These are ten things that worked for Ned and me. You may find others to add to the list. Somewhere in the thicket of emotional needs and cultural pressures, we all hack our way through. Lisa has a list of her own.
Many people, mothers mainly, ask me how they can help with their daughter’s or son’s fear of food. The questions make me sad and worried that I’m going to disappoint them. These diseases vary so much. Among my friends with anorexia and bulimia, we all played by our own schedules and rules. I’ll do my best with what I do know:
1.
Watch those transition years, from middle school to high school, and especially from high school to college.
If your child is struggling, encourage her to take time off and get healthy. College won’t make issues go away.
2.
If you’re worried about a friend, sibling, or child, it’s okay to say something.
Don’t accuse, but do express concern. Often the ED individual takes silence as an insult. A reality check may be just what they need to realize they have an issue.
3.
Be careful with what you say about someone’s appearance.
Say, “It’s great to see you!” instead of “You look great!” which young girls often take the wrong way. I know I did. Hear it often enough and you think your outer shell is all that matters.
4.
Go out to eat, but avoid buffets.
One evening I was watching the TV show
Intervention
(which should be called
How to Be a Better Addict
) featuring a bulimic woman named Selena. Her sweet husband, Neil, wanted to take her out for dinner after work, but he picked an all-you-can-eat pizza buffet.
Intervention
then filmed Selena, up close, heaping piles of pasta, pizza, salad with creamy ranch dressing, baked potatoes, soup, ice cream, and finally cinnamon rolls onto her little plate. She kept going back, while Neil sat there helplessly. They had driven separate cars to the restaurant, so that while he was paying the check Selena rushed home in plenty of time to purge. She didn’t use the toilet, which he would have noticed. Her system was to throw up into zippered plastic bags she kept in her closet and take them out to the trash when he wasn’t looking. A young bulimic could’ve gotten a few tips from watching
Intervention
, but it did demonstrate the hazards of buffets.
Many in recovery find it easier to just eat alone for a while, because we take any comment about our meal choice the wrong way.
Of course, eating alone can backfire. I’ve had my own Selena scenes, alone in Fresh Choice. I had a system, too. I took my plate and began with greens, healthy enough, and then started piling on the forbidden items like bacon bits, ranch dressing, and croutons. I got a real drink instead of a diet soda and my money’s worth from the restaurant’s soup, salad, pizza, baked potato and bread sections. I especially loaded up on cheesy bread, fried chicken wings, and spaghetti sauce (the juicy-smooth quality of the sauce made it easier to purge the rest). It was like a trance. While I didn’t feel my stomach at all, I knew exactly what I was doing: bingeing and purging. In order to get a good purge, though, I had to hit up the ice cream machine, swirl out the vanilla and chocolate soft serve, and top with caramel sauce, chocolate sauce, and Oreo chunks. I ate this faster than a kid with birthday cake and then dashed to the bathroom. It didn’t take long to see the evidence of my binge before my eyes, to see the baked potato and sourdough roll, the chicken and dumpling soup, and the entire salad bar. I spent $8.99 to continue my disease. Still, my meal wasn’t complete until I went to the nearby donut shop where I bought two donuts, or an apple fritter and a glazed twist, then ate them and threw them up, too.
At the time, I was working at a reading program for mostly Spanish-speaking kids. I spent each lunch hour bingeing, ending with donuts in the car. Then, I’d go back to work, head straight to the bathroom, jam my fingers down my throat, wipe up vomit here and there, and keep jamming my fingers down until I got all the food out. Back in the classroom, I helped a child distinguish words with a soft
g
from those with a hard
g
. I was posing as a good person, as a tutor and mentor to kids. All they wanted was my help for an hour, but I still needed to satisfy my sickness.
5.
Don’t talk about food during meals.
Very difficult, I know, but there is nothing more uncomfortable than discussions of last week’s fried chicken bucket and mashed potatoes while a recovering or hopeful recovering anorexic and/or bulimic sits hesitantly picking at her chicken and potatoes with a side salad, trying so desperately not to engage in an ED behavior. Don’t bring up body image, weight, the pretty girl you used to play tennis with, or anything to do with eating disorders. My parents often did this, and asked me over dinner if I’d thrown up that day. A hard shot of embarrassment paralyzed everything. How do I answer that? If it’s a yes, how will they feel? If no, will they believe me?
6.
Consider modifying the foods you keep in the house, at least temporarily.
Maybe ask the person with the disorder for a detailed list of binge trigger foods. I know it can be hard not to have ice cream around the house, but buy it and it may not even last a day. Don’t fool yourself into thinking that writing your name on whatever you buy will make an impression on a bulimic. I ate one roommate’s entire ice cream carton and bag of chips and didn’t bother replacing them. I figured she was stupid for buying this kind of food, knowing I was bulimic, and for doing nothing about it. She could have called my parents, asked me about it, done something to show concern. As with drug addicts, with ED it doesn’t matter who you trample on to get your fix because if you don’t get it you will explode. I couldn’t have ice cream in the house, because all too easily I would start eating it right out of the carton, and even when I tried scooping smaller amounts into a bowl for portion control, all of a sudden it would be gone and I’d be bending over the toilet, puking it all out.
Baked goods, chips, salty crackers, and frozen or fried foods couldn’t be in the house. Dad would sometimes buy baked goods and try to hide them in the freezer, but during a binge I would scoured the shelves for treats and would always find them. I’d stick to cereals like Special K that aren’t all that interesting to binge on. At my worst, though, I could pretty much binge on anything: a whole block of cheese or a loaf of bread with a stick of butter. Now that’s pretty hard to purge. Bread turns to clumps in your stomach and almost hurts to get out, but I never quit until I was sure. I have, at times, baked cookies or cake not intending to binge and purge them but ending up having a little, and then a little more, and then more until I had no choice—in my mind—but to purge. Once, as a peace offering to my parents after we had gotten into a huge fight, I baked a cake from scratch and spelled out “I’m sorry” on the frosting with chocolate and butterscotch chips. My parents never saw it. I tried a little corner piece, just as a taste, but then the surge of adrenaline passed through my body and a little turned into more, which became me taking a fork and diving right in.
In September 2008, I became horribly exhausted from my extreme bingeing and purging. At the time of this writing, six months have passed. We’ll see. Sometimes I start eating something like chips and have to tell myself to stop. I buy baked chips, for when I really need a salty snack, but, like many salty or sweet treats, there is no satisfying limit to them. I think about bingeing, but know it could ruin my relationship and living situation. I now live in a house with five other people, where there’s very little privacy, and the toilet gets clogged easily. That for sure keeps me from purging.
7.
Know that often you can’t say anything right.
If you mention that you think your daughter’s skirt is too short, prepare for a reaction like, “Oh, so that means I’m
fat
?” People with ED are beyond self-conscious. When I was eighteen and anorexic, I purchased a denim miniskirt and giggled in the excitement of wearing a loose-fitting size 0. When I got home to show Mom, she disapprovingly commented, “Don’t you think it’s a little short?” No, I thought I looked cute! I didn’t want her protective mom reaction. I wanted her to have the same giddy feeling I had to this new skirt and instead of seeing her as my mother, I saw her as a harsh critic. When she said “a little short” about the skirt, I heard it as something was wrong with my body.
Mom was very careful about making
any
comments about my physique. Still, at times no matter what came out of her mouth, she set me off. Or it was the tone or the situation.
Maybe I’m overshooting this, but it seems mothers and daughters will always be in some sort of competition with each other. Either the mother struggled with weight her whole life and her daughter went the other direction as a thin, beautiful young lady; or you have a slender mom and a dieting daughter and the mom—maybe disapprovingly, maybe she thinks she is being helpful—makes comments about the daughter’s weight, which makes the girl even more internally conflicted and uneasy in her own skin. Maybe they are competing for the same body, or they share clothes, or they act like best friends and get coffee together on weekends and exchange shoes for different events, but really, on the inside, one strives to be better than the other.
Mom has mostly, as far I have seen, had the pleasure of being on the slender side. People ask me how she stays so thin yet gets paid to eat, and I don’t have the faintest idea. Good genes? Maybe. All I know is I’ve always been envious of her lean legs. Mine get buff. Every time I get bent on exercising, my legs return immediately to my soccer legs, not to those of lean, petite girls like Mom.
Often Mom makes a comment she means to be complimentary, but I take it in a negative light. If she tells me I look healthy, I take that to mean I look
fat
. If I’m healthy by her standards, I’m no longer thin and therefore must be fat. Once when I was no longer starving myself but secretly bingeing and purging, she told me I shouldn’t eat so many carrots with my lunch, because they were starchy. I couldn’t understand why she bothered giving me grief for eating a vegetable! Too much cheese I could understand, but carrots?
Parents, there’s often not much you can do. Your child has an eating disorder and until that is resolved you may have to keep walking on those eggshells or just keep your mouth shut. Whatever the actual words or tone of voice, those of us with eating disorders often only hear:
You aren’t good enough.
Everyone is constantly judging you.
No matter how hard you try you won’t succeed.
The way you talk, sing, dance, act, paint, exercise, eat, pray all are wrong.
And of course, someone else always looks better, even your own mother.
8.
Question the experts.
Eating disorders and their medical consequences are vast and varied, and I have seen more than enough treatment methods. I know some patients have been helped by psychiatric medicines. My experience with them was terrible. Rather than genetics or a chemical imbalance, I think a lot of my problems were the result of poor nutrition and depletion of oxygen to the brain. My anxiety, depression, and panic attacks subsided with the progress of talk therapy, moderate exercise, and regular eating habits.
For so long I just kind of sat back and listened to doctors, nurses, psychiatrists, and various therapists. When I tried to challenge a diagnosis, I felt like I was met with more criticism and patronizing words. Soon enough I just went along with everything. In the end, I got my way and managed to (silently) prove everyone wrong. I don’t need medication or, in more textbook medical professional terms: There is no conclusive evidence indicating my need for psychiatric medication.
And yet I am often sick. Bulimia does its damage. They were right about that. I have more difficulty breathing when exercising, and digesting food takes a horribly long time.
Being the patient, I don’t know what my parents went through during those hospital visits. I’m sure the experience gave them nightmares and made them very sad. I never meant to hurt them and although my illness was not my fault, I can’t help wishing I could take it all back and start fresh.
9.
Avoid fitness magazines.
If there’s a difference between
Fitness
and
Shape
, I don’t know what it is. I fixated on any piece of “expert” advice, reading in the April issue about how to get a bikini-body ready and in May, how to get the best summer body ever. Different titles, same content.
Since I read my first fitness magazine in high school, I have been trying to get the best bikini body ever and still haven’t succeeded. Recently I scanned
Shape
, featuring “8 Minutes to Your Best Upper Body,” “Bikini Body Countdown” (score! another way to get my bikini body!), “Best New Lower-Body,” “Facts About Fat,” “The Bikini Body Diet,” “Carb Lover’s Diet,” “The Best Fast-Food Breakfasts,” and much, much more. Three years ago I was almost certain I had found the best upper-body workout. I was also almost completely sure that I knew the facts about fat. Then I would pick up a magazine that told me I didn’t know anything, and promised to teach me all there is to know. The problem is, the next month there would be something entirely new.
But of course, fifty experts give you fifty different plans, and then they change. It all becomes a mumbo-jumbo of information overload that is impossible to keep up with, but I tried. Pretty soon there was very little that I felt comfortable eating because at one point in one of my magazines I had read something “bad” about each food. One issue told me to get forty-five to sixty minutes of cardio a day; the next said no, lift weights.
I now realize that dieting and exercise are extremely individual, and what works for one person may not be beneficial for another. Making peace with my sweet tooth has been a good example for me. I have read over and over again that deprivation leads to bingeing and if we are truly craving something, the best thing to do is wait fifteen minutes and if that craving is still there to give in to one serving and enjoy every bite. Recently, however, I stumbled across this nutritionist’s advice in a fitness magazine article on (surprise!) the bikini-body diet:
Many people have something sweet after they eat and I’m not in that habit—I think it’s a habit you can get out of. One thing I do enjoy in summer is some ice cream. I go out for it so I don’t have it tempting me at home. [When] I get the real thing—maybe four times over the summer—I have a small scoop and enjoy every bit of it.
Four times over the summer? A small scoop? Is that not still deprivation? The summer is three months long and so she basically has half a cup of ice cream once a month. What happens if she craves the ice cream in between? Does she wait four weeks?
For a long time I lived in fear of dessert. I thought that if I had just one bite I would immediately blow up. However, I do remember one time, when I was still deep in my anorexia, my friend’s family threw a graduation party for me and a bunch of our friends. Mom had bought an ice cream cake. At first, I was determined not to have any. But as the time got closer to cut the cake, and I saw all the guests, especially my friends, enjoying their food, I somehow let myself go a bit and realized that maybe a piece of ice cream cake wasn’t going to hurt me. And so, I had a piece and not just any slice but a corner slice with extra icing. And then, a surprising thing happened: I enjoyed it! I loved every slow bite. I didn’t get fat. I probably could have had a piece of ice cream cake every week and I would have stayed the same size.