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


Staying in touch yet separate

October 4, 2009

Hello, hello!
If you're looking for a way to stay in touch with your family without crowding them or being crowded by them, my family's system might just be of interest. The following was published in the LA Times today...,0,97946.story
Hello Today
One family finds that a daily e-mail chain keeps everyone connected.
By Aimee Liu
October 4, 2009

Two years ago, following my father's death, my mother found herself living alone for the first time in six decades. The situation, to her children and grandkids, was fraught with peril. Yes, my 86-year-old mother was a miracle of health and vigor. But her house in Connecticut, which she and my father had built in 1952, was designed around staircases, inclines and passages too narrow for emergency management. Its dramatic architecture made it possible to entertain hundreds -- but not to house a live-in aide. And my mother's suburban enclave offered such pristine seclusion that the closest neighbor could not possibly hear a cry for help.

I'd long ago moved to California. My brother lived half an hour from Mom. We thought she should consider moving, but ours had never been a family to meddle in one another's business. She insisted she was fine with the status quo.

Her solution to our concerns was to start a phone tree with nearby friends. "We call each other every morning," she told me briskly, "to make sure we're alive."

Mom was good to her word. Alas, her friends proved less reliable. First, Francis departed for the Cape. Lily had her hands full with her invalid husband. And Sara got overloaded at work.

My brother and I tried to pick up the slack by phoning Mom on alternating days, but we were busy too, and each of these calls stretched an hour or longer. My mother, lonely and hard of hearing, did 90% of the talking.

"You know," I finally said, "we could do this by e-mail."

I expected her to resist. She was just getting her digital bearings and claimed her computer was demonically possessed. So the next morning I sent her a prompt: "Happy Earth Day!"

"Rush out and kiss a flower," she wrote back. "Celebrate the miracle of Green." The subject on her reply message was "Hello Earth Day." By the next morning, the subject had morphed into a permanent header -- Hello Today -- and our online party line was launched.

A listserv or group distribution list would have required too much explanation. Whoever got to the computer first each morning -- usually Mom -- simply pasted the addresses for the rest of us into a new e-mail, and we each hit Reply to All. It was my mother, brother, sister-in-law and me at the start, but soon my uncle joined from his mountain home in Georgia. Occasionally, we included the wider family.

This simple system represented a great leap forward. There had been whole years when my mother and uncle did not speak, phone or write. And my brother and I hadn't had this much contact even when we were kids. Never had our group communications seemed so relaxed, even effortless.

At first our daily rounds began with Mom's "On deck this morning!" announcement, followed by her report on the hedgehogs, wild turkeys and deer in her garden or her latest squirt-gun battle with the squirrels raiding her bird feeder. I'd reply with a snapshot of my current writing project or book recommendation. My sister-in-law would update us on her toy inventions, and my brother would fill us in on publishing industry antics, finishing up with links to the day's most outrageous political screeds and YouTube phenoms.

Then came the recession. Within our extended family, first unemployment hit, then the specter of foreclosure, then serious illness. Suddenly Mom was not the only one who needed attention. Hello Today became less a party line than a family council and group therapy forum.

Electronically we conferred, comforted each other and voted on available interventions. We traded references to lawyers, doctors and real estate brokers, brainstormed job possibilities, researched diagnoses and support groups, and swapped links to online information about mortgage modification, Social Security benefits and insurance coverage. With all of us working together, despite our geographic separation, the immediate crises eventually peaked and subsided.

Stress had historically pulled our family apart instead of bringing us together, but Hello Today altered that pattern. Because we now had this routine of checking in on one another, we found it easier to confront problems as they emerged.

My mother still lives in her home, alone. Doubtless many more crises await us. No one is immune to the vagaries of this recession -- or of life, for that matter. But through my family's lows, highs and in-betweens, Hello Today will continue like a reassuring heartbeat in our collective inbox.

Aimee Liu's most recent book is "Gaining: The Truth About Life After Eating Disorders."

Copyright © 2009, The Los Angeles Times
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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