Eating Disorders - Connecting the Dots : Part 4

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

(Page 4 of 7)

"How deprived," Knapp wondered, "how unentitled, how full of sorrow and self-hatred did the essential self become?" The answer, in her experience as a former anorexic - and in mine - was too often too full. But recent surveys suggest that rates of anorexia nervosa throughout Asia and in nonwhite populations as far from Western culture as Curaçao and Ghana are about the same as they are in the Western world (though in societies such as Japan the stigma against seeking psychiatric treatment means that many cases go undiagnosed). Between 10 and 15 percent of anorexics and bulimics are men. And in 1994 Essence magazine surveyed two thousand women and concluded that the proportion of African-American women struggling with eating disorders matched the proportion of white women. Do their eating disorders get at the same "complicated questions" as white women's struggles with appetite? If not, why do these disparate individuals all engage in the same behavior? And do all white, affluent, educated women in fact feel compelled to deprive themselves?

I asked my friend Lindsay to read Knapp's work and tell me what she thought. Lindsay, a licensed therapist with three graduate degrees, is the mother of two teenage daughters. She, Knapp, and I were born just a few years apart, all in New England. Lindsay was a victim of incest as a child and later suffered from severe depression and post-traumatic stress disorder. She has hardly led a charmed life. Yet Lindsay flaunts her bodacious figure and vehemently rejects the suggestion that all white women in our culture are victims of fear and despair. A self-described feminist, she told me she was moved by Knapp's personal story, but her sympathy sprang from the fact that this experience "was so far from my own. Knapp's worldview, which she presented as a 'woman's'worldview, was not mine. As a woman who's never had an eating disorder, that annoyed me."

Tiffany Rush-Wilson's background bears little resemblance to Knapp's. Tiffany spent her early childhood in inner-city Cleveland, surrounded by her extended African-American family. Her family moved to middle-class Shaker Heights, a suburb of Cleveland, when Tiffany was thirteen. That year she "decided to be anorexic" by restricting her diet to McDonald's french fries, but it didn't take. Her parents refused to accept her argument that she needed to lose weight and insisted she eat normal meals with the family. A year later, she read an article in YM magazine about bulimia and followed it like an instruction manual. Tiffany powered her way through college and graduate school, took up marathon running, held down sometimes as many as five jobs at a time. No matter how much she achieved or earned, however, it never seemed enough. For eleven years she remained secretly bulimic. Every time she reached out for help, she was told she couldn't possibly have an eating disorder because black girls were "culturally protected." Now thirty-three, married with a daughter of her own and a Ph.D. in psychology, Tiffany specializes in the treatment of eating and body image disorders. She knows that cultural protection is a myth. "It's in me still," she said of bulimia. "Dormant, but I have to watch for it, especially when I get stressed."

University of New Mexico psychiatrist Joel Yager told me that his work in and around Albuquerque, with patients from rural as well as urban communities, has convinced him that eating disorders span all cultures. He recalled one patient who lived a hundred miles from anywhere. Little town, father is a fifth-generation Hispanic maintenance worker for the county; the mother is a nurse in a residential home for retarded kids. This kid has been raised by these lovely blue-collar people, no competition at all in this family. She doesn't have to succeed to make them look good; it's not that kind of a family. But she's a born perfectionist. Not only is she the first kid in the family to go to college, but she had it in her mind when she was seven years old that she was going to college. That's her sense of self. So when her jerky narcissistic boyfriend went out with her best friend when she was fourteen years old, she started to think, maybe I'm too fat. She realized there was something weird about that, but it stuck in her mind. Eventually the girl became anorexic, just like one of her cousins"and one of her aunts."

A final example that throws Knapp's conception of eating disorders into question is my Santa Fe friend Carol. Duly white and affluent, Carol grew up with a mother who did everything in her power to suppress her three daughters' appetites. The girls were forbidden second helpings at the family table and allowed to speak only in order of seniority (being the youngest of three, Carol rarely opened her mouth). Mrs. York considered excess weight gain a punishable offense and, like Candace's mother, kept herself trim and her home immaculate. Yet Carol emerged from her childhood exuberant, with an appetite for love, food, and art that would not quit. In adulthood, this lust for life has buoyed her through her long battle with cancer. When I recently told her about another of our classmates who had slipped into anorexia after her son went off to college, Carol said, "Maybe it's because my health is so precious to me; I can't understand why anyone would purposely go hungry."

There were doubtless common reasons why Caroline Knapp, Tiffany Rush-Wilson, Candy Lunt, and I all developed eating disorders while Lindsay and Carol did not. There were doubtless related reasons why, long after recovering, Candace, Tiffany, and I still tended toward aggressive self-discipline and restraint. I was beginning to think these had as much to do with how we were wired as where, when, or how we were raised.

Kim Olensky at sixteen radiated the kind of wholesomeness one associates with Miss America. She dated the captain of the basketball team and had the votes to be queen of the prom before school even started. Toward the end of junior year, however, she began to lose weight. Over summer vacation she dropped thirty pounds. She traded her miniskirts for baggy jeans, and her boyfriend the jock for a poet. Senior year Kim carried a pillow because she lacked enough flesh to cushion her tailbone when she sat down. Speculation around school abounded. Something must have happened. Maybe to do with the basketball player. Maybe to do with her hard-drinking father. Maybe she just got fed up with the fawning of all those idiot boys. No one I knew ever got close enough to ask.

The last time I saw Kim, we had recently graduated from college and both happened to be visiting Carol, who then lived in New York. My weight was back to normal, but Kim still needed her pillow. The three of us spent an evening together talking about the older, wealthy men she and I were dating and Carol's recent breakup with her boyfriend from high school. Then, like Candy, Kim moved and left no forwarding address. We had no idea what had become of her until a quarter century later, when Carol's search for her "disappeareds" turned up a number for Kim's older sister.

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.