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



January 27, 2008

Okay, Friends-
We all now know that eating disorders are biologically based conditions. We know that anorexia nervosa has a higher mortality rate than alcoholism or schizophrenia, but that the cause of death is not always directly related to food intake or starvation. We know that DNA determines who is likely to develop an eating disorder and who is not. We know that eating disorders serve as distress signals – symptoms – of much deeper and more complex syndromes of personality, anxiety, and behavior.
We ALSO know that these conditions can be re-directed toward health instead of disease. Here is a note I just received from Mark Warren, MD, PhD -- a brilliant doctor, medical director of the Cleveland Center for Eating Disorders, and dear friend who has a history of anorexia himself:
“Eating disorders never go away. The behaviors get better, the thoughts get less, body image improves, happiness comes. But what really happens is the ED goes from being a driver of pain to a driver of happiness and success and friendship and intimacy. It will often stay an organizing principle, but the organization becomes one of health, not disease. And it can lead to a very wonderful life. After all, I found love, made wonderful friends, have a career I treasure, work with amazing people, feel purpose and delight.”
Why are eating disorders so radically misunderstood? Why does the media trivialize and marginalize an issue that affects more than 10 million people? How can men and women with body issues themselves make jokes about “getting just a little anorexic”?
I suggest that the term “eating disorder” is largely to blame, as it implies the problem begins and ends with food.
We all know this could not be farther from the truth.
Here, then, is my challenge to you:
Let’s give “eating disorders” a new NAME!
I invite you to send me your ideas for a term that will reposition the syndromes of bulimia, anorexia, and binge eating disorder in the public consciousness -- a term that will command the attention, respect, and concern these complex conditions deserve.
Although the specific eating disorders are all very different, the central labeling problem is that they are lumped together under the word “eating.” This is primarily what I’d like to change.
But I’m also not keen on the word “disorder.” Given the complex and enduring nature of these realities, I prefer “condition” or “syndrome,” but let’s hear all ideas, both serious and attention-grabbing.
With your permission, I will publicize the most provocative and/or on-the-money ideas in future blogs and op-eds. If we come up with a legitimate contender, I will propose it to my colleagues at the Academy for Eating Disorders for “official” consideration.
We have the power to generate a sea change in public awareness!
Please send your ideas to
If there’s an interesting story behind your proposal, tell me about that, too.
And let me know if you are willing to be publicly credited with the idea.
I will announce the top 5 entries during Eating Disorders Awareness Week at the end of February. Those 5 winners will receive a signed hardcover copy of Gaining.
Thank you so much for your thought, your creativity, and your healthy and power-full inspiration!
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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