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



January 18, 2009

Dear friends,

I just received the following announcement from Rebecca Lester, PhD, MSW, PLCSW, who has recently launched a non-profit organization dedicated to education and advocacy issues for eating disorders and other culture and mental health issues called The Foundation for Applied Psychiatric Anthropology (FAPA). The website is

She wants us to know about two new initiatives, in case you (or other people you know!) might be interested in participating.

Please reply to Dr. Lester via the website. Here’s her announcement:

We are currently soliciting submissions for an edited volume of poetry and other writings created by Eating Disorder survivors. The aim of this project is to convey the profound suffering this illness brings, as well as the hopes and successes that can come with recovery.

We consider an eating disorder "survivor" anyone who has suffered, or is currently suffering, with an eating disorder, yet who remains alive to share the experience. One does not need to be fully recovered to be a survivor. However, we do ask that people who are currently in treatment or early in their recovery discuss their participation fully with their therapists and/or treatment teams before submitting their work.

As we know, many survivors of eating disorders are amazingly talented and eloquent, and many write poetry or other musings as part of their journey. Unfortunately, most of it remains in the pages of personal journals or filed away somewhere, and is not shared with others who might have their eyes, minds, and hearts opened by reading it. It is our intention that this volume will become a valuable resource for clients, professionals, families, and the general public by illuminating the complex and devastating contours of these illnesses, as well as the strength and reliance of those who battle it every day.

We welcome any and all submissions written at any stage of illness or recovery. Although we may not be able to accommodate all submissions in the present volume, our aim is to include as many as possible. If we get enough submissions, we may consider publishing additional volumes.

The collection will be marketed to established publishers and will be available for purchase nationally (and perhaps internationally) All proceeds will go to The Foundation for Applied Psychiatric Anthropology to fund additional education and advocacy initiatives related to culture and mental health, including eating disorders.

Contributors to this volume may remain anonymous if they do not wish to reveal their identities. As the editor, I will need to know who they are (in order to get permissions signed and so forth), but authors may remain unnamed in print if they wish. Certainly, others may want to use their real names.

On our website (on the Advocacy and Education page) is a form that may be given or emailed to anyone who might be interested in contributing to this effort. Contributors can send in hard copies of the form and their work, or they may send both by email or secure fax. Please let ANYONE who might be interested in participating in this project know about it!

The other initiative currently underway is the arrival of our first Advocacy and Education Poster, which promotes the message that no one CHOOSES to have an eating disorder. Posters are 11 x 17, full color,100lb text gloss print, and may be viewed on our website.

Posters are available for FREE via our website with a $5.00 donation to The Foundation for Applied Psychiatric Anthropology (shipping is free, too!). Visit our website at to get yours today!

Thank you for your support!

Rebecca Lester, PhD, MSW, PLCSW

Department of Anthropology Executive Director and Psychotherapist
Washington University in St. Louis The Foundation for Applied Psychiatric Anthropology

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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