to our numbers on Sunday morning."

When I suggested that some might see Amazing Grace's new project as copy-catting the well-known U2charist movement, she turned slightly combative.

"Look, this is all about updating the sacrament to give it relevance again," she said. "And Winnie-the-Pooh obviously makes a better messiah-figure than Bono."

"I mean, Bono's all about fixing poverty and getting rid of AIDS, but he still parties like a rock star."

When I asked Karen what exactly made Winnie a Christ-figure, she was ready with a laundry list of answers. "For one, Winnie wandered around the Hundred Acre Wood doing good, just like Jesus in Galilee."

Hmmm, I thought, that makes Winnie a good person, er, Pooh, but not exactly Jesus-like, right? Wrong.

"And just look at his friends," Karen went on. "Eeyore, Piglet, Tigger, Kanga, and Baby Roo. What do you call them?"

"Uh, talking animals in a children's story?" I ventured.

"Outcasts and marginalized! Think about it. Eeyore is clinically depressed. Tigger's got ADD. Kanga is a single mom trying to raise a kid. And Piglet? The ultimate playground wimp. Those critters are as lost as any leper or blind man in the gospels!"

Karen gulped down the last of her latte.

At this point, my jaw was laying on the table. "Just wait till you see the service," she said with a wink, before donning the head of her Tigger costume. "Come on!" And with that, we bounced into the sanctuary.

[I'll conclude my experience at Amazing Grace in a post tomorrow. Stay tuned. You won't believe what comes next.]

Wish list for 2008

My New Year's resolution for this year is to live more into a life of holiness. I'm in a Covenant Discipleship Group with four other guys, and I know that will be a great source of strength for me. I'm trying to look more at holiness in an integrated way, encompassing my mind, body, and spirit. After all, God wants to transform all of me, not just one part!

But beyond that resolution, I also spent some time a few days ago thinking about what I would like for our church in the coming year. I put those thoughts to paper and shaped them into a my first United Methodist Reporter column for the new year. You can find that column here. Here's a short version:

1) One of the most pressing concerns, I believe, is in helping our young hear the voice of God - and this goes for both laity and clergy. We have declining numbers of both, and the reasons why are complex. My suspicion is that the greatest reason is that families no longer see the church as the center of their lives, but rather one among a laundry list of extracurricular activities. And if that's the case, it is not just a failure of the church reaching the young, but of the failure of the church to nurture God's people overall. That will only change when we once again understand the church as the only community where we can know true life.

2) My greatest hope in the area of worship is that the church experiences a renewal of the celebration of the Lord's Supper. I believe that Holy Communion is the chief means of grace available to us, and if that's the case, we ought to put it at the center of worship! That doesn't mean we have to shortchange preaching, but we should rather understand preaching as a proclamation which finds its fullest embodiment in the sacrament. If the church is about sharing the word of God, we should be eating the sacred meal together at every opportunity.

3) General Conference needs to be clothed in prayer. If you have any questions about that, see General Conference of 2004, General Conference of 2000, etc.

4) I hope that a part of our growing reclamation of our Wesleyan heritage will be a greater understanding of the unity of holiness and compassion. There can finally be no separation between works of piety and works of mercy. We are called to love God and neighbor, and focusing only on one to the neglect of the other produces a thin faith. Lord, give us both!

Dreading the Eucharist

A good friend of mine, Jenny Redding Rhodes, is working on a degree in special education at Vanderbilt University which focuses on adolescents with eating disorders (and she's also an M.Div graduate of Vanderbilt Divinity School). Jenny has just written an article on the way that people with eating disorders experience church life. Some of her comments are heart-breakingly shocking:

"Many eating-disorder patients have told me that they participate in the Lord's Supper only half-heartedly at best. They feel compelled to take Holy Communion because Jesus commanded us to do so. Because some see Holy Communion as God's reward for virtuous or faithful service, they refrain. All of them dread the Eucharist because it involves food."

You need to read this article. The link goes to the main page for the current issue of the Reporter. Scroll down to find Jenny's article, which is entitled, "Anorexics mirror, distort Wesleyan 'perfection'."

Obviously, we all know that eating disorders afflict thousands of Gen-X'ers. But many sufferers remain hidden by a veil of secrecy or shame. Jenny's commentary begins to help us know how to embrace those who experience anorexia, bulimia, or other related disorders.