Friday, July 24, 2009

Sneak peek: Prologue

Hello all,

I appreciate very much the community that has developed around this blog (and others) over the last few years. Which is why I'm asking if you will do me a favor and read the prologue of the book I'm working on, tentatively called THE DEMON IN THE BAKERY. It's a family memoir about my daughter Kitty's anorexia and recovery.

Warning: This prologue may be triggering for those who are actively eating-disordered or in recovery, so please, skip it.

The rest of you--I'd value your honest reactions and feedback.



Close your eyes. Imagine that you’re standing in a bakery. Not just any bakery—the best bakery in Paris, its windows fogged, crowded with people who jostle for space in front of its long glass cases. The room is fragrant and you can’t take your eyes off the rows of cinnamon rolls and croissants, iced petits fours, flaky napoleons and elephant ears. Every counter holds at least one basket of crusty baguettes, still warm from the oven.
And you’re hungry. In fact, you’re starving. Hunger is a tornado whirling in your chest, a bottomless vortex at your core. Hunger is a tiger sharpening its claws on your tender insides. You stand in front of the glass cases, trying to swallow, but your throat is dry and your stomach clenches and contracts.
You want more than anything to lick the side of an ├ęclair, swirl the custard and chocolate against your tongue. You dream about biting off the end of a cruller, feeling the give of the spongy dough, the brief molecular friction of the glaze against your teeth, flooding your mouth with sweetness. The woman beside you reaches into a white paper bag, pulls out a hunk of sourdough roll. You see the little puff of steam that flares from its soft center. She pops it into her mouth and chews and you chew along with her. You can almost taste the bread she’s eating. Almost.
But you can’t, not really, because how long has it been since you’ve tasted bread? A month? A year? An eternity. And though your stomach grinds against your backbone and your cheeks are hollow, though the tiger flays your belly, you can’t eat. You want to, you have to, but your fear is greater than your hunger. Because when you do—when you choke down a spoonful of plain yogurt, five pretzel sticks, a grape—that’s when the voice in your head starts up, a whisper, a cajoling sigh: You don’t need to eat, you’re strong, so strong. That’s right. Good girl.
Soon the whisper is a hiss filling the center of your head: You don’t deserve to eat. You’re weak, unworthy. You are disgusting. You don’t deserve to live. You, you, you. The voice is a drumbeat, a howl, a knife sunk in your gut, twisting. It knows what you’re thinking. It knows everything you do. It has always been inside you and it always will be. The more you try to block it out, the louder it becomes, until it’s screaming in your ear: You’re fat. You’re a fat pig. You make everyone sick. No one loves you and no one ever will. You don’t deserve to be loved. You’ve sinned and now you must be punished.
So you don’t eat, though food is all you think about. Though all day long, wherever you are—doing homework, sitting with friends, trying to sleep—part of you is standing in the bakery, mesmerized with hunger and with fear, the voice growling and rumbling. You have to stand there, your insides in shreds, empty of everything but your own longing. There will be no bread for you, no warm, buttery pastries. There’s only the pitiless voice inside your head, high-pitched, insistent, insidious. There’s only you, more alone than you’ve ever been. You, growing smaller and frailer. You, with nowhere else to go.
The voice is part of you now, your friend and your tormentor. You can’t fight it and you don’t want to. You’re not so strong, after all. You can’t take it and you can’t get away. You don’t deserve to live. You want to die.
This is what it feels like to have anorexia.

* * *

I’ve never had anorexia, but I’ve lived with it. I’ve observed it closely in someone I love: my oldest daughter, Kitty, who was 14 when she got sick. I watched as the happy, affectionate girl I knew became furious and irrational, obsessed with food but unable to eat. I saw her writhe in terror, heard her beg my husband and me for help and then, in the same breath, shriek that we were trying to poison her, to make her fat, to kill her. I heard a voice I did not recognize come out of her mouth, saw her gaunt face changed beyond knowing. I held her in my arms and felt the arc of every rib, counted the bones in her elbows, saw her breastbone press out through the paper-thin skin of her chest. I felt her body shake and knew that whatever comfort I offered it wasn’t enough, it was nothing in the face of the thing that was stripping the flesh from her bones and the light from her eyes.
I had no idea anorexia was like that.
Before Kitty got sick, I thought eating disorders happened to other people’s children. Not to my daughter, who was savvy and wise, strong and funny, the kind of kid who picked her way through the pitfalls of toxic middle-school friendships. She did fit the profile: she was a perfectionist, fastidious about how she looked and dressed. She was hard on people sometimes, especially herself. She was athletic, a gymnast, traveling around the Midwest for meets; her favorite event was the balance beam—fitting, I thought, for a child who so gracefully walked the line between childhood and adolescence.
But she would never have an eating disorder. She was way too smart for that.
Before my daughter got sick, I thought kids with anorexia or bulimia wanted attention, that they were screwed up and tuned out, bored or acting up or self-destructive. But my daughter was none of those things. She seemed cheerful and well adjusted; she had friends, interests, a passion for new experiences. She wrote her sixth-grade research paper on eating disorders. She knew the dangers. She would never choose to have anorexia. She was safe.
I was wrong about many things, but I was right about that one thing: Kitty didn’t choose anorexia. Anorexia chose her. And it nearly killed her.
At Kitty’s lowest weight, her heart beat dangerously slowly; it could have stopped at any time. Between 10 and 20 percent of people with anorexia die from heart attacks, other complications, and suicide; the disease has the highest mortality rate of any mental illness. Or Kitty could have lost her life in a different way, lost it to the rollercoaster of relapse and recovery, inpatient and outpatient that eats up, on average, five to seven years. Or a lifetime: only half of all anorexics recover in the end. The other half endure lives of dysfunction and despair. Friends and families give up on them. Doctors dread treating them. They’re left to stand in the bakery with the voice ringing in their ears, alone in every way that matters.
Kitty didn’t choose anorexia because no one chooses anorexia, or bulimia, or any other eating disorder. Intelligence is no protection; many of the young women (and, increasingly, men) who develop anorexia are bright and curious and tuned in. Families are no protection, either, because anorexia strikes children from happy families and difficult ones, repressed families and families who talk ad nauseam about feelings. The families of anorexics do share certain traits, though: A history of eating disorders, or anxiety, or obsessive-compulsive disorder. Or all of the above.
I’ve never had anorexia, but I know it well. I see it on the street, in the gaunt and sunken face, the bony chest, the spindly upper arms of an emaciated woman. I’ve come to recognize the flat look of despair, the hopelessness that follows, inevitably, from years of starvation. I think: That could have been my daughter. It wasn’t. It’s not. If I have anything to say about it, it won’t be.
This is the story of our family’s struggle. Kitty was diagnosed with anorexia in June 2005. In August of that year we began family-based treatment (FBT), also known as the Maudsley approach, to help her recover. That was the start of the hardest year of our lives and, especially, Kitty’s. That year, I learned just how brave my daughter is. Five or six times a day, she sat at the table and faced down panic and guilt, terror and delusions and physical pain, and kept going. And she emerged on the other side. After months of being lost, she came back to us and to herself, and the world took on color and sound and meaning once more.
So this book is for Kitty, and for all the children and teenagers and adults who have struggled or continue to struggle with an eating disorder: for your courage, your strength, your capacity to not just endure but overcome. I honor you with every word.

Wednesday, July 22, 2009

10 reasons why BMI is bogus

I love, love, love this piece from NPR on the top 10 (suggesting there are more than 10) reasons why BMI is a bogus measurement. My favorite:

The person who dreamed up the BMI said explicitly that it could not and should not be used to indicate the level of fatness in an individual.

Go read the rest for yourself.

Hey kids!

Want to develop a lifelong obsession with eating? How about an eating disorder? Or at the very least years of self-loathing toward your body? Have we got an idea for you! Start writing down everything you eat. That's right--every single bite you eat goes into this handy-dandy food journal that the folks at the Washington Post think you should keep.

Start now! Before you know it, you'll be on your way to a lifetime of unhappiness!