Eating Disorders - Connecting the Dots : Part 3

Gaining: The Truth About Life After Eating Disorders
by Aimee E. Liu

(Page 3 of 7)

I felt this gridlock, too. In my bones. In that silly mug drawing. In my lifelong habit of biting my nails. I glanced across the table. Yes, Candace also chewed her nails, although, tellingly, she had succeeded in restricting herself to her left ring finger.

Was anorexia nervosa merely another symptom of this internal constraint? The more Candace and I talked, the more we did seem to have in common. Our similarities went way beyond where and when we were raised: we both dreaded making a mistake; both hated being the center of attention, even though we craved praise and needed to excel; we didn't laugh easily or openly or trust ourselves to relax. I imagined the two of us standing side by side, question marks tattooed on our foreheads.

That night I said to Candace, "If we went back and talked with the other women we knew who had eating disorders in high school and college, I think we'd find we all have more in common - even today - than we have with the rest of our classmates."

But Candace was not so sure. "Don't you think people change?"

"I think they can when they know what needs changing. Gaining weight was only a first step - for me, at least."

She studied her hands. Something I'd said seemed to pain her. But when she looked up, she said only, "I'd be interested in knowing . . . in hearing those stories."

I thought about asking to interview Candace right then, but Carol and Ruby pulled us in other directions. Besides, I was not yet sure what questions to ask. The skeptic in me warned that women who'd had eating disorders constituted a broad and diverse group. Their lives were affected by a multitude of factors, and if they appeared similar it was as likely because of shared culture as any innate parallel. But Candace's phrase "connect the dots" stayed with me long after I was back in LA. I kept remembering that look she'd shot me as we labored over our mugs, the two of us still holding back in a way no one else in the kitchen that night could understand.

In 1979, when I published Solitaire, anorexia nervosa was generally considered a recent phenomenon, and bulimia had just that year been named - by British psychiatrist Gerald Rus- sell, from bous, meaning "ox" (read: "beastly") and limos, "hunger." In fact, neither disorder was new. In Phthisiologia, or, A Treatise of Consumptions, published in 1694, British physician Richard Morton wrote of a twenty-year-old girl who refused to eat, studied all the time, and looked "like a Skeleton only clad with Skin." Anorexia was named from the Greek an, meaning "lack of," and orexis, "appetite," by French physician Charles Lasègue in a paper documenting eight cases of willful fasting in 1873. And countless girls before 1979 practiced bulimia. Jane Fonda, for instance, learned this "secret" from a friend in boarding school in the 1950s: "We assumed we were the first people since the Romans to do this," she recalled in her memoir My Life So Far. Diana, Princess of Wales, admitted in 1997 that she'd begun bingeing and purging in the early 1970s; and her sister Sarah was hospitalized with binge-purge anorexia in 1975. Yet because the true scope of eating disorders wasn't recognized until the 1980s, most doctors treated such cases back then as mystifying oddities.

In 1978 in The Golden Cage, Hilde Bruch had painted the typical anorexic as a birdlike child "too plain and simple for the luxuries of her home, but also deprived of the freedom of doing what she truly wanted to do." Anorexia nervosa, Bruch suggested, was a symptom of arrested development caused by lack of parental encouragement. She identified overconscientious, overstudious, and compliant performance as a warning sign and noted that when patients first came to her, "they looked, acted, and sounded amazingly alike" even though they had widely differing backgrounds and included several boys. She rejected, however, any possibility that these kids might have looked, acted, or sounded alike before they got sick. The medical similarities, she argued, were due to the fact that these patients were all starving organisms. And the psychological and behavioral parallels were the result of coincidentally parallel family dynamics.

To explain why anorexia nervosa seemed so lopsidedly to affect middle- and upper-class girls, Bruch pointed to "the enormous emphasis that Fashion places on slimness" and the message delivered through advertising that women can be loved and respected only when slender. She also worried that the women's liberation movement of the 1960s, while expanding their opportunities, had intensified the pressure on teenage girls to prove themselves in arenas such as physics, soccer, debating . . . and bed, before they were ready. All this new freedom threatened to overwhelm the overconscientious, Bruch suggested, and some turned to hunger as an obsessional escape.

Feminist social critics deflected the blame by broadening it. In 1978 Susie Orbach declared that "Fat Is a Feminist Issue." In 1981 Kim Chernin described "the tyranny of slenderness" as "The Obsession" that our society imposes on women, primarily through the marketplace and media. The true villain in the feminist portrait of eating disorders was not the mother figure, and certainly not women's liberation, but our image-obsessed, patriarchal society. Anorexics and bulimics were merely mirroring cultural attitudes that encouraged women to use unnatural measures to subjugate their own physical appetites to a warped beauty ideal of prepubescent thinness.

Both Bruch's indictment of family and the feminist analysis sounded logical, but neither theory made sense when compared with eating disorders statistics. Although about half of American women and men are on a diet at any given time and virtually everyone is exposed to advertising, the lifetime rate of anorexia and bulimia nervosa combined is less than 7 percent of the U.S. population. This amounts to nearly twenty-one million people, without doubt a significant problem. Yet while the rate of anorexia has remained essentially unchanged since 1991, the rate of obesity has tripled, to include more than 30 percent of all Americans. So when I read Caroline Knapp's declaration in Appetites that all "white, affluent, and highly educated" women suffer from self-deprivation akin to anorexia, I was more than a little skeptical.

Copyright © 2007 by Aimee E. Liu

About the Author

My past lives include early childhood in India; middle childhood, adolescence, and anorexia in the Connecticut suburbs of New York City; three years of teenage modeling through the Wihelmina agency; a major in painting at Yale University followed by turns as a waitress in New York and a flight attendant with United Airlines. Between flights I wrote my first book, Solitaire, a chronicle of my passage through anorexia, which was published in 1979, when I was twenty-five.