The Truth About Life
After Eating Disorders

Essays, Articles, & Nonfiction Works
by Aimee Liu

These treatment facilities offer specialized programs for eating disorders, including men and women over age 21.
Discover the many ways others are using their voices, talents, and passions to turn suffering into creativity and hope.
Links to websites and organizations that provide information and referrals.
References cited in GAINING
How do anorexia and bulimia impact life AFTER recovery? GAINING is one of the first books about eating disorders to connect the latest scientific insights to the personal truth of life before, during, and especially after anorexia and bulimia.
"I've read countless books about eating disorders, but I've never seen one like this. Combining the professional wisdom of leading experts with personal experiences from women and men all over the globe, this book fills a gap on the recovery bookshelf. Anyone who has been touched by an eating disorder needs to read this."—Jenni Schaefer, author of Life without Ed
America's first memoir of anorexia, and one of the earliest books about eating disorders, originally published in 1979



October 1, 2007

Dear Friends,

I recently had a fascinating online discussion with one of my readers that I’d like to share with you. It energized both of us. I hope it will do the same for you!

From: Megan
Sent: Sunday, September 30, 2007 7:26 PM

Hi Aimee,

I have been bulimic for 18 years. While I have sought recovery a few times, the treatment programs were obviously not successful. I loved "Gaining", and I have people in my Facebook group "Bulimia - Living with It" reading it. (By the way, before you shake your head, my group is not pro- "ana or "mia", it is a group for bulimics in all are not encouraged, only support).
There is one girl in my group who is legally blind and has never even seen Mary-Kate Olsen or Nicole Richie. It just goes to prove what I keep trying to point out - that the idea eating disorders are "caught" by other girls and celebrities and the media is a very superficial viewpoint.


Hi Megan,
Your group sounds quite amazing. Blind and anorexic-- Of course, it makes sense, but I've never come across the combination before.


The woman in my group who is blind yet also has an eating disorder, is so lovely and intelligent - it's hard to imagine a person who can't even see yet wants to be 'like' the accepted norm. Right now she is feeling like a failure because she wasn't able to complete the so-called "Master-cleanse" - a fasting diet that consists of a recipe of a liquid detox. It's funny and ironic to me (and to other members) that we often wish ourselves that we were blind so as never to have laid eyes on the "ideal" celebrity figure, yet here we have someone who still adheres to the so-called ideal figure/body, and cannot even see what it really is.
- Megan

Dear Megan
Your mention of the “Cleanse” makes me irate! Not at you, but at the quacks who promote this dangerous idiocy. I met a beautiful woman recently who got sucked into this fraud --not only was she sick at the end of it, but she was so defensive in the classic ED ways. These fads are SO irresponsible. Think about the parallel message for cars: your beautiful Mercedes Benz will run like a dream if you just completely empty out the gas tank and force it to function for 10 days on lemon juice and syrup instead of its normal fuel. INANE!!!!!

Anyway, with all your friends, please spread the word that eating disorders are NOT about beauty. They are pantomimes. The blind connection is so fascinating, because anorexia screams at the world "I feel invisible." Or "I feel empty" or "I feel hollow."
Bulimia screams at the world "I have to get rid of the feelings you're forcing me to swallow." Or "I'm too ashamed or frightened to feel and experience all that I crave."
The "thin ideal" is just a prop, really, that the subconscious seizes as a means of getting the deeper message out: HELP, I'M LIVING OUTSIDE-IN.
- Aimee


In my group, we are certainly all aware that EDs are not about beauty. That's what makes it so painful - how can we as intelligent, empathetic and mostly reasonable women have these irrational thoughts and do such destructive things? It drives me crazy (even though I know I do the same thing), how everyone seems to write with a disclaimer: I know I'm pathetic, I know it's crazy, I'm so stupid, etc. I even wrote in one discussion thread about the frequent use of the word 'pathetic'. I think every member who has ever posted has described themselves this way at some point. Everyone thinks of themselves as a less worthy, less deserving being.

There are many "pro-ana" groups on Facebook, and I've seen many of my own members join them, and I go and check them out to see what is being said. It really depresses me how much EDs have become a "fad" - girls wish they were anorexic and see out "thinspiration". I end up joining sometimes because I want to bicker with the people who are joining only to make fun of and scold and insult people with EDs. I've pointed out many times that EDs are not about weight and food, despite the perpetuation of this myth by the young and immature girls. It's just such a mess. In my own group, I've made it clear that we are not discussing the best diet pills or other "tips", but I welcome advice on keeping in the best health possible. You may disagree with this, as have others, but it irritates me to no end that medical personnel will not tell you how to keep yourself as safe as possible, so as not to encourage bulimic behaviours. Over the past 18 years (I'm 32 now), I have been told over and over again how I'm going to have teeth falling out, or strokes or heart attacks, and this did not stop me from being bulimic. In my twisted mind, the risks were worth it. I had asked many times over the years how to reduce the damage on my teeth, and I was only told "stop", there's nothing else you can do. I did not care. In my group we have a whole discussion thread devoted to keeping your teeth healthy. The way I see it, is you can get to a point where you've damaged yourself so much that it's not worth trying to get help anymore. (Who wants to live longer with nasty teeth or bone-density loss?).

The blind member who tried the "Master Cleanse" - we all said to her that we were worried because it would drive her right into heavy bingeing (you deprive yourself so much so you wind up heavily bingeing, more than usual), and she acknowledged this, but said she wanted to do anything to "give her body a break" from bingeing and purging...yet she knew that really it wasn't healthy and completely unrealistic. She spent $70 on the maple syrup alone from EBay (it's one of the ingredients) and lasted about two days before she couldn't take it anymore. And now she has posted that she's a failure, and I'm sure these feelings will be expressed in bulimia for weeks to come.



Oh Megan-
YES! Keep jumping on that destructive self-talk. We live in a society that bathes us in lies, to such an extent that we are conditioned to believe them. Just remember: NO ONE can live up to a lie -- ever.
And this is NOT OUR FAULT.
The whole goal of a commercial culture is to keep us dissatisfied so we keep buying and consuming more products. Remember that the cigarette manufacturers load cigs with chemicals to make them more addictive; such tactics may be secret but they are hardly uncommon. Addiction represents multi-billion dollar profits in a host of industries, including fashion, exercise, and food.

The solution is not to starve ourselves but to get smarter about these outside pressures AND ourselves.


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Anorexia's Red Herring

Too-skinny models may be a factor in spawning eating disorders, but they're just one of many.
By Aimee Liu

Published in the Los
Angeles Times,
September 22, 2006

THIS WEEK in Madrid, heroin chic was prohibited. For the first time, the organizers of a major international fashion show recognized that by showcasing emaciated models, the fashion industry promotes eating disorders. Under pressure from the Madrid government, medical associations and women's advocacy groups, the Assn. of Fashion Designers of Spain finally rejected morbidly thin models.

When selecting models for this year's Madrid fashion week, which ends today, the designers set a minimum body mass ratio (calculated on the basis of height and weight). Their required ratio was 18 — meaning a minimum of 119 pounds for a 5-foot, 8-inch woman. The bar was by no means high. For ordinary mortals, a ratio of 18.5 qualifies as underweight. Even so, five of the 68 auditioning models flunked.

To understand why they flunked, we need to look beyond the fashion industry to the true causes of eating disorders. These include genetic predisposition, temperament, family dynamics and personal trauma. I know; modeling fueled but did not cause my own adolescent eating disorder nearly 40 years ago.

Twiggy was my generation's Kate Moss. I fixated on her at age 13, and by the time I started modeling one year later, I'd dropped 30 pounds. Being skinny became my identity. At 5 feet, 7 inches, I didn't weigh more than 100 pounds again until I was 21.

My anorexia ultimately destroyed my career.

Models were — and still are — paid to make fashions look good, and that meant fitting sample wardrobes. Reigning teen cover girls Shelley Hack and Colleen Corby understood this. In dressing room lunches between shoots, I'd watch them wolf down tuna salad sandwiches while I pretended not to be hungry. They were lucky, I told myself, they could get away with eating. I began to lose jobs when I became so thin that stylists couldn't even pin dresses on me to look right. Still, I felt I couldn't eat.

Like many anorexic models, I was drawn to the fashion world because it reinforced my anorexia. I would be willing to bet that most, if not all, of the runway models disqualified in Madrid fit the same pattern — as do many emaciated gymnasts and ice skaters.

Three years ago, I began interviewing medical researchers as well as middle-age women and men with histories of anorexia and bulimia. I wanted to find out what we know now that we didn't know in the 1970s, when I quit my self-imposed hunger strike. I learned that researchers now are discovering genetic links between eating disorders, depression and obsessive-compulsive disorder. Genes also shape the temperaments of people who are prone to anorexia and bulimia, although the mechanisms for this are still poorly understood.

A landmark 2003 British study found that certain innate childhood traits, such as perfectionism, inflexibility and cautiousness, each increase an individual's risk for anorexia by a factor of seven. Someone like me, possessing all five traits measured in the study, is 35 times more likely to develop an eating disorder than a daredevil who happily wears mismatched socks.

Further, eating disorders are triggered not by pictures of Kate Moss but by sudden or cumulative experiences of intolerable emotion, such as shame or fear. Puberty unleashes a natural tidal wave of these emotions. Adolescence also happens to be the age when rates of sexual abuse soar, academic and social pressures intensify and parents become a source of embarrassment rather than solace. It makes sense that this is prime time for eating disorders. Obsession with weight offers a distraction. Extreme weight loss signals distress.

It also makes sense that rates of anorexia and bulimia spike in middle age, when many women again face emotional turmoil. Women over 30 now make up a full third of residential patients at the Renfrew Center, a Philadelphia treatment facility specializing in eating disorders. Divorce, grief, the empty nest — all can trigger illness if the individual possesses a genetic predisposition.

The onset of eating disorders is like the firing of a gun. Genetics form the gun. Cultural influences such as the fashion industry and familial attitudes about weight then load it. And intense emotional distress pulls the trigger.

Healthier figures on international catwalks may help to disarm the gun. However, of the more than 40 women I interviewed, only a handful had ever paid any attention to fashion. When they started starving, they were asking for help, not admiration. Those models who failed the test in Madrid need treatment, not rebuke.

Copyright 2006 Los Angeles Times