Sunday, January 10, 2010

At the Y

She was there again this morning, in the vigorous Zumba class I take most Sunday mornings. I love this class because it's fun--exercising to blaring Latin music, following an instructor who shows rather than teaches the moves. I also love it because there's such a wide variety of ages and body types represented, from the hunched-over 70-something woman to 10-year-olds with their mothers. The women in the class--and we are women, although men are welcome--range from thin to fat. Each of us moves to the best of her ability. There are good dancers and bad dancers in the class, and it's all OK.

There are plenty of thin women in the class, but the woman who turned up this morning--second time I've seen her in class--is far thinner than anyone else. Her close-fitting black leggings reveal the shape of her femurs where they meet her jutting hipbones. Her arms look like they might snap at any moment. Her face has a look I've come to recognize, a driven look that also conveys flatness, a certain kind of despair.

You can't tell whether someone has an eating disorder from looking. But I'd bet a year's salary that this woman has anorexia.

Last time she turned up in the class, I went out to the front desk afterward and asked if the Y had a policy about people with eating disorders or whose health was compromised in other ways taking vigorous exercise classes. Shockingly, they do not. I explained my concerns to the woman at the desk, saying I was afraid this ill woman might collapse in class. Or worse. I hoped I wouldn't see her again.

But there she was this morning. In a sweltering room, she wore leggings and a sweatshirt zipped to her chin. I watched her exercise in the mirror; she didn't know most of the steps, being new to the class, but she threw herself into the dancing with determined force. She was burning calories. I couldn't tell if she was having fun. Most women in the class smile through much of it, but this woman's expression never changed.

I'd thought at lot about her since the last time I saw her in class, and decided I would try to talk to her after class, befriend her, get to know her. Only this time, like last time, she ducked out of class before the end. I glimpsed her on one of the elliptical machines on my way out, and wondered how many hours a day she spents at the Y.

I was struck recently by a quote in this film, made by documentary filmmaker Hope Hall about her mother, who's struggled with anorexia and bulimia for many years. The film includes a voiceover phone call between Hope and her mother, where her mother says, "Through all my growing up, through all my marriage, I was always trying to measure up, trying to be somebody else. And all of a sudden, you said, 'I just love you. I don't need you to be well.'"

I think about the woman at the Y, and am torn by what I wish for her. I hope she people in her life who just love her. But I also wish that she, and everyone with an eating disorder, had people in their lives who could help them get well. Who could help them out of the private hell of anorexia and bulimia and into a life filled with something besides starving and binging and suffering.

I hope the woman does not come back to class, because, selfishly, I am uncomfortable seeing her there. In her gaunt face I see the face of my daughter, Kitty, at her sickest. I imagine Kitty at age 40, living this kind of hell, and I feel sick.

I wish I knew what I could do to help.

34 comments:

KDrumm said...

Harriet, this rings really true for me. I'm sure that I used to be someone that other gym-goers would stare at, and perhaps worry about. But even when I was running two hours a day, emaciated, nobody ever said anything to me about my appearance or unusual behaviors.

Now, healthier, I see other people at the gym who remind me so much of myself. And, honestly, I'm not sure what to do. Maybe they have an illness and it isn't an eating disorder. Maybe not. Is it my place to say anything? To them, or to management? I struggle with that question all the time.

The issue of whether fitness centers should have policies on this is difficult. But, I would argue that if someone demonstrates "excessive" tendencies - seven days a week, two hours a day - that gym management should step in. Then again, how can they help? These people run a business, not a counseling service.

...Sorry. Rant. I just don't know the answer, but really appreciate that you raised the issue.

Harriet said...

You're right, Katie. They run a business, not a counseling service. I wonder how issues of liability might play into this? Because I imagine someone's family suing the Y if their loved one dropped dead after excessive exercise day in and day out at too low a weight.

I don't have any answers either. Just questions. I do know that it feels wrong to pretend everything's fine when someone is obviously in pain of some kind.

Rant away any time.

pata said...

You don't know she's sick from her thin-ness anymore than she knows you're sick because of your fatness. I thought this was some huge point the FA movement was trying to make. You're reinforcing a double standard.

Harriet said...

Pata,

As I said in my post, you can't tell just from someone's weight whether they're ill.

But when someone's acutely anorexic, there are often other signs, and unfortunately I've come to recognize them: A certain level of frenetic hyperactivity. A flat look--what psychiatrists would call lack of affect. A haunted look in the eyes. And then extreme thinness. When you can see the shape of someone's femur, that's extreme.

My other clue in this case is the fact that this woman was in the class and exercising hard. If she's been ill with something else--cancer, say--that has made her lose this much weight, I doubt whether she'd be working up a sweat so enthusiastically in a fitness class.

Of course, I could be wrong. Which is why I couched this conversation the way I did in the first place.

You sound very angry, Pata. Want to tell me more?

Chrissy said...

This post moved me so much. I am grateful to have found your blog. Thank you for your honesty.

Harriet said...

Thank *you*, Chrissy.

Joan Fischer said...

We go into a kind of collective irresponsibility when someone like this appears. There's a woman here in town who must have an eating disorder because she truly looks like a walking skeleton--and walk she does, routinely, for long hours, and with a vengeance. I would bet that everyone she passes has pretty much the same thought I do--this woman is sick, she is emaciated to the point where she seems ready to collapse--but of course no stranger will stop her. I hope she has people to help her. My guess is that one day I'll notice I haven't seen her out walking for some time and I'll wonder: Did she recover or die?

Harriet said...

I think it would be easier to take responsibility if there were a defined path toward recovery. One of the toughest parts of eating disorders is that they tend to be anosognosic--it's hard or even impossible for people to recognize they're ill.

Then, too, I'd have to say that a lot of the treatment we've experienced has been ineffective. So even if I did go up to this woman, what would I say? "Let me help you"--except what kind of help would I be offering?

I swear I am getting a tattoo that says "I hate eating disorders."

Chrissy said...

I agree, I should add to my collection of tats "Down with eating disorders" with a a grim reaper holding the banner. Battling Bulimia for 31 years, i have grown to hate its insidious complete consumption of my life and sense of self.To watch another trapped in its grip is heart wrenching.

Rosalie Y said...

This post stirs up a lot of emotions for me.

It's always tough to see people with eating disorders. If you reach out, it migiht be unwelcome and intruding, but then again, the person might be longing for some kindness. I have been in both situations when I was sick: if some stranger had approached me, I might have felt extra self-conscious (why are people watching/noticing me?!) and defensive, but then there were times when I would have loved a short chat about nothing after a workout, because it made me feel more "normal."

Since I attend a college notorious for eating disorders, I see people like the girl you describe pretty often. My gut tells me they have an eating disorder: it's not just their weight, but little things like only drinking diet sodas and using a bunch of splenda in black coffee. There's this urge in me to smile whenever I see these people, say hey, maybe make a friend... but it's kind of exhausting, and I've recently come to the conclusion that if I can just take good care of myself, it will be enough for now. My own sanity and health are enough to worry about. I have difficulty reconciling being an activist with limiting my responsibility to only myself sometimes. I'm always inspired by that gandhi quote, "Be the change you want to see in the world."

Lurking your blog,

Rosalie :)

Rosalie Y said...

Oh yeah,

I love zumba for the same reasons! Every time I walk by a zumba class (at my gym zumba is in a room with glass walls), I see women and men (yeah, and men) in all shapes and sizes and fitness levels smiling and dancing whether they can follow the steps or not and I think, "thank goodness for un-intimidating, body-positive classes like this."

Jessie said...

I'm of two minds about this. Whereas, I feel that we do have a responsibility to speak up, particularly when we have reason to believe a person may be in danger because of illness or something else, I also just really fail to see what you could have said that would have been helpful here. Most likely this woman would not appreciate hearing from a complete stranger about how that stranger believes she has an eating disorder and wants to help her. You might give her information about ED resources, in which case she would then have some place to go for help no the unlikely chance that she would take advantage of them. The truth is that when I was at my sickest, the random comments from people about how they thought I should get help or their attempts at "advice" were not helpful, only made me ashamed of the way I looked, and made me more determined to hide my disorder. These people were well-meaning and said what they did out of a desire to help but my brain did not interpret their comments this way. I think it's a hard, hard issue because I certainly don't believe in forced treatment but there's often nothing you can say to a person with an eating disorder to make them seek treatment. So honestly I'm curious--what would you have said to her?

I agree that it's impossible to tell based on weight alone whether a person has an eating disorder. But there is a level of emaciation that suggests something is very wrong.

Harriet said...

"I agree that it's impossible to tell based on weight alone whether a person has an eating disorder. But there is a level of emaciation that suggests something is very wrong."

Jessie--

Yes, yes, and yes. Anyone who's had any experience with eating disorders also develops a kind of radar for others who are struggling. Doesn't mean we're always right . . . but we often are.

Rosalie, I'm proud of you for your conclusion. Taking care of yourself is an extremely worthwhile place to put your time, energy, and effort. Keep it up!

Cammy said...

I agree, the issue of official policies on these things is sticky. Just an anecdote: I obsessively worked out at the YMCA in high school, like clockwork, 7 days a week. In my junior year I had finally saved up enough money for my own treadmill, so I started coming home from school to exercise instead of going to the Y. After the 3rd day, the YMCA staff actually called the police to come over to my house and do a welfare check to make sure I was ok, because 1) they were sure something bad must have happened to me if I was missing workouts and 2) I was absolutely obviously unhealthy at the time, and they were afraid "something bad" was a medical emergency because I was emaciated. I had to wonder. They were aware enough of the problem to call the cops when I didn't show up, but no one tried to approach me to ask what was going on while I was there...not that I *wanted* them to, I was happy for them leave me the hell alone and let me carry on with my eating disorder, but the episode just seemed a little ironic to me.

So sorry to hear about the woman in your class. I hope that she is able to get the help that she needs, and in the mean time maybe it can be an example of how being underweight/unhealthy with an ED really is neither attractive nor happy nor anything else that could possible be "worth" the sacrifices involved.

Anonymous said...

I love to see the range of size and ages in our local Zumba class. I think of it as a sexy dance class that happens to double as exercise.

We have a walking anorectic in our town, too. I think she struggles with eating disorders, and possibly other mental illness....no, I don't know what to say, either...

wellroundedtype2 said...

Harriet,
With all due respect (emphassis on All and Respect), you are a stranger to this woman and probably would do best to put it in the category of "things you can't change."
Friends, teachers, doctors, family members and others with first hand experience of a particular condition are all well within the appropriate boundaries, but strangers are a different story. I recall you wanting to (and maybe telling) a mom of a girl in a clothing store that you were concerned, and that made sense to me, on a mom-to-mom level.
Here's one situation I was in to consider: I spoke at a course at a local university as a guest speaker. One of the students approached me afterwards and was prostelytizing for Overeaters Anonymous. I was a bit offended, but also could see that she was coming from a particular perspective. If she was observing my eating habits, that would have been one thing, but this was solely based on my appearance. It could be that the woman you are seeing is having a relapse from recovery, you don't have the whole picture. Yes, it's difficult to watch, the way it might be for someone with a parent or child with drug or alcohol dependency would react to someone who appeared to have an untreated drug or alcohol problem. But unless someone is violating the law or policy of a particular location, there isn't much a stranger can do.
Your gifts as a writer are what help "strangers" who are open to what you have to say, and help them through difficult times.
As a Jewish person, I would say that sometimes the "don't just stand there, do something" part of my training takes over, but I need to sometimes just be there, and do nothing but watch. If my heart is open, I might be able to be approached by the person who needs help just by continuing to show up (in all of my fat, Zumba-ing glory).

Harriet said...

Hello wellrounded,

I appreciate your comment. And believe me, I am not under any delusions about the power of a stray comment from me to change someone's life. On the contrary.

It's just I find it awfully hard to see and watch someone in that kind of pain, especially when I know that the very nature of the disease makes it extremely hard if not impossible for that person to help herself. It feels to me like watching someone drown, knowing they can't swim, seeing the life ring within reach, and not throwing it because dammit, it only counts if they save themselves.

I'm Jewish too, and I know what you mean. We butt in. :) It's a trait that sometimes leads us into trouble but on the whole I appreciate it.

Jae said...

I've so been there.

When I first joined my gym, I went on my lunch hours and every time I went, I saw this woman. She had that look you described: driven, haunted, and extremely thin. Often she was exercising when I got there and still at it when I left an hour later. Lots of regulars have their things that they like to do, but she never varied her routine: elliptical or stair-stepper to the bike. Never a treadmill. Never weight machines. While one can burn a lot of calories on a treadmill, you can burn more in the same amount of time on the machines she chose; I often suspected that was why she picked them. Because I would've done that too; I have a hard time convincing myself that it is okay to use the treadmill even now.

Once, I was on my way in and she was on her way out and we made eye contact. I smiled at her and she glared at me. I knew I couldn't say anything to her, it wouldn't help, but I hoped that a little smile could at least let her know she wasn't alone in the world.

I don't see her now, no matter when I go to the gym. If she was indeed ill, I hope it is because she has entered recovery.

Maybe the same thing will happen here. At least we can hope.

Harriet said...

What I'm hearing is that this is actually quite a common scenario.

I wish we could collectively come up with a better solution.

Kelly S. said...

Heartbreaking.

I worked at my university's gym, manning the 6am to 10am slot. I was in my midst of my own ED and would work out before or after starting my shift. For the first 5 months I worked there, I saw the same girl on the treadmill every single day...until she just disappeared. I still wonder what happened to her, and I wonder if she was able to recover like I did.

Harriet, thank you for your blog! I named you one of my top 5 for 2009!

Harriet said...

Kelly,

I'm so glad you are doing well. And thanks for the shout out! I grew up in South Jersey, so I feel a certain connection there. :)

Rachel said...

You're right, Katie. They run a business, not a counseling service.

I know that the Y, like any other organization, has to at least break even in order to pay overhead and whatnot, but isn't the Y technically a non-profit organization?

Even so, I don't know that they would be able to do anything to prevent this woman from working out. And I don't know that you saying anything to her would make a difference, either. During my disorder, I had plenty people tell me that I looked sick and to stop losing weight and will I please just eat this sandwich? It didn't work. If this woman does have anorexia, it may even reinforce the disorder. To a committed anorectic, hearing "You're too thin" or "You need help" sometimes translates into A)"She's just jealous" and/or b) "I must be on the right track."

Assuming she comes back to class, perhaps you could meet up with her after class and hand her a copy of your book, "Feed Me," while making some excuse such as, "Hi, I'm Harriet. I noticed you in class before and I'd love to get a stranger's opinion on my new anthology" or perhaps covertly slip it into her gym bag. It's non-confrontational and if the woman reads the book, may lead her to healthier realizations in her own time and way.

IrishUp said...

Yup, we have her too, in my town. The Walker. She walks about 10mi/day. I live on a beautiful 3mi beach, and there are walkers and runners of all kinds. We're a friendly bunch - everyone smiles, says hi, greets each other's dogs; but not her. She walks fast and determined, never looking at anyone, never greeting or returning a greeting. She wears windbreakers on 80 degree days. My neighbors think she's in her 70's; she's 20yrs younger than that. She has a kyphosis (widow's hump) so bad that her chin is below her colar bone. My grim guess is that may well be what kills her in the end - that kind of bone loss and compression on the lungs becomes fatal.

Yes, it may be that she has cancer or some other wasting condition. It may be that she walks for the joy of it. But it's not.

I wonder: Does she have family who are "used to her way"? Friends who never see her anymore and don't know what to do? Does she have anyone who watches her illness in agony? I look for her at other town events - it's a small town (at least by North East US standards), and we have town meetings, festivals, carnivals. You see everyone eventually. I never see her.

I tell myself, if I ever get a chance to meet a friend or family member of hers, I'll take the risk. I'll ask them if she's ill. I'll tell them that she is. I'll tell them where and how to try to get help.

I check the town obits each week. I look at our d and say "No f'n way, baby!"

Harriet said...

Amen, sister!

I hope your d is doing well, Irish.

IrishUp said...

Thanks Harriet.
She's doing worlds better in lots of ways, but we are struggling to support her during a relapse, with 18 fast approaching. Alas, not everyone on our team right now "gets it", and while MA may be the best medicine for everything ELSE in the world, we may as well be blood-letting when it comes to EDs here. Finding ED clinicians clued into the 21st century's medicine has been a challenge.
However, a very good lead has turned up, so we keep slogging away!

Anonymous said...

I do think this is a situation that a stranger cannot solve or approach. Just as I would hope strangers respect my personal space by not commenting on or approaching me about my extra weight, I give them the same space, even when they don't meet my own definintion of healthy.

I have an extremely thin friend, who is that way 'naturally.' I've seen her eat and go about her daily life... she is not anorexic. She likes to work out to stay strong (thin does not automatically equal in-shape), but is constantly glared at and given gentle talking-tos. She does not work out obsessively or even strenously, but her appearance draws attention. At first, she started dressing from head to toe, hoping no one would notice her bony arms and collarbone, but that didn't do it. Now she just works out at home. If she were more local to me, I would go with her and tell people not to break up our Laurel & Hardy act, but she is many states away.

She and I are like two ends of the spectrum, and I'm sad to say she has received far more discrimination than I ever have, just based on her appearance.

It seems the woman you've observed has deeper issues, but you don't know that for sure, and IMO it's not worth trampling her self-esteem to satisfy your own worry/guilt.

I can see why you are struggling with this issue. Your heart is in the right place, for sure. Hopefully she has someone close to her who can give her the help she needs.

Harriet said...

Trampling her self-esteem isn't exactly what I had in mind. More like giving her back her life.

sayhealth said...

Ugh. What a TOUGH situation? Have you thought about asking the Y if they could make information about eating disorders & treatment support available? For example, perhaps they could have some info at the front desk, or some brochures from local treatment facilities in the locker rooms (both women's & men's). For that matter, perhaps they could have an educational program done by a treatment professional, or team up w/ a treatment center to figure out ways to productively handle situations like this.

I also probably used to be one of those people that others looked at and wondered about at the gym. I don't know how I would have reacted if a total stranger approached me. I would like to think I would take the offer of support, but I know that I probably would have felt ashamed that I was so obvious, and I probably would have switched gyms.

What about handing her a note or something? Something that makes it clear that you have resources for her, but that there's absolutely no pressure & you won't approach her again unless she approaches you . . .

I also blogged about this issue of gyms & their response to people with eating disorders here: http://wp.me/pE9vI-f

Anonymous said...

That's a tricky situation at a public gym-- at my university, the athletic dept heads would usually catch onto someone with overtly unhealthy exercise habits.


When I was ill, my trainer [who'd worked with me for years of being at a healthy weight] would comment to me about it-- wasn't I just here? Shouldn't I go home now? Did I want to get lunch or something? Comments on my weight, etc.

It made me kinda skittish at the time, but honestly, it was a kinda nice reminder that I wasn't okay. Even to people who's jobs revolved around fitness, I was overdoing it. It made it harder for me to pretend that what I was doing was normal.

That's different, obviously, because while this woman didn't know my ED history, she did know what "normal" for me was, and did have enough of a history with me to say something in a casual but direct way.

I've had fitness instructors comment on me being at the gym too much-- even when I was at a healthy weight/place with food [but training for endurance events] in a non-committal way.

You know, if I was doing back to back spinning classes the instructor would be like-- are you sure? Feel free to take it easier/duck out early if you feel like it, or encourage me to get extra fluids/carbs in between or a shake after. I was never offended by this, and got to know a few of the instructors by talking about my training etc.

And that wasn't offensive for me at all, and I think made the instructors feel better/not worry about me in classes, gave me more people to talk to about training etc.

Of course, that's all moot, because you're not on staff at the gym-- but just wanted to add my opinion from the other side.

Harriet said...

Sayhealth,
That's a reasonable idea. I can ask them about putting out info.

Anon, thanks for sharing. I think I have a bias about gym staffers that comes from when my d was developing anorexia. She'd been training at this gymnastics place for years so the 2 coaches knew her well. And they knew, it turned out, that she was getting into trouble long before we did. But they never said anything, to her or to us.

Nice to be reminded that not everyone is like that. :)

pata said...

I'm really not that angry. For example, I see a very fat person huffing and puffing to get around, on oxygen, or riding a mobility scooter. It's clearly their fat that's causing the health problem...or is it? In this community, it would be considered very uncouth for me to approach that fat person and attempt to tell them what they need to do to get better, or to ask them about their health problems at all. Why would you want to do the same thing to this woman at the gym?

Harriet said...

Pata,
I think we've agreed that you can't tell someone's health simply by looking at their size.

You can't assume that someone's health problems are caused by their size, either. For instance, someone who uses a mobility scooter to get around may be disabled by something other than size. Being unable to move much can cause weight gain. So can many, many medications.

I'm not going to rehash the conversation above, except to reiterate that there are other clues to whether someone has an eating disorder than simply their size, that this woman's emaciation was *extreme*, and that the reason I would want to talk to this woman is to offer help with an eating disorder, if that's what's wrong with her. And I'm pretty sure it is. Whereas in your example, you have no idea whether the person in question has an eating disorder.

Anonymous said...

I am not recovered and I feel like I am at my lowest point ever with both disorders. I will offer another perspective. I would be taken aback and probably a little embarrassed if a stranger commented to me, but secretly I would be grateful. I would feel more validated to seek help.

Harriet said...

Thank you, Anon, for your insightful perspective.

Please, please, please, seek out help. You deserve to live a full and happy and healthy life.