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


The Fallacy of Fasting

August 7, 2010

I listen to the NPR radio program This American Life
as often as I can, but not until today did my fascination with the show’s wacky insightful way of observing the world coincide with my fascination with eating disorders. Today, in pursuit of the spiritual “enlightenment” that’s supposed to accompany fasting, contributor David Rakoff embarked on a 20-day guided fast to see if he could find nirvana through restriction.

I was particularly interested in this because, some years ago, a member of my meditation group embarked on one of these Web-driven fasts. She was talked into it by friends, resisted in the first week, lauded it the second, and became visibly sickly and defensive the third. When I told her I was worried about her because the fast had made her gaunt and the hunger high she was experiencing could be an invitation to anorexia, she looked at me with an expression that can only be described as hatred. I recognized that expression too well; she’d become both hostage and guardian of her brain’s starvation.

So I was curious to hear what David Rakoff, a self-acknowledged skeptic, had experienced on his journey to “purification,” which, by the way, cost him $300. That fee was paid to the Internet shyster who promised nirvana in exchange for deprivation aided by enemas and “special” elixir recipes designed to “detoxify” the body and restore “balance.” Rakoff’s radio journal tracked what sounded to me like a 12-step program INTO an eating disorder.

1. Surrender to the higher power of an online Oz who proclaims fasting to be the Ultimate Key to Perfection.
2. Follow in lockstep Oz’s rules and regulations for self-deprivation and abuse.
3. Defend the ideal of restriction from all objective and rational detractors.
4. Utilize guilt, shame, pride, and fear to override the physical, emotional, and psychological weakness and pain caused by hunger.
5. Interpret the lightheadedness and emptiness of prolonged hunger as “clarity” and “wellbeing.”
6. Embrace the all-consuming self-absorption and self-involvement that results from self-induced starvation as an earned privilege –even an attitude due to the superior “specialness” of those who are able to persevere on a fast.
7. Enjoy the illusion of separation and disengagement from anxiety as the body’s normal reactivity to stress gradually fades away. Even if the slow reaction time does put the body in some physical danger, the mind won’t notice.
8. Value the “success” of staying on the fast above any other accomplishments that might have been achieved with this same time, energy, and discipline – it’s not what you actually do with your abilities that counts, it’s the fast-induced feeling that you could achieve anything.
9. Discount or deny the abundant scientific evidence that the mental and spiritual “benefits” of fasting are, in fact, caused by the brain’s forced metabolic shift from carbohydrates to ketones as fuel – and that the “clarity” that follows initial hunger pangs is, on an evolutionary basis, designed to enable the starving body to survive until the food supply resumes, not to voluntarily prolong starvation.
10. Seek evidence of enlightenment in every waking moment, thought, perception, and experience and, should anything beautiful or out of the ordinary occur, credit it to the fast –never mind the possibility that this same level of focus brought to a well-nourished body might actually produce equally or more rewarding breakthroughs.
11. Reach out to others who admire you for fasting, who will reinforce the belief that depriving the body somehow elevates the soul and improves the spirit – and of course, dismiss or avoid anyone who says you look like you have cancer.
12. Notice how challenging it is to return to eating after a long fast, and marvel that even a single apple can taste like a feast.

I have to note that Rakoff touched on these pointers without necessarily submitting to them all himself. But if he didn’t actually feel them, he noted that others seemed to or that the message had gotten through to him that he was supposed to feel or abide by these rules – all of which, by the way, I vividly recall pumping through my mind when I was in the throes of my eating disorder.

Rakoff’s conclusion was that he “failed” at his fast because he didn’t “feel” the spiritual ecstasy that he was “supposed” to. Based on my own research, I’d take this as evidence that he didn’t have the genetic predisposition for an eating disorder, and he should count himself lucky in that. Also, it seems likely that the sources of anxiety in the rest of his life were not existentially threatening; if they had been, he might have embraced the disengagement (#7) he felt through his fast as a solution to his problems. People who fall prey to eating disorders tend to be drawn into ED’s self-absorbed cocoon as a sanctuary from overwhelming distress that they feel powerless to confront.

My takeaway from Rakoff’s report is that fasting doesn’t cause eating disorders, but it does invite them. All these online con artists taking money to “help” you fast the “right” way are promising nothing more than the human body’s natural response to deprivation. And just as some people’s bodies respond addictively to a taste of alcohol or a single pill, others are primed by experience and genetics to turn a “healing” fast into a potentially lethal eating disorder. Fasters beware.

There’s a poignant moment in Rakoff’s piece when he hears a woman on the subway asking her fellow passengers if they have any food to share. He’s too embarrassed to tell her exactly why he doesn’t, and in that painful split-second of truth the fallacy of fasting explodes.

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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