Friday, May 08, 2009

Guest post: One woman's story

This moving guest post, written by a 36-year-old reader, expresses vividly one young woman's slide into disordered eating and then an eating disorder. Her story involves a family that unwittingly triggered her ED. For every family like this, there are many others who do not value their children's thinness above all, and who don't contribute to pathology. So while I don't agree with her conclusion that "It's hard to have an eating disorder without the support of family and friends," I know from my own family's experience just how much validation and--as she points out--admiration comes your way just for being thin. Many of us don't realize we're validating pathological behaviors. I hope this will be a wake-up call for some.

A few months before my younger sister's wedding, she jokingly challenged my older sister and I to lose weight. My younger sister is very petite. She has always been very skinny. My parents (especially my mother) adore her.

At the time I was going through a spiritual crisis and felt a loss of control. I decided to go on a calorie-counting diet. I felt I couldn't control other things in my life. But I COULD control what I ate, and I could control how much I weighed.

It started fairly healthy. I bought a food scale and allowed myself the minimum amount of calories that experts recommend. My feeling is I'd get to my goal weight for the wedding, and when that was done I'd go off the diet.

I started off this diet as someone who has never really been overweight. I just wasn't thin like my sister. My weight was within the recommended ranges.

By the time the wedding came around I was thin. My parents were so proud. My dad even made comments in private about how he thought my beauty overshadowed the bride's. I received so much attention. I felt so proud. One of my parent's friend's kept praising me about my amazing willpower. One aunt did express concern. She said I looked too thin. I remember loving this attention.

At the wedding, I ate...a LOT. After weighing myself I realized that I couldn't just go off the diet. All the weight would come back. I'd have to stay on the diet for life. I told myself that was fine. I'd go on breaks sometimes and eat what I want.

My life and happiness became centered on these breaks which usually occurred on holidays and trips. Food became the center of my life. Nothing else could really excite me or make me happy. I'd spend hours and hours looking at restaurant and food websites.

Meanwhile, I kept wanting to lose more weight. Soon I came to the point where my weight at my sister's wedding seemed fat to me.

I don't think I had a body image distortion problem. I knew I was thin. I didn't look in the mirror and see a fat person. I saw a beautifully thin person. (Now though I look back at these photos and I AM thinner than I imagined).

The wedding had been in May. By Thanksgiving, I was underweight. My birthday was around this time and has a gift my mom took me shopping. She was so proud of my weight loss--bought me clothes to show it off.

At Thanksgiving, I opened my presents. Everyone wanted me to try the clothes on. Even though I was underweight, they had bought me clothes that were still tight. I could wear them, but I knew if I gained a little weight, I could no longer wear them.

I wasn't a teenager during all this. I was a mother with a four year old son and an aunt with two nieces. I think a part of me knew I had a problem, but another part of me denied that. I remember seeing someone horribly thin jogging and thinking. I am NOT like her. I'm okay.

I didn't want to die and leave my child an orphan. I told myself I was fine. I told myself there was a difference between eating disorders and strict healthy dieting. But I think a small part of me knew I was fooling myself. Maybe? I'm actually not sure.

The dieting continued. The numbers on the scale got lower.

During the beginning of the dieting, I had begun walking. I'd put my son in a stroller and do a long walk everyday. (or almost every day) My parents were very impressed with this. I received a lot of praise. Eventually, I bought a pedometer and made outrageous rules about how much I'd have to walk each day. I'd do this by never sitting down. I'd just walk and walk around the house--constantly. I remember having guests over and wanting them to leave because I was too embarrassed to obsessively walk in front of them. I felt they were intruding on my walking time.

I made rules for myself such as you can't eat another piece of food until you walk a certain amount of steps.

I started wanting to take more breaks from the diet. I made rules that if I was at a certain weight I could do this. I started drinking herbal laxative teas in hopes that this would make me lose those extra pounds. I didn't have much luck. My system was so slow at that point. I stopped having daily bowel movements.

About a year and a half after it all started, I received comments on my Livejournal blog from an anonymous stranger. An LJ friend had recovered from an eating disorder and was disturbed by my constant public recording of my weight. She approached another ED friend and they gave me a mini-intervention. She said it seemed like I had an eating disorder. She talked about my issues of control. And she scolded me for recording my weight. She said all this might be a trigger for someone.

I was furious and disgusted with her.

A few months later my sister (the thin one) approached me about the eating disorder. I actually don't remember my response. I can't remember if I denied it, or if by this time I knew I had a problem.

Eventually though I got over it.

I put away the scale (food and body). I stopped wearing a pedometer.

I stopped dieting.

I was disturbed to find myself quickly returning to my old weight, but I have grown to be mostly okay with it.

I have taken the scale back out, but I never weigh myself more than once a day. I also NEVER punish or reward myself based on my weight. I accept the number and realize there are so many things about myself that are much more important.

For the most part, I'm happy with myself.

I'm no longer obsessed with food. I like to eat, but it's definitely not the center of my happiness. My husband is a bit of a foodie and I actually get bored now when he starts going on and on about food.

I have had setbacks. My husband's friend went on a diet where you fast every other day. I read about it, decided it was safe, and tried it too. I lost a few pounds, but found myself obsessing about food again. I decided this was unhealthy and quit after a few weeks.

Every so often I have days/nights where my self-esteem sinks very low...usually caused by some interpersonal conflict. I get very depressed and feel worthless. I make a vow that in the morning I'm going to go back to strict dieting. I think this is less about being thin though and more about feeling self-destructive and needing a sense of control.

Fortunately, in the morning I usually come to my senses and eat normally.

When I first came to terms with my eating disorder--around the spring of 2007, I emailed my family about all of it. I told them about how I now know I had an eating disorder and I'm going to stop the negative behaviors. I expected to get sympathy, concern, and kudos for wanting to overcome my problem. That is not what happened. One of my brother-in-laws didn't believe I had a disorder and told me that. He told me I was just very dedicated. That's all it was. I put my mind to something... a goal and I achieve it. During the ED times, he'd frequently ask me how much weight I had lost. He was so impressed and gave me a lot of attention over this.

My dad showed no concern or regret for what happened to me. He merely scolded me for confessing that I had not gone to certain family outings because I had wanted to avoid food. (in the beginning I was one of those who would happily watch other people eat--even make huge desserts for others, while I ate a piece of fruit or nothing. But later this became harder for me and I sometimes avoided social events so I wouldn't have to jealously watch other people eat). Family togetherness is very important to my dad and he was horrified that I'd choose not to be with family.

After getting the email, I had shocking encounters with my family. Although I told them I was no longer dieting, they still sometimes acted as if I were At one time, we had some kind of celebration that involved cake. My BIL said not to worry. He had fruit for me! Even after I told them my problem and that I'm not on a diet any longer, he went out to get a special meal for me. I was horrified and hurt. I felt they were trying to push me back to the diet.

Another time, we were all about to have cake. My mother turned to me and said something like "Are you going to have some, or are you dieting?"

I was so disgusted that they'd say these things knowing I had an eating disorder. I would think they'd be HAPPY to see me eating.

For the past two years, I have resented their reaction...but I resent a lot about my family. For some reason, the past few weeks I've been thinking about it and wondering why they didn't give me more support.

My mom is on the Jenny Craig diet. I saw her eating a JC cake, and started thinking maybe I should go back to dieting. Maybe this one would work for me because it doesn't involve counting. I know it would be dangerous for me to do any diet where numbers are involved.

I brought it up to her in the car. I asked if she thought it was an okay diet for someone who has an eating disorder. I confess that I think I wanted to see her reaction to the eating disorder thing. After that email, we had never discussed the issue. I guess I wanted to see what she thought.

Well, I found out. She told me she didn't think I had an eating disorder. She says almost everyone goes through yo-yo dieting and if I had an eating disorder probably most women do. She asked...isn't it just as bad to keep eating and gaining weight. Isn't that a disorder?

I told her I'd rather be a few pounds overweight than have an eating disorder again.

I basically then learned she feels to have an eating disorder you have to be in the hospital close to death. She feels because I was never officially diagnosed by a doctor, and was able to gain the weight back on my own, I never had a problem in the first place. I think to her what I did back then was GOOD. The bad thing I'm doing is now--not being thin anymore.

It is really hard to struggle with something, overcome it the best that you can, and then be told you never had a problem in the first place.

I think eating disorders are unique in that instead of getting sympathy and get admiration.

When I got home from being with my mother, I cried on my husband's shoulder. We talked about the past and how neither of us knew I had a problem back then. I think he feels some guilt. He saw some old pictures of me and realized how thin I had been. He hadn't realize it back then. Then he told me about his friend (the same one who went on the fasting diet). He told me he's concerned with her because she has stopped eating. She is now a very low clothes size. She's in an emotionally abusive relationship. Her boyfriend said something like "I usually date women who are thinner than you." My husband's friend has major relationship and self-esteem issues. She obviously has serious problems. But despite knowing all this, there's this small part of me that's jealous of her. There's a small part of me that admires her.

Anyway, that's my story.

From my experience, I think family members play a big role in eating disorders. I may be going too far in saying this, but my motto is "It's hard to have an eating disorder without the support of family and friends."

I can imagine it's worse for teenagers who actually live with parents. But as an adult, I have a very troubling co-dependent relationship with my parents. They live close by and we see them frequently.

If I had advice for family and friends of people who are dieting, it would be this:

1. Know the signs of an eating disorder and know when your relative/friend is going too far.
2. Do NOT make big deals about someone's weight loss. Do not give them extra attention over this. Find other things to praise them about.
3. Do not point out that a dieting person is eating. Don't say things like "Oh, I can't believe you're eating that" or "Are you off your diet?"
4. Do not praise them for their willpower. Don't praise them for their excessive exercising or their ability to eat an apple while everyone else eats a huge sundae.
5. Do not take them shopping to award them for their weight loss. If parents do this, they should at least buy things that are a little big so the person can grow into them. Do not buy things as small as possible--giving person idea they MUST stay at this weight.

I know ultimately I'm responsible for my own health. It was my fault I had these problems and it's up to me not to return to them. But I do think certain family situations contribute to these problems. For me, it was having a family that highly values thinness, fashion, and beauty.

As a teenager and young adult, I wrote multiple novels and screenplays. My parents gave me much more attention and praise for the weight loss.

Having a skinny sibling who is clearly the favorite also contributed to that. I felt if I got down to her weight, they'd love me like they love her. And in some ways, it did work.

You know ....I think about what contributed to my recovery. I want to say it was the Livejournal visitor or my sister. But you know who probably made me come to my senses. JK Rowling. On her website, ( she has a great essay about eating disorders. I'm a huge fan of hers and I think reading that helped me realize I was doing a bad thing not just to myself but to my son and nieces.

I started thinking what kind of message am I sending to these two little girls. They already have one very skinny aunt. What if they have two? And what if one of them is constantly dieting and exercising?

When you have an eating disorder, you're not only hurting yourself. You're hurting anyone who might see you as a role model. It's great to be a role model, but be one for something that's great. Don't be one for self-destructive behavior.

Thursday, May 07, 2009

What will it take?

I write this post in sorrow and distress, after reading this story about a 57-year-old woman in the U.K. who died after 40 years of being anorexic.

It's a tragedy when anyone dies from an eating disorder, especially someone like this woman who, according to the article, died friendless, without family, alone in the world.

But the overarching tragedy here is the profound misunderstanding of anorexia expressed by the medical establishment here. While her doctor obviously cared enough about her to be checking up on her at home (he's the one who spotted her lying on the floor), he clearly doesn't get some of the most basic facts about anorexia.

Here's a quote from the story:

Discussions of her case with psychiatrists and other experts in the past had all concluded that any effort to force her to eat would only make matters worse.

"I believe that she understood the nature of her illness and its perils," Dr Knight told the inquest. "She seemed to have a very firm understanding of her condition. The anorexia was a long-term chronic condition which would not be significantly modified – she was set in her ways."

This makes me want to cry. Then scream. Then change something.

"Any effort to force her to eat would only make matters worse." Let's say a person was delusional about the act of breathing. Breathing makes you sick, they say, and they spend as much time as possible holding their breath. They have to breathe sometimes, but they do it as little as possible. Now imagine a doctor saying "Any effort to force her to breathe would only make matters worse."

I didn't think so.

When someone has been chronically ill with anorexia, their delusions are, as the doctor goes on to say, "set in their ways." But that doesn't make those delusions true. Efforts to force this poor woman to eat would have caused enormous upheaval and distress for her and likely everyone around her. That's the nature of the illness, especially when it's become chronic. (Which is why I'm a big proponent of the Maudsley approach; if you can cure anorexia while someone is still young, they often don't go on to become chronically ill. And that's why it makes me so angry when doctors still take this line with teens who are sick; don't they understand what's at stake? But I digress.)

One of the most well respected ED docs/researchers in the world, Dan le Grange, once told me that there is something about anorexia that seems to affect the people around the anorexic as well as the ill person herself. This story is a heart-breakingly good example of that kind of distorted thinking legitimized. Why is it OK for someone under a delusion like anorexia to starve herself to death? Could it be because of our messed-up ideas about body image and weight?

Here's a later quote from the doctor: "Her body image was such that she thought that she looked the right way even though to everybody else she was very, very thin."

One of the hallmarks of anorexia is an inability to see your physical body realistically. People with anorexia literally look at themselves and see oozing fat even when they're emaciated. This is one of the profound neurological distortions that we know is part of the disease even if we can't understand it yet.

So yes, this woman "liked" the way she looked. But she was in no position to "like" anything about her body, because her self perceptions were profoundly and utterly distorted.

So here's what I want you to take away from today's post:
1. People with anorexia cannot choose to get well. They need at the very least support and help from others. Often they need others to begin the recovery process for them, and stick with it for a long time, until their thinking and ideation is restored to normal.

2. There's nothing sacred about anorexia. It's a terrible, tragic illness. There is nothing glamorous about it.

3. As a society we have a responsibility to help people with this disease recover. Which doesn't include letting someone starve herself for 40 years, only to die, alone and friendless and emaciated, on her bedroom floor.

To this woman's doctor in particular I say: You meant well but you failed. And guess what? Good intentions don't count for shit. What will you do differently with your next anorexic patient?

To the rest of you, I ask that you think about this woman the next time you talk to a friend with anorexia or bulimia. And see if there's anything at all you can do to help your friend recover.

Wednesday, May 06, 2009

Happy No Diet Day!

Ways to celebrate:

1. Take the I-Love-My-Body pledge. Better yet, print out a few copies and leave it in public places--on subway and bus seats, tacked to bulletin boards, tucked into bathroom mirrors. (I'm working on finding a way to upload the beautiful graphic version designed by Mary Brown and will post that shortly. Blogger doesn't like my files, apparently.)

2. Eat a cupcake. Better yet, bake a dozen and hand them around.

3. Buy your very own copy of Lessons From the Fat-o-Sphere by the inimitable Kate Harding and Marianne Kirby. (If you can get it from an independent bookstore, even better!)

What are YOU doing today? Send me your no-diet-day stories.

Tuesday, May 05, 2009

Dear Kirstie Alley,

You seem like an intelligent person; I've admired your acting skills over the years. You seem eloquent and tuned in, except on one subject: weight.

Interviews like this one make me cringe for you and with you, Kirstie. There you are on Oprah's show, being watched by millions, most of them women, many of them, like you, beating themselves up over failed diet. How can you not know by now that it's not a question of your failure? That it's not like "falling off the wagon," as Oprah put it, but rather a basic scientific fact: Diets don't work.

Don't take my word for it. The nice researchers at UCLA did a study two years ago that showed that more than 90 percent of diets don't work--in fact, that dieters wind up gaining back all the weight and then some. Just as you did. Just as so many of us have done.

You say you feel bad because you've inspired so many people and now have let them down. I say you have an opportunity right now to inspire people in a much more meaningful way than before--you and Oprah both. You are both smart, powerful women with some of the best resources in the world at your fingertips. If you can't make your bodies look the way you want, maybe the problem isn't you. Maybe your bodies aren't meant to be size 2s or 4s. Maybe you are both tall, strong, powerful women who are built the way you're built because of genetics.

Maybe the real story here is this: What will it take to make you acknowledge your power in the world and use it for good? What will it take to help you stop wasting your time and emotions on an impossible quest?

You want to inspire other women? Try learning to love and accept yourself for who you are. Now that would be inspiring.

--From a fan