GAINING:
The Truth About Life
After Eating Disorders

Essays, Articles, & Nonfiction Works
by Aimee Liu

RESOURCES
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
Books
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

Newsletter

Hot news to kick off 2008: It’s the Biology, Stupid!

January 10, 2008

Dear Friends,

Hot news to kick off 2008:

It’s the Biology, Stupid!

No, you are not stupid, but the general public is and always has been when it comes to understanding eating disorders. Unfortunately, anorexia, bulimia, binge eating, and other food-related illnesses have been projected onto the public’s consciousness as girl problems, or gay problems, or histrionics, or social protests. The feminist attacks on the media, fashion and diet industries have helped to raise awareness of some of the forces that contribute to eating disorders, but they have inadvertently trivialized the medical gravity of these illnesses by focusing on cultural conditioning, or "nurture," to the exclusion of "nature."
Eating disorders are caused by nature AND nurture, biology AND culture, genetics AND experience.
Here’s why this matters: when it comes to women’s issues, only nature gets respect. Researchers at the University of North Carolina at Chapel Hill have just released a landmark study showing that the public is far more likely to take eating disorders seriously when told they are caused by biology. As long as those surveyed thought these conditions were a reaction to bad parenting, or society’s thin ideal, or adolescent angst, they considered them a choice that could ultimately be blamed on the victim. This pervasive attitude encourages clueless jokes about “scarfing and barfing” and remarks such as “I wish I could have just a little anorexia.” It discourages insurers from covering these disorders and patients from seeking medical treatment. It has also deterred scientists from researching the biology of eating disorders.
But scientists over the past few years have proven that eating disorders are largely genetic, and when the public gets this message, their views change radically in ways that could have enormous benefits for those both suffering and recovering.
Below is the press release about the study. Be edified!


http://www.newswise.com/articles/view/536677/

People with Anorexia Less Likely to be Blamed When Biology, Genetics Explained

— People given a biological and genetics-based explanation for the causes of anorexia nervosa were less likely to blame people with anorexia for their illness than those given a sociocultural explanation, a University of North Carolina at Chapel Hill study found.
“This is a potentially important finding,” said first author Michele A. Crisafulli, “because it suggests that wider dissemination of information about the biological and genetic underpinnings of anorexia nervosa could help decrease the blame-based stigma that is associated with the disorder.”
The study was published Jan. 9, 2008, in the online version of the International Journal of Eating Disorders. It will be published in the print version of the journal later.
Crisafulli conducted the experimental study as an undergraduate honors thesis project while she was a student at UNC. She is currently working toward a doctoral degree in clinical psychology at Boston University.
“There is a lot of false information about anorexia nervosa disseminated in pop culture. This study suggests that even a nugget of accurate biological information can influence how health care professionals perceive the illness,” said Dr. Cynthia M. Bulik, William and Jeanne Jordan Distinguished Professor of Eating Disorders and Psychiatry, director of UNC’s Eating Disorders Program and the study’s senior author.
“It opens up new horizons for accurate information campaigns to help the public understand that people with anorexia nervosa are not to blame for their illness and that biology plays a role,” Bulik said.
Anorexia nervosa is characterized by the relentless pursuit to be thin and obsessive fears of being fat. Self-starvation, extreme weight loss and related medical complications that accompany the disorder can result in death. More people die from anorexia than from any other mental illness.
Anorexia nervosa is frequently perceived as something that is under the personal control of those who suffer from it, according to research cited as background information in the UNC study. As a result, many people tend to view those with anorexia as being responsible for their illness. This stigma is believed to create additional difficulties for people with the disease, including making them more reluctant to seek treatment.
In the UNC study, 115 undergraduate nursing students were first given a questionnaire that asked about the participants’ prior level of contact with people with anorexia nervosa. Then each was given a one-page information sheet. Roughly half received an information sheet that emphasized what is currently known about the biological and genetic contributions to the development of the disorder. The other half received an information sheet that emphasized sociocultural explanations for the causes of the illness.
After the students read the information they were given a second questionnaire in which they were asked to indicate on a seven-point scale the extent to which eight factors contributed to the development of anorexia. These factors were poor living habits, parenting, biological factors, lack of social support, self discipline, society’s thin ideal, genetic factors and vanity.
The questionnaire also asked other questions intended to measure the participants’ attitudes toward people with anorexia, including whether or not they would sign a petition asking insurance companies to provide equal coverage for anorexia as they do for other medical conditions.
The results showed that individuals in the group given the sociocultural explanation were more likely to agree with the statement, “They are to blame for their condition.” They were also more likely to agree that parenting, vanity and lack of social support were causes of anorexia nervosa.
The study concluded that “people who were presented with even minimal information about the biological and genetic underpinnings of (anorexia nervosa) did tend to blame people with anorexia for their condition less than are those who were only informed of the sociocultural factors that may contribute to the disorder.”
Ann Von Holle, a biostatistician at UNC, is a co-author.
To read the study, visit: http://www3.interscience.wiley.com/journal/34698/home


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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