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


There’s No Accounting for Fashion

February 21, 2008

With the end of the 2008 spring fashion Season in Paris coinciding with Eating Disorders Awareness Week next week, it seems a good time to ask what became of the international designers’ grand promises to replace the look of starvation with a glow of health on the catwalks.

Last year, if you will recall, the anorexia-related deaths of two runway models (since followed by at least one more) prompted fashion week organizers on both sides of the Atlantic to vow with great fanfare to promote “the message that beauty is health.” Milan’s Chamber of Fashion issued a non-binding “manifesto” stating that design leaders had a responsibility to "creatively and constructively transmit positive aesthetic models as an instrument of prevention" of eating disorders. In order "to give value to a healthy, sunny, generous Mediterranean model of beauty," mannequins working Italian runways were to have a minimum body mass index, or BMI, of 18.5. That’s about 127 pounds for the minimum runway height of 5’ 9 1/2”.

The Council of Fashion Designers of America issued its own "Health Initiative," stressing voluntary measures to "create an atmosphere that supports the well-being” of models. Unfortunately, the key word was not health or well-being, but voluntary. The CFDA actually specified that it would not recommend models be required to have a physical or body-mass assessment.
In its defense, the CFDA stressed that fashion alone does not cause eating disorders. But that’s like saying that Las Vegas does not cause gambling.

It’s true that certain people are biologically predisposed to eating disorders, just as alcoholics and compulsive gamblers have a biological vulnerability to addiction. But modeling lures those prone to eating disorders the same way casinos attract high rollers. At least 40% of fashion models struggle with anorexia or bulimia. These disorders, however, have a higher mortality rate than craps or roulette – or, for that matter, alcoholism, depression, or schizophrenia.

The problem extends far beyond the runway. Of the 10 million American women and girls who develop eating disorders, many avidly study glamour shots of skeletal models for “thinspiration.” This is the real reason why the size of models matters.

So what happened to all that bold talk about designers’ responsibility?

I serve on the advisory board of the Academy for Eating Disorders. Earlier this month several of my AED colleagues called on CFDA president Diane von Furstenberg, CFDA Executive Director Steven Kolb, and Nian Fisch, chair of the CFDA Health Initiative, for an update on their implementation of the Initiative. We have yet to receive an answer.

“Their failure to respond underscores that the CFDA health panel was all for show--just lip service and empty promises,” said Cynthia Bulik, PhD, past-president of the AED. “If there’s no accountability, there’s no action.”

In Europe, supermodel Marvy Rieder, whose marVie Foundation aims to create a healthier working atmosphere for aspiring models, has noticed that designers are showing clothes even smaller this year than last. One model who dropped to a European 34/36 (equivalent to a U.S. 0) in order to qualify for the Milan shows was told she still was “too fat.”
“Agencies often do not agree on the strict measurements made by the designers,” Rieder told me, “but they don’t want to be put out of business so they tell the girls to lose weight if they want to do the shows.”

Of fourteen recommendations made last year by the Model Health Inquiry chaired by Baroness Denise Kingsmill, the British Fashion Council has chosen to implement just four: London Fashion Week will ban models under 16; no more backstage drugs, smoking, or champagne; models will be allowed to rest between shows at a staffed apartment; and maybe by next September's Fashion Week, the Council will begin model health certification.

Susan Ringwood, chief executive of the British eating disorders charity Beat, is fed up. "We want the fashion industry to put its words into action, to just get on with it.”

In a world where real women wear an average size 14, why does the fashion industry mount such resistance to more substantial models? When asked, most designers reply bluntly that skinny girls make their clothes look better.

Here, then, is the ugly truth that each of us should consider whenever we open the latest Vogue or check out what’s new on the catwalk: in the world of fashion today, looks matter more than people do. Style is literally to die for.

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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