*CW: discussion of disordered eating
Over the past ten years I have starved and binged and purged, lost handfuls of hair down the drain, and unwittingly encouraged my eight-year-old cousin to shove her Cheerios away. “Not hungry,” she tells me proudly, our stomachs grumbling in sync. What a role model.
I have gulped litres of water to skew mandatory weigh-ins. I have scratched the back of my throat with a toothbrush until I spat blood. I have spent hundreds of dollars a week on regurgitated feasts, and lied to loved ones through the eroding enamel of my teeth.
I have no sense of who I am or what I want. But at least I’m thin.
Slowly, painfully, I’m beginning to understand the futility of disordered eating, both as a coping mechanism for underlying personal anxieties and as a protest against our culture’s misogynistic beauty ideals.
This insight derives from a hobby I share with countless other young women who suffer from anorexia and bulimia. We read. In the absence of food, we devour autobiographies, self-help books, photographic essays and academic texts – anything that might give us an identity, a cure, a good enough reason to live.
According to Marya Hornbacher, the Pulitzer Prize-nominated author of Wasted, an eating disorder is a bundle of deadly contradictions: a desire for power that strips you of all power, a gesture of strength that divests you of all strength. “When you cannot say who you are or where you’ve been,” she writes, “when you’ve reduced yourself to no more than a skeleton with a bunch of puzzling awards, you cannot even begin to have a sense of yourself as a whole person.”
As a 22-year-old who has spent irrecoverable hours slumped over splattered, rancid toilet bowls, I would do anything I could to prevent others from experiencing such virulent self-loathing. That’s what this is about. An eating disorder is a severe, disabling, sometimes fatal mental illness. It’s also a choice. I want to explain what it is that you, your daughter, your best friend, your mentor stands to lose by nibbling the occasional lettuce leaf, downing the bottle of ipecac.
Among other valuables, your self.
In 2006, American photo-journalist Lauren Greenfield released a documentary film and companion book exploring the personal struggles of eating disorder patients at Florida’s Renfrew Centre. In the introduction to Thin, Greenfield notes that “the way girls present, decorate, reveal, and manipulate their bodies is a reflection of society’s conflicting messages and expectations of women.” The paradox in physical form.
Consumer culture urges us to indulge our desires while simultaneously glamorising self-discipline. Creamy chocolate mousse competes with gut-busting diet pills for our wallets and souls, seducing us from consecutive pages in the most popular women’s magazines. It’s hard to hold onto the middle ground in this vicious tug-of-war; much easier to stop struggling, let go of the rope and slip into disorder.
Kathy was a patient at Renfrew whose emaciated, prematurely withered body bore the brunt of society’s punishing dualisms. Then 48, Kathy suffered from debilitating osteoporosis and had lost all of her teeth due to malnutrition. “I’ve had my eating disorder for 33 years,” she said. “I just thought it was the thing to do, part of the whole hype of, you’ve got to stay thin to look good. And now I look like hell. Right now, I’m a 15-year-old girl trying to grow up to be a 48-year-old woman, and I’m not there by a long shot. I’m not even 20 years old yet.”
A tragic fate befalls the girl who stays at home, starving or vomiting or binging, terrified of the challenges outside her door. In the words of Kim Chernin, feminist activist and former anorectic, “her life will narrow… her growth as a human being will cease and in place of all her other strivings and idealisms, she will develop the one, sole, obsessive ideal of becoming thin.” Soon, she cannot imagine a world beyond her plate.
The Eating Disorders Association of Queensland (based in Brisbane, Australia) reports that 0.5 to 1.0 percent of young women develop anorexia nervosa. Significant weight loss due to self-starvation characterises the illness, often with serious physical and psychological complications. The medical effects of anorexia can include hypothermia, brain dysfunction, impaired heartbeat, muscle and cartilage deterioration, loss of bone density, and infertility. Of all mental illnesses, anorexia has the highest mortality rate – death due to physical complications or suicide.
A case in point is the tragic loss of Alana Goldsmith, a 23-year-old woman who stepped in front of a train in 2011 after slipping unnoticed from the Sydney eating disorders clinic where she was receiving treatment. Alana’s death has received a wave of media coverage in the last month after the State Coroner’s Court handed down an unprecedented finding: that anorexia nervosa was the cause of death. This finding has been welcomed as an affirmation that eating disorders are real and they are deadly, and there is not enough support in place for sufferers and their loved ones.
This is perhaps even more the case when it comes to bulimia, often considered the ‘less severe’, ‘less newsworthy’ or ‘less glamorous’ cousin of anorexia.
Bulimia nervosa usually starts with restriction of food intake that leads to uncontrolled consumption of large amounts of food. Feelings of guilt and panic follow a binge, prompting attempts to purge through vomiting, laxative and diuretic abuse, or compensatory exercise. Bulimia affects 1 to 3 percent of young women, placing them at risk of dehydration, electrolyte imbalance, epileptic seizure, abnormal heart rhythm, tooth decay, intestinal ulcers, kidney failure, and death.
Brittany, a 15-year-old Renfrew patient whose story is documented in Thin, spoke openly about the physical tolls of her eating disorder: “My skin was so thin, it was like ancient. I lost most of my hair. Everyone said I looked kind of yellowish-grey. I had fine hair on my face. I was having to shave all of my arms and even my face sometimes, and I had blue hands and feet… My eyes were turning yellow because my liver was not working from throwing up so much. I had canker sores all over my mouth, and for a while I had blood in my vomit.”
People who’ve never ‘dabbled’ in self-starvation may question its appeal. The truth is, you think you’re in control. You’re eating nothing but canned cabbage and diet jelly, you’re running 15 kilometres a day on the cross-trainer, hooking your feet under the bed and doing crunches past midnight. You don’t have the energy to feel angry or sad. Instead, you focus on the gap between your thighs. You touch thumb to pinkie around your upper arm and grin.
Until suddenly, you can’t stop eating. You pay $27 for a large chocolate cheesecake, drive home as fast as you can and shovel globs of stodgy sweetness straight out of the cardboard box and into your gaping mouth. Devoured, untasted, in less than half an hour. Apparently still famished, you race to the grocery store and stock up on supplies: a dozen mini custard tarts, two litres of strawberry milk, peanut butter, macaroni cheese, four double chocolate muffins, frozen pizza, cheese and bacon buns, whipped cream. An elegant buffet.
You stuff food down your throat until you can barely move, your stomach protruding grotesquely. There are empty packets everywhere. Crumbs and guilt. Having gagged down several glasses of lukewarm salty water in a bid to throw up, you wake the next morning to find your ankles puffed up to twice their usual size. You are ashamed.
And you do it all again.
The likelihood and definition of ‘recovery’ from anorexia and bulimia is much-debated. Dr Kathryn Zerbe, author of The Body Betrayed, has found that at least one-third of eating disorder patients remain severely ill at follow-up. Some therapists insist that eating disorders must be managed forever; that freedom from food and body-related struggles is impossible. Eating disorder expert Dr David Herzog is more optimistic in his prognosis, but stresses the importance of early intervention and comprehensive treatment.
It took eight years for me to get sick of feeling like shit all the time; to hope for something better. But, before this hardened sceptic could contemplate recovery, she needed to know it was possible. So I sought advice from Marya Hornbacher. This was a woman who met the full diagnostic criteria for bulimia at age nine, was hospitalised five times before she turned 18, and whose lowest weight was 23.5 kilograms. Here, I figured, was the ultimate authority on rehabilitation prospects.
“I do believe full recovery is possible,” she wrote in reply to my mid-2011 email. “I know that to be true, in fact, because I have reached what I can only describe as just that. Hell of a journey here, no question, and recovery itself is really a journey more than a destination per se. But I myself live at peace with food and with my body – and I know both women and men who have come to full recovery as well. It can absolutely be done. It’s very hard work; it’s a choice to completely change the way you live, perceive, and experience; but it can be done. I hope you will make that choice.”
The decision to diet is the number one risk factor for developing an eating disorder. Researchers at the University of Melbourne have found that girls who diet at a moderate level are five times more likely to develop an eating disorder than those who do not diet, while girls who diet at a severe level are 18 times more likely. The Eating Disorders Association reports that, on any given day, 30 percent of young women are restricting their food intake.
As Naomi Wolf explains in The Beauty Myth, denial of hunger has strong social and symbolic meaning. “Where feminism taught women to put a higher value on ourselves, hunger teaches us how to erode our self-esteem. If a woman can be made to say, ‘I hate my fat thighs,’ it is a way she has been made to hate femaleness.” Compelling, fabricated images of beauty and success (read: slenderness) bolster patriarchal power structures – invisible but equally coercive as the Victorian-era corset.
Economics is also to blame for the erosion of girls’ self-esteem. “Consider,” writes Kim Chernin, “what it means to persuade a woman who is depressed and sorrowful and disheartened by her entire life, that if only she succeeds in reducing herself, in becoming even less than she already is, she will be acceptable to this culture which cannot tolerate her if she is any larger or more developed than an adolescent girl.” It means big business. The diet industry is worth around $600 million each year in Australia alone.
So we become masochists, cultural colluders; addicted to the self-inflicted torture we’re certain we deserve. We gobble a dozen doughnuts and wash them down with tepid lemonade, then hunch over the rubbish bin and purge until the blood vessels burst above our eyes. We run and starve and binge and purge, and we forget what it means to live.
What the hell happened? We were the girls who were adventurous in childhood, who did handstands against the wardrobe at night, who sauntered off school grounds to explore the neighbourhood and spent our banking money on pikelets at the tuckshop. We didn’t realise we were unacceptable. It wasn’t until we graduated from high school with top marks, muffled voices and nothing to look forward to that we realised an important part of us was missing.
I wish I could sit down with my 11-year-old self and get to know that girl. The garlic bread fiend. The sturdy varmint who decided to write a novel in the summer holidays and ride her boogie board down the stairs, oblivious to the meaning of regret. We’d cram into my favourite hang-out – a burnt out van in an overgrown clearing, cluttered with junk and juvenile treasures – and toss marshmallows into each other’s mouths. I’d tell her everything I wish I’d known before my carefree, scab-picking days came to an end.
Gruesome accounts of tooth decay, kidney failure and gastric rupture won’t make individuals with anorexia and bulimia any prouder to take up space in the world. Hope is more powerful. As Naomi Wolf suggests in The Beauty Myth, a girl has much to gain by striving for an imperfect and exhilarating future:
“What if she doesn’t worry about her body and eats enough for all the growing she has to do? She might rip her stockings and slam-dance on a forged ID to the Pogues, and walk home barefoot, holding her shoes, alone at dawn; she might… fall in love with her best friend and do something about it, or lose herself for hours gazing into test tubes with her hair a mess… She might revel in all the freedoms that seem so trivial to those who could take them for granted; she might dream seriously the dreams that seem so obvious to those who grew up with them readily available.”
Each of us shapes the culture we live in, writes feminist philosopher Susan Bordo. In our public activities and our most intimate gestures and relationships, we model attitudes towards beauty and perfection for our children, friends, siblings, students, colleagues and lovers. By extension, Dr Zerbe suggests, “questions about how to take care of our bodies ultimately encompass how we care for all aspects of ourselves and those we love.” How then, as role models and young women in our own right, do we answer those questions?
I can’t “just eat” and spontaneously become the picture of mental and physical health. Eating disorders are complex and recovery is not that simple. I do have some choices, however.
I can cling to my disorder for two or ten or thirty years and become a Brittany or a Kathy; a scrawny, lonely, starving girl who will never grow up. I can become an Alana and step off a railway platform — not because I didn’t try to get well, but because I couldn’t endure the pain of sickness any longer.
What I can do is seek help and give recovery everything I’ve got. I can sit at the breakfast table with my eight-year-old cousin and race her to the bottom of a bowl of Cheerios, milk spraying out of my nose with laughter, our hungers satisfied.
It’s not too late to make good on lost time.
Featured image courtesy of the author, edited by Maria Fernanda Hernandez Tort.