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

LOVE, TO LIVE

April 27, 2008

When I give talks to patients and families I’m sometimes asked if there is one piece of advice that I would give to ward off eating disorders. To a point, this question makes me cringe, since these disorders are such complicated beasts and so often entangled with other complex circumstances and conditions. However, there is one common denominator that all eating disorders share, and that is fear.

Fear of being fat. Fear of being imperfect. Fear of being criticized. Fear of being exposed. Fear of being rejected. Fear of being unloved. Fear of being smothered. Fear of being honest. Fear of being at all…
Quite simply, anxiety is the root of all eating disorders. It is far from the only root, and it is hardly unique to these illnesses, but it is a core component that both instigates and feeds anorexia, bulimia, binge eating disorders and all the other variations on the spectrum. So fighting anxiety – fear – can go along way toward both preventing and recovering from these disorders.

How do we do that? By cultivating fear’s antidote – love.

I am not talking about love in the romantic sense or necessarily the religious sense. I am talking about internal passion, the experience of feeling engaged and enthusiastic and curious. I am talking about appetite for life.

When I speak to school groups I often begin by asking girls what they, personally, are hungry for that they cannot eat, wear, or buy. Most say love. But I push them, then, to think about love that they do not depend on another person to deliver – love that they hold within themselves. What do they love doing? What do they love studying? What do they love to hear, to see, to feel?

Next, I ask them to consider how many of their decisions are driven by these internal passions. Do they crave straight A’s because they actually love the class or the subject they’re studying? Are they applying to Ivy League colleges because there is something about these colleges that they, personally, love? Do they really love all the things they do, or are they sometimes simply afraid of being rejected by family or friends if they want to do something different? For that matter, do they love how they feel around friends and family, or could they disentangle the parts of these relationships that they love from those they would like to change?

What girls find, all too often, is that most of their choices are driven not by genuine love but by fear – especially by fear of failure in the eyes of others. Instead of learning to direct their own future according to passions of their own, they let the standards and expectations of others shape their future. This fear creates a steady undercurrent of anxiety that is a set-up for problems like eating disorders. It also is a recipe for an inauthentic life.
Women of all ages struggle against pressure to conform to the rules and expectations of others, and because of this, women of all ages tend to let fear, rather than passion, direct their lives. Instead of living from the inside out in a healthily “self-centered” way, we too often center our lives on the demands of others, and end up living outside-in, as if we had no right to our own genuine interests and desires. We all need to reverse this trend not just because it is a recipe for eating disorders but because it is a recipe for existential misery.

I believe that eating disorders physically signal an existential disorder. When sick, we do not feel that we have the right to properly feed our own existence. The best way to prevent and cure this existential disorder is to develop our own internal passions.

Love who you really are, from the inside out, quirks and all, and make the choices that shape your life out of this love instead of fear. Choose work that you love to do. Choose studies that you love to learn. Choose to surround yourself with people you truly love. Choose to make a home that you love. Choose to get to know the teachers and mentors you love. Choose to create a life that you love.

It is impossible to have a perfect body, face, family, or life, but this does not prevent us from loving what we do with these “imperfect” gifts. It does not prevent us from making choices that give us genuine satisfaction and make our existence feel meaningful. Passion is the root of love, and each of us has the power to cultivate a whole host of passions in our lifetime. Love, in this sense, is not the prize of a “good” life; it is the key to life itself.
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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