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



February 25, 2008


Thank you, one and all, to everyone who submitted a new name for eating disorders! The diversity of ideas alone shows how complex these problems are – and what a grave disservice it is to pigeonhole them as “food and weight” issues.

Before I list the 5 names that spoke to me as the most right-on, I’d like to share the whole list. I think it reflects the difficulty of coming up with one label that applies to the wide variety of these conditions, especially when we consider factoids such as 1) most people who die of eating disorders do not die directly of starvation or obesity, but suicide; 2) weight is not always an indicator of an eating disorder; and 3) eating disorder behavior and thoughts often have nothing to do with food.

Here then, are all your suggestions, along with comments that you submitted to explain them. THESE are truly “food for thought”:

• Metabolic Manipulation Dis-order.
The initials, MMD, give it a sense of respectability.
• Starved Self Syndrome... SSS
• No-self syndrome
• Empty self syndrome
• Self-awareness escape condition
• TrEATable disorder
• "Undeserving" complex
• Dissociative eating syndrome
Named because we dissociate into food, either
avoiding it or finding it. We dissociate from painful
events and go into food thoughts
• Not-eating disorders
• Nourishing Syndrome
• Sustenance Deprivation
• Sustenance Support
• Feast/Famine Crisis
• Feast or Famine Defense
• Nurturing Reception
• Dissociative syndrome
(the mind and body are dissociated from one another)
• Maladaptive coping syndrome
• Deprivation addiction
• "Drowning to death in a sea or plenty"
It reminds me of a stanza from the poem The Ancient Mariner:
"Water, water everywhere and all the boards did shrink,
Water, water everywhere, nor any drop to drink."
I would change a few words to describe anorexia as:
"Food, food everywhere for one and all to eat,
Food, food everywhere, but none allowed for me."
• Genetic identity syndrome
• “S.E.A.S.” self evaluated anxiety syndrome
I have had an ED for 27 years and it leaves me washed
out like the sea can. Also, we make our own
evaluation of our worthlessness, nobody makes us hold
onto these feeling. In the air of hope, the tides can
always change, perhaps washing IN healing.
• Obsessive-compulsive Food Disorder
How many other disorders do you obsess over just the food. . .and almost nothing else?
• Food Dysmorphic Disorder
since we have a dysmorphia about the amount/type of food we put into our bodies.
• Food-focused Disempowerment Disorders

I shared these suggestions with several friends, both in and out of the eating disorders field. We all agreed that it is near impossible to find a single term to encompass conditions as different as anorexia and bulimia and binge eating disorders. It’s easy to see why they were lumped together around the single symptom of disordered eating, but this label does not even hint at the emotional, chemical, or genetic underpinnings of these conditions. Worse, this label has directly contributed to the trivialization of these illnesses by the general public, much of the medical establishment, and insurance carriers.

As one of you wrote to me:
“I hear young girls through grown women say, ‘I wish I was anorexic - just for a week.’ I remember being an adolescent and being obsessed with eating disorders. I would read everything about them at the library (we did not have the Internet), I would secretly read the ED section in our health books, and would read any magazine that had something about them on the cover. I wanted people to think I didn't eat (I did), and I thought it was symbolic of being good, in control. I wanted to be anorexic. Eventually it grabbed a hold of me and has not let go… Let's stop making it so glamorous.”

I heartily agree! That’s why I launched this contest.
Here, then, are the names that we believe most closely describe the underlying reality and internal experience of all eating disorders, whatever their shape, size, or duration. They do not wildly overlap with other broad conditions such as depression, anxiety, and personality disorders, and yet they also do not fasten on abnormal eating as the sole common denominator:

1. Metabolic Manipulation Dis-order (MMD)
2. Starved Self Syndrome (SSS)
3. "Undeserving" complex
4. Deprivation addiction
5. Feast or Famine Defense

Again, thank you to all of you who submitted entries. I’ll be in touch with the winners to send them a copy of Gaining. And feel free to share these alternative names with any of your friends or acquaintances who ask why people with eating disorders don’t just “gain (or lose) a little weight”!

Have a healthy, pro-active, and power-full Eating Disorders Awareness Week!
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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