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

On Becoming a "Professional"

May 10, 2008

One of the choices that invariably accompanies recovery is the choice of occupation. “What do you want to be?” we ask the reflection in the mirror.

There are several possible variations of this question:
“What do you want to be tomorrow that you are not today?”
“What do you want to become that will impress your family and friends?”
“What do you want to become that will pay the bills?”
“What do you want to become in order to feel safe?”
“What do you want to become that will reflect the true you?”

The problem is that all these questions assume you must become some thing in order to be someone. This common assumption confuses two essential aspects of identity: who you are and what you do.

You are already someone. You have been since you were born. You will be until you die. The core challenge of recovery is to recognize, give voice to, and develop compassion for that essential person who is comprised of certain specific personality traits, talents, strengths, and curiosities.

What you do does not define who you are. But it can either support, undermine, or conceal you. An eating disorder or an addiction is not an identity; it is something one does that overwhelms one’s identity.

This is why I have such an aversion to describing anyone as an anorexic or a bulimic. The very language turns human beings into things, defined solely by their most disturbed behavior.

Unfortunately, our culture so routinely defines people by their behavior that we don’t even question this pattern. We don’t recognize the distinction between being a writer and writing, between being an architect or doctor and practicing architecture or medicine. That’s one of the reasons students so often panic as they face graduation; they feel as if their career choice must turn them into some thing that will define them – happily – for life.

It’s too tall an order. I am a novelist, a wife, a mother, an activist, a lecturer, a teacher, a student, an essayist, a daughter, a breather, a sister, a traveler, an aunt, a swimmer, a thinker, a walker, a memoirist, a reader, a photographer. The list changes every day. Does any one of these roles define me? No. But my personal goal is to see that they all accurately reflect various parts of me. (My screensaver reads: “WRITE AS YOU ARE.”) Furthermore, I can try to be mindful of the ways these different roles reflect and support each other. I need to engage in relationships, for example, in order to write well about relationships. I need to read in order to teach well. I need to swim and walk in order to think and breathe well. I cannot isolate any one “behavior” any more than I can let one role dominate all the others.

This is why I worry when patients or recent graduates at treatment centers ask if I think they should become therapists, or dieticians, or fitness specialists. I worry because all these professions mandate a preoccupation with food, body, exercise, and/or illness that, if adopted as an identity, can sustain the half-life of an eating disorder, albeit under the guise of “health.” I worry because I do not want to encourage individuals to become Professional Anorexics or Professional Bulimics.

Does this sound disingenuous for someone who has written two books about eating disorders? Perhaps, but I can assure you it’s been a source of great struggle for me. The hardest part has been the pressure from others who insist on “branding” me by my latest work. These include members of the publishing profession and my own family. They include both those who urge me to devote my life to fighting eating disorders and those who are ashamed of me for exposing this part of my life. Both misunderstand me and my motives.

I have no intention of becoming a Professional Anorexic. Neither have I any intention of suppressing insights and interests that have to do with my history of anorexia. The latest science about eating disorders fascinates me because it proves these illnesses are just as badly misunderstood as I once misunderstood myself. So I raise my voice as I can to correct some of these misunderstandings. But this is not all I do, and it certainly does not define who I am.

Some people default into professions that come easy or that their families or friends select for them. Others actively choose careers because they promise status or money. Still others discover activities and interests they love, and the professions evolve from there. I’ve tried all three routes at different times, and the only one I’d vote for today is the last. Let who you are determine your professional choices in life, not the other way around. And if you don’t yet know who you are, then make that your first priority as you keep yourself open to change. Remember, the only career that ultimately counts for any of us is the profession of life.
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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