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



November 20, 2007

Dear Friends,

The holidays present a special challenge for people who are vulnerable to eating disorders. Too much stress, social pressure, family tension, performance anxiety, and – of course – the omnipresence of food. Every one of these holiday elements can trigger the urge to binge, purge, or starve. One way to curb the urge is to study it – closely – and respect the message it is sending.

The impulse is not the enemy. This mistaken notion is part of the myth that surrounds eating disorders. Like all self-destructive impulses, urges to restrict, overeat, or purge are distress signals – warnings that the body is under attack and in danger of overloading. Attack from what? Here are a few of the infinite possibilities, depending on your particular experiences:
• Dread of the parties your family will drag you to, in spite of the fact that parties make you intensely nervous.
• Grief over the loss of the boyfriend you had hoped to spend the holidays with.
• Anxiety over your parents’ reactions to your lower-than-anticipated semester grades.
• Fear that this year’s holiday gathering will bring you face to face with the uncle who molested you at age five.

In a perfect world, a young woman who stopped eating would attract compassionate concern, empathy, and solace. She would live in a family or community that paid attention to each other and knew how to read the warning signals. The need for food is so primal that in primitive cultures such internal warning signals are indeed understood, respected, and heeded: unnatural eating behavior is a cry for attention and help.
In our society, the internal signals are the same as they have been for millennia. Bingeing, purging, and starving are bodily responses to chemical stress reactions in the brain involving a host of neurotransmitters. Certain people are genetically primed to over-eat, under-eat, or vomit when they are intensely anxious or depressed. Yet instead of respecting the warning signals as our tribal ancestors did, we have so wildly twisted the cultural meaning of these signals that we dismiss them as “normal,” a “passing fad,” or “self-centered acting out.” Some even romanticize anorexia as the mark of delicacy, femininity, or “perfect beauty.” Not until the warning signals threaten life itself do we sit up and take notice that maybe something really is wrong. And then, more often than not, the response is not to locate the true source of distress, but to further attack the messenger: the body.

After waging my own misguided war against my body for decades, I have finally come to recognize my figure not as an adversary, nor as a mere battleground for some war between different factions of my psyche; I have come to view the body as the soul’s translator. The soul I have in mind is not a religious entity but rather, the culmination of mind, emotion, and spirit. Some prefer to call this “consciousness” or “self.” Neuroscientists describe it as the ever-changing totality of the neural firings that occur throughout our nervous system throughout our lives. Boiled down to its absolute and most mystical, as well as biological, essence, our soul is what happens in the space between one neuron and the next. The body merely translates what happens into action, thought, sensation, and change.

An eating disorder is one kind of translation, an action that “acts out” what the soul is feeling. In other words, restricting anorexia is the physical pantomime of a soul that feels so crushed, empty, hollow, invisible, or lost that there is too little even left to feed. Bulimia acts out the plight of a soul that wants, or feels compelled, to swallow far more sensation, emotion, or stress than it can tolerate until it has no choice but to get rid of it. And, by this reasoning, binge eating signals a soul so starving for sensation, touch, recognition, or peace that it has never known satisfaction.

If this rings true to you, I hope you will take good care of the messenger this holiday season. Your body is neutral and innocent, and it tells the truth. So instead of fighting it, pay attention to what it is trying to tell you. If you start to feel anger, loathing, or disgust, step back and think about the real source of these intense feelings. I can assure you, it’s not your belly fat or the food on the table. And stuffing, starving, or purging will only worsen the way your body and soul both feel.

So instead, heed the early warning signals. Excuse yourself from the party or encounters you genuinely dread. Make holiday plans that spare you from the deepest sources of your anxiety. Schedule extra meetings with your most trusted friend or therapist, and explore what is really causing your distress. In the meantime, go for a walk. Meditate. Or, take positive action against some of the forces in our culture that have perverted our ability to read our innate warning system: write a letter to Vogue demanding a return to models of health instead of anorexia; write a letter to Us demanding that the stories about celebrity diets stop now!; go online and join one of the many organizations that fight eating disorders, and promote self-aware girl power and health at every size.

Make a New Year’s resolution to make a real difference, not only in your own life but in your whole world. I wish you true joy and peace this season, and throughout the year.

Gaining: The Truth About Life After Eating Disorders will be released in paperback from Wellness Central this January, 2008.
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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