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


Participate in an online research study?

October 13, 2007

Dear Friends,
I've just received the following invitation from Sarah Williams, a PhD student in the UK who is looking for people who have recovered from anorexia to participate in an online research study looking at experiences and opinions of anorexia and its treatment. If you are over 18 and meet her other criteria, perhaps you would like to lend her your thoughts? If you have a website or blog, please help spread the word!

The rest of this blog is from Sarah, so read on.

And always, be well!

"My name is Sarah Williams and I am conducting research at Queen Margaret University in Edinburgh looking at people’s understandings of anorexia and I would like to hear about your views and experiences.

As part of this study I will be conducting an online focus group with those that have recovered from anorexia. The online focus group takes the form of a private discussion board and will give you an opportunity to talk about your experiences and feelings towards anorexia with others who feel the same and are in the same situation.

Below I have provided some questions and answers that will further inform you about the study. However, if you have any other questions about the research then please do not hesitate to contact me at

How does the online focus group work?

The online focus group will work in the same way as a private discussion board. I will post discussion topics at regular intervals for everybody in the focus group to discuss and get involved in. You are not limited to answering the questions I post up and are more than welcome to introduce your own topics to the group as long as it is relevant to the subjects of anorexia, recovery and treatment.

Will the information I give remain anonymous and confidential?

Yes. As the online focus group takes the form of a private discussion board only participant members and I will be able to gain access. All the information that you give in the discussion boards will be anonymous to other users of the site. When you agree to participate you will be asked to choose a username, which you will then use to log onto the site. Every time you post a message on the board it is this username that will show up.

At the end of the four-week focus group the discussions will be downloaded and analysed for the purpose of this study. This research may be published in a journal and may use quotes taken from your posts, however, this will not include any defining characteristics (e.g. name, e-mail address, username etc) if any of these do occur in the quotes used these will be censored or left out.

What will be the focus of the discussion topics?

Discussion topics will be based on your experiences and opinions of anorexia, your experiences of recovery and your opinions about treatment interventions.

Am I eligible to take part in the study?

You are eligible to take part if you meet the following criteria:


You are 18 years old or over

You have access to the internet

You have recovered from anorexia

So, what am I being asked to do?

Once you have read the information sheet and decided that you wish to take part you need to e-mail ( When I have received your consent form I will e-mail you three quick questionnaires which will ask you for some background information about yourself, your anorexic behaviours and your mood. Once I have received your questionnaires I will begin setting an account up for you to access the discussion board.

On the first day of the focus group I will send you information about logging into the focus group discussion board; this will include a password which you will need to use when you log in for the first time. On your first visit you will be asked to change this password to something that only you will know and remember.

On the first day there will already be a couple of discussion topics posted up for you to get involved with. New topics will be posted on the discussion board every couple of days. You are advised to log onto the focus group site at least three times a week to keep updated with the discussions that are taking place and contribute to any new discussion topics. Near the end of the focus group I will post a summary of the discussions that have occurred and will ask you to verify that my interpretation is correct and to add any other comments that you think are important or that I have missed out, therefore you are specifically encouraged to log onto the site near the end of the study.

The focus group will last for a period of four weeks. It will begin on the 12th November 2007 and will end around the 9th December 2007.

Are there any rules to using the online focus groups?

The purpose of the focus group is to discuss your views and experiences about anorexia, recovery and treatment therefore you are invited to speak openly and freely about your opinions of these subjects. However, I must stress here, that triggering information is prohibited on this site. Please don’t give out any advice that others may use to maintain their anorexic behaviours further. This includes (but is not exclusive to) tips on diets, exercise regimes, laxatives, diet pills, and diuretics. Any posts with such advice will be edited or censored and the person’s access to the site will be stopped. I have a responsibility as a researcher to ensure that participation in the study does not lead anyone to any kind of harm.

How will I benefit from participating in the study?

There are many benefits to participating in this research, not only will you have the opportunity to talk to others in the same situation as you, but the information that you provide in the focus groups can be used to aid people’s understandings of anorexia. As someone who has experienced anorexia, you are an expert and this is why I would like to hear your views.

Are there any risks to participating in the study?

There are no known risks with using online focus groups. However because of the focus of the study (meanings and experiences of anorexia) some discussion topics may be considered sensitive and personal. You are not obliged to contribute to every discussion topic and if there is a discussion topic that you wish to contribute to but you would rather do that away from the group then you are welcome to e-mail me your contribution instead. Similarly you are free to withdraw from the study at any time without having to give a reason, in this situation simply send me an e-mail with the sentence ‘I withdraw from this study’ in the subject box.

The study will take the form of an online focus group held on a private and confidential discussion board where you can meet with likeminded people in a similar situation to you and discuss your experiences and opinions of anorexia and recovery.

The online focus group lasts for four weeks and participants are asked to log in a few times a week to keep up to date with discussions and add their contributions. One of the good things about the project is that people can log in and get involved in the discussions at a time and place that is most convenient for them. I have updated my myspace site with details about the study so that people can visit it to read about the project."
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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