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



July 7, 2008

Dear Friends,

If you want to help make a real difference in the fight against eating disorders, please read the action alert below, and Call in support of Mental Health Parity this Wednesday.

Use your power!


Aimee Liu

"Connect the dots... to know thyself"

National Call-in Day for Mental Health Parity Wednesday July 9th! Your help is urgently needed to help pass Mental Health Parity this session!

Here is a link to National Call-in Day Online Advocacy Action Center:

On the website you will see background information, a script for the call and a tool you can use to punch in your zip code and get your Member of Congress and Senator' names and phone numbers.

The US House of Representatives and the Senate negotiators have reached a final agreement on all the remaining mental health and addiction parity issues. However, approximately $4 billion over 10 years in offsets is needed to pay for the bill and must be found before parity can be brought to the floor in both chambers for final passage. Once an offset has been
found, there is commitment from leadership in the House and the Senate to bring the bill up for a vote as quickly as possible.

Although House and Senate leaders have not decided yet where they will find almost $4 billion over 10 years to pay for the cost offsets required by Congressional rules, negotiations have successfully concluded on the
key policy provisions. This compromise is the result of long negotiations and advocacy of organizations all across the country. The compromise includes many key provisions that were included in the House-passed bill,
the Paul Wellstone Mental Health and Addiction Equity Act and would be an important step in ending insurance discrimination facing people with addiction and mental illness. Here are some key points in the compromise:
- The compromise requires parity in insurance coverage for addiction and mental health treatment for both in-network and out-of-network coverage. This does not mean that the bill requires that insurers cover addiction and mental services, only that if they do cover these services, there must be parity with medical/surgical benefits. This of course would be a very positive development both in requiring fairness in insurance coverage and taking a strong stand against discrimination toward people in recovery or still suffering from addiction and mental illness. - The compromise requires plans to disclose their medical necessity criteria and reasons for any denials of coverage. This would be a major breakthrough, as many
plans refuse to disclose medical necessity criteria or reasons for denial, especially when addiction treatment is sought. - On the issue of protection of state laws, the compromise bill language is silent. The House bill explicitly protected state laws, and in earlier versions the Senate bill explicitly preempted state laws. Silence is a victory for those of us who agree with the House approach that state laws should be
protected, since in most situations Congress must take explicit action to overrule a state law in order for state laws to be preempted. However, to make protection of state laws even more ironclad, we will be working to ensure that the legislative history of the bill makes clear that the sponsors' intention is to protect all state laws. That way, as important as the passage of a federal parity law would be, stronger state laws would remain in effect and states would be free to enact additional stronger protections in the years to come.

Wednesday July 9th is National Call-in Day so please call your Member of Congress and Senators on July 9th and tell them that now that an agreement has been reached between the House and the Senate, Congress must find the money to fund this historic mental health and addiction parity legislation and pass parity now.
Thank you for supporting Mental Health Parity and for taking a few minutes to make these important calls. With your help we can get this done!

Kitty Westin
Eating Disorders Coalition for Research, Policy & Action

David Jaffe
Executive Director
Eating Disorders Coalition for Research, Policy & Action
(202) 543-9570
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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