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

Setting the Stage for Recovery

January 14, 2009

Eating disorders thrive on self-deception. The most obvious lies ED tells us have to do with our relationship to food, fat, and weight – specifically, that however much we have or are is just not good enough. But in my opinion, the most pernicious lie in the ED arsenal has nothing directly to do with eating. Rather, it is the notion that we “need” to be left alone.

In fact, it’s not the person but the illness that depends on isolation. Starving, bingeing, and purging are secretive and solitary behaviors that feed on shame. And shame itself is alienating. Shame tells us that no one else could possibly understand, care for, or help us. Shame insists that we do not deserve friends or loved ones. Shame makes sure that we feel alone in the world, and stranded. As a result, isolation becomes the hollow core around which an eating disorder spirals.

Full recovery demands that we confront that lie of isolation. In truth, no one on earth is alone. There are billions of us here! And we are all to greater and lesser degrees related by our mutual flaws and yearnings, our weaknesses and frustrations, our common human needs. The challenge is to identify and reach out to those who can help us tap into that shared humanity in the healthiest possible ways.

Think of this as setting a stage. You may feel as if you’re alone on this stage. But actually, crowding in the wings is a large cast of friends, family, teachers, pets, classmates and colleagues, doctors and therapists. Some have known you your whole life; others may have just met you. Some are worried for you, but don’t know what to do. Others have the tools to help but need your permission to approach. Many are as baffled and frustrated by ED as you are, and will gladly support you in your battle – if only you will let them.

Here’s another truth: you have the power and the right to decide who will join you on the stage of your own future. But staying out there alone is not a viable option.

Setting the stage for recovery, then, means exercising your power to connect to others. If that sounds daunting, it may be because ED has convinced you you’re powerless to make your own choices, especially when it comes to love and trust. ED trains us to fixate on our bodies instead of relating to each other. So the longer you’ve had an eating disorder, the more difficult it may be to accurately see or hear the people around you.

It may help to think of yourself as a casting director. Before a play is cast, actors must audition. The casting director pays close attention to each candidate’s voice, expression, and body language. He asks himself which of these individuals will be best for the play – which will bring the most genuine energy, useful skills, and honest commitment to the common effort? The people you choose to set the stage for recovery should meet the same criteria.

So take a long and honest look at the people who surround you. Consider how you are connected. How has your ED affected them? How much do they want to help you? What could they contribute to your recovery? What do you need to do to help them help you?

Those you choose to join you on your stage need to support you without judging you or tearing you down. They’ll be the ones who make a genuine effort to understand what’s wrong, and do their utmost to help you figure out how best to make it right. They’ll admit they don’t have all the answers, and they may have flaws of their own. They’re not perfect; they’re human. But they are wholeheartedly there for you, for your health, for your wellbeing.

You just need to push ED out of your way long enough to notice them.
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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