Bulimia; Science of the Holiday Season and Food

copyright © 2007 Betsy L. Angert

The holiday season is the best and worst of times.  It always was.  The food is phenomenal.  The feelings that fill a heart, mind, or is it my stomach can cause enormous misery.  For a person immersed in the rituals of bulimia the latter weeks of the year are better than all others.  Opportunities to indulge are ample during the holy days.  The selection of food fare is far superior.  Scientific research on food reaps ample rewards.  The secretive practice of self-imposed solitary confinement causes much angst, or could, if one were not able to find an escape in food.

Fortunately, a bulimic can and does take flight.  She or he can sprint to the stores.  There selves are filled with cashew nougat cookies.  Boxes of these white wonders melted in her mouth.  Delicate doughy dinner rolls lined every end display.  These delicious buns were strategically placed in case a customer forgot to grab them when in the bread aisle.  Buns sold for pennies.  Christians, Jews, Gentiles, those who worship Jehovah, Muslims, Agnostics, Atheists, and more must love these doughy delights.  While stuffing was a staple, in the winter, the cost was nominal, and the supply was grand.  She could fill her shopping cart with boxes a plenty.

In the dairy section, sweet and savory eggnog was available.  This liquid ambrosia did not appear before or after the national celebrations.  She could hardly wait for the New Year.  Grocers would reduce the price on this stock and she would buy all she could.  She would place the excess in the freezer and save these for another day.  As America celebrated, so too did she.  However, her festivity was a bit less conventional.

She needed no lights, no tinsel, or tree.  A menorah, or a Kinara were not necessary.  An image of the crescent moon, or the five-pointed star, was not important parts of her ceremonial gala.  All she needed was food.  She no longer required family to enjoy.  Food was her kin, her kind of company.

When Bethany was a child, Thanksgiving Day brought songs of the good cheer.  Merriment filled the house.  Mommy and the little lass would sing all the traditional carols.  Dradle, dradle, dradle, I made it out of clay.  O Tannenbaum, oh Christmas tree, Sleigh bells ring on a silent night.  As December 25th approached, the family dashed through the snow, roasted chestnuts, and pa rum pum pum pumed with the Little Drummer Boy.  Her Daddy said the gaiety made no sense to him.  Yet, he laughed aloud and reveled in the expressions of glee.  Daddy tried not to croon and carol; however, at times he joined in the caroling.

Times were good.  The late November dinner was usually turkey.  Mashed potatoes and gravy made from scratch graced the table.  Home-baked breads also adorned the setting.  Daddy carved the meat with studied finesse.  Mom dished out the stuffing.  Homemade pies and cookies sat in wait.  There were many choices.  Mommy baked for days on end.  Lemon meringue was for Lisa.  Bethany preferred pecan pie.  Dad did not decide until he was ready for desert.  Would he dive into a traditional pumpkin pie or save that slice for another occasion?

In her family, food was considered the means to celebrate life.  Mom, Lisa, and Bethany ate when they were happy, dined when they were sad.  Each of the ladies filled lonely days and nights with chow.  Fodder brought thought; it stimulated reflection.  Realizations occurred over a bowl of soup, cereal, salad, or stew.  Daddy was not as dependent on victuals.  However, Bethany’s first father was a glutton, for punishment and pleasure over a plate of steak, veal, lamb, or lobster.  That man customarily consumed as though there was no tomorrow.

Bethany recalled every New Years Day, Michael sat on the bathroom floor slumped over the toilet bowl.  He puked and purged until he could do no more.  When his stomach was empty, then he would stop, only to await the time when he would fill up again.

For Michael, bingeing and ridding himself of all he ingested was not habitual.  However, it occurred often enough.  The activity was a vivid memory for Bethany.  Perhaps she learned to adopt bulimic behaviors.  After all, aspects of the conduct were part of her experience.

For her natural father Michael, life was an adventure.  He thought it fun to be spontaneous.  Bethany was more of a scientist just as her Grandfather had been and as her Dad trained her to be.  The little bit of a girl questioned everything.  Studious as she was she researched the minutia.  There was nothing in her life that did not involve great thought.

When she first chose to relieve herself of food, it was a calculated decision.  Early one evening, during dinner Bethany ate so much.  After the meal she could barely move.  Consumed with a sense of discomfort she sought relief.  It occurred to her, if she simply flushed out the food, all would be well.  However, she discovered as all scientists do, it is never possible to truly control the environment, or the outcome of any experiment.  Indeed, in an investigation, what seemed a solution to a problem, could, and did control the researcher.

Physiology and psychological components are more powerful than mere mortals might wish themselves to be.  Addictions may begin with a conscious decision as all actions do.  Nonetheless, there are forces that preclude logic and rational thinking.  The body is more than a reasonable brain.

Quickly, what was meant to be a moment became a lifestyle.  Hence, Bethany concluded she must learn to cope.  To survive this young being would have to learn the science of intake and surrender.  She measured her moves.  What edibles went down smoothly, and which released themselves from the stomach walls smoothly.

While cottage cheese is often considered the finest pabulum for those who wish to lose weight, for a bulimic, this provision is a nightmare.  The tiny curds stick to the innards.  The amount of acidic bile needed to breakdown this dairy product is ample.  It seems a single soul cannot produce enough enzymes to eliminate this compound within a reasonable amount of time.  Most cheeses clump once in the digestive system.  

All through the holidays, cups of cheese spreads fill the grocers delicatessen cases.  Spreads are smooth to the taste, and smoother on the tongue as they slide in and out of the most central orifice.

Milk will cuddle if it sits on the kitchen counter for too long.  It does the same if left for any length of time in the stomach.  Eggnog, however, glides through the system.  She knows not if the egg, sugar, or other additives make the difference.  Bethany only understands that this is a delight.

Summer potato salads may be flavorful.  However, a boiled and particularly pulverized tuber does not travel as well as the mashed perennial plant does.  The moist breadcrumbs that we call stuffing are an interesting delicacy.  The ingredients within the mixture matter more than the actual entrée.

Hard cookies can crumble into bits in the outside world.  They do the same once digested.  Miniscule particles spilled on the floor can be difficult to clean up.  When in the body cavity these small pieces scatter.  The fragments of food do not gather in as a group, and exit as one.  Flat crisp baked goods do not easily escape; yet, the holiday goodies cashew nuggets, goes down and comes up as a silk scarf might.

Indeed, the holidays are wondrous.  The food is more fun than time with family might be, or so Bethany hoped as another year approached.  Sadly, in truth, during the winter solstice she felt more alone than she ever did.  No matter the trials and tribulations, the gift of a shared experience means more than any other event might.

Science and food could not, did not, and would never suffice for what she sacrificed.  Those the little bit of a being was closest to were a greater source of solace than what she, a bulimic labeled nourishment.  Nature, in the form of ingested plant or animal products, does not nurture a starved soul.  A satiated stomach could not compare to a heart filled with joy.

Happy Holidays, Merry Christmas, a Joyous Kwanzaa, a regal Ramadan, none would be as long as Bethany remained bulimic.  If only emotions, epidemiology, and the effects of these could be as easily understood as the study of food.

Obesity: Friendship Fills a Heart, Mind, Body, and Soul

Please view How Obesity Spreads Through Social Networks

copyright © 2007 Betsy L. Angert

I awoke to the question; Are Your Friends Making You Fat?  Apparently, according to a longitudinal study involving 12,000 people, if your best friend is obese you are more likely to gain weight.  Researchers say obesity is growing as an epidemic would.  The results did not surprise me; the reaction to such a speculation did.  People postured; “I make my own choices.”  “My friends and family do not influence my decision to take good care of myself.”  The research is flawed.  The findings are faulty.  It is not possible.  Friends cannot make friends fat.

Yet, according to this well-respected study, Obesity Spreads In Social Circles As Trends Do.  All around us we see overweight people.  There are more hefty individuals than there were in years past.  The chubby, chunky, and corpulent fill the streets.  These persons find it difficult to sit comfortably in a chair.  On airlines, the flabby stuff themselves into small seats.  These individuals are stigmatized and suffer physically.  There are many health risks when one’s weight is high.

As the researchers’ note, obesity is virtually epidemic.  Scientists wanted to know why this is and what might be done.  They explored.

The study, involving more than 12,000 people tracked over 32 years, found that social networks play a surprisingly powerful role in determining an individual’s chances of gaining weight, transmitting an increased risk of becoming obese from wives to husbands, from brothers to brothers and from friends to friends.

The researchers found that when one spouse became obese, the other was 37 percent more likely to do so in the next two to four years, compared with other couples.  If a man became obese, his brother’s risk rose by 40 percent.

The risk climbed even more sharply among friends — between 57 and 171 percent, depending on whether they considered each other mutual friends.  Moreover, friends affected friends’ risk even when they lived far apart, and the influence cascaded through three degrees of separation before petering out, the researchers found.

Several state, the theory is thoughtless.  It is obvious, ‘Birds of a feather flock together.’  Even the esteemed doubt the veracity of the study.

Some researchers, however, questioned whether the study had fully accounted for other factors.

“People pick friends because they are similar in the way they eat or the way they move,” said Barry M. Popkin, who studies obesity at the University of North Carolina, Chapel Hill.  “It’s a nice piece of work but still stops short of being able to deal with causality.”

I understand this statement.  Look around you.  It seems the rotund rally round the obese.  The plump find pleasure in spending time with others that will understand their plight.  Often we see a heavy miss or missus with a portly mister. 

Some say the truer cause of obesity is in the genes.  Many a chubby child has a corpulent parent, or two.  However, recent trends, a population growing large by leaps and bounds may disprove that theory

Any physician, dietician, or athlete might tell you there are other matters to consider.  We must take cause and effect into account.  Each of these experts has evidence.  They can demonstrate numbers make a difference.  Calories count.  Exercise is important.  If you want to lose weight, get off the couch.

Certainly, friends cannot make us eat what we choose not to.  Most individuals think themselves freethinking, independent, separate from all others.  Numerous persons interviewed on the topic declared, ‘Friends and family cannot and do not influence my food intake, or much else.’

Considering one ‘close’ association, I could make that argument.  I was never a victim to peer pressure.  I was, am, can be very independent.  I revel in my autonomy.  Acknowledging that I do care about every aspect of life, what others think, say, or do has an emotional effect on me.  However, I do not recall a time that I let the desires of another affect my decisions.  I did not, and do not, follow the crowd.  Dawn’s eating did not direct mine.

Dawn and I have been friends since Middle School.  We attended the same High School.  We hung out together.  Up until little more than a year ago, we lived only fifteen miles apart.  At times, our weight was similar, on other occasions it was not.

I recall during our freshman and sophomore years in secondary school, Dawn and I spent hours doing whatever it was we did.  We lunched; did dinner, and yes, of course, there was snack-time.

I often felt as though my friend was encouraging me to eat.  ‘Here, have this.’  ”Try that.’  It is delicious.  I recall contemplating, did Dawn want me to be fat?  If I gained weight, would she think it fine for her to add a few pounds?  It seemed to me, she wanted to be the thin one.  If I lost weight, I sensed that she thought she too would have to reduce the tonnage.  I cannot be certain; nonetheless, I experienced a subterranean competition. 

Since childhood, I shied away from competition.  Rivalries feel antagonistic to me then and now.  Perhaps that is why I never fully related to Dawn.  There was an air, an aura that I found disturbing.  When we were young, some thought we looked alike.  Each of us said aloud, we do not see it.  Possibly, she too knew we were not close.  We have known each other for decades, and no matter the miles between us, remain [barely] in touch.  However, our weight gains and losses do not support the findings.  Therefore, one might think that I would consider this study lacking; yet, I do not. 

Appearances are deceiving.  Often companionship is an illusion.  People may seem close and still independent; However, I experience if an individual authentically admires their chum, they are influenced by that person, In my estimation, truth be told, Dawn and I are not good friends.

For me, observations corroborate the conclusion of this study.  I think the results of this report are valid.  Ample investigation reveals that the influence of friends reaches far beyond the superficial.  Individuals do not merely imitate those they spend time with.  Nor do people choose to engage with others that do as they do.

I believe this comprehensive report considers the cause and effect of obesity beyond calories and exercise.  We all wonder why do the pounds not peel away when we diet and deliberately do our calisthenics.  Many muse; why do I often slip back into old habits, or how might I adopt new, more productive, patterns of behavior. 

Some seek social environments that promote weight loss.  For a few, this works.  However, consciously or not, for most, a little help from their friends does more than assistance from strangers might.  Those we are fond of ignite a fire that fills the heart, mind, body, and soul.  Miles do not lessen the effect of a strong association.

This research compares and contrasts the power of our connections.  For centuries Social Scientist have acknowledged, people learn from those they most admire.  Friends speak a language that cannot be replicated.  Reciprocal reverence helps us to realize what we would never dare imagine on our own.

As emotional resources, friendships furnish children with the security to strike out into new territory, meet new people, and tackle new problems.  Friends set the emotional stage for exploring one’s surroundings, not unlike the manner in which caretakers serve as secure bases for the young child.

I recall the influence of a true friend, two, three, four, or more had on me.  My experiences replicate and validate the portion of the study that addresses the benefits of letting another human into your life.  As the experts explain, much of this examination relates to weight gain, for currently, worldwide, and particularly in the United States, people are expanding their girth.  However, not everyone engages in unhealthy practices.  Numerous individuals lose weight with thanks to their friends.  Others not feeling the need to transform their appearance chose healthier habits, just as those closest to them do. 

The same effect seemed to occur for weight loss, the investigators say.  But since most people were gaining, not losing, over the 32 years, the result was, on average, that people grew fatter.

Dr. Nicholas A. Christakis, a physician and professor of medical sociology at Harvard Medical School and a principal investigator in the new study, said one explanation was that friends affected each others’ perception of fatness.  When a close friend becomes obese, obesity may not look so bad.
“You change your idea of what is an acceptable body type by looking at the people around you,” Dr. Christakis said.

Those we admire often look good to us; we see the beauty within.  As we share, we have an opportunity to experience the wisdom that makes them as special as they are to us.  In my own life, those physically near and far have the most amazing, beneficial effect on my decisions and me.  Proximity, in an emotional sense enhances and enlightens my life.  My bodily health is improved as is my psyche, all with a little help from my friends.

I met the person I often title my closest and deepest friend when we worked together.  Danae does not enjoy disruptions.  For her, chatting while at the office is a distraction.  She is focused.  I understand this.  I too prefer being productive.  Stopping to converse, for me, takes me away from the task I wish to complete.

While we worked, Danae and I walked and talked.  We each apologized in advance for the possible lack of eye contact.  We were only willing to split our attention slightly; however, not completely.  Over time, we grew very close; however, I left that job.  I lived almost thirty miles away and took a position close to home.  Danae does not like to drive; nor do I.  For years, Danae and I rarely, if ever saw each other.  Nonetheless, we spoke on the telephone for hours at a time, almost daily.  We discussed everything, and then some.

I recall sharing that my skin was dry.  Every ointment and lotion I tried did little to relieve the itch.  I was scratching myself until I broke the skin.  I stopped using conventional soap.  I switched to Cetaphil® recommended by dermatologist for babies.  While this helped greatly, I never forgot the words Danae uttered as I searched for a solution.  She said, “It is not what you put on your body; it is what you put in it.”  Danae went on to explain much about diet, not in terms of losing weight, but in respect to good health.

I never forgot this statement.  Slowly I began to consider what I put into my mouth.  I studied the effects each food had on my health.  The transition was measured; however, deliberate.

My friend Heather was also a huge influence on my eating.  Heather is a nurse.  Health is her main concern.  Studying the body, chemistry, and physiology are her hobbies as well as her profession.  Heather observed my poor eating habits and said so.  Most of the calories I consumed were in the form of fluids.  Heather spoke of the nutritional value of fruits and how juices cannot compare.  I read much and realized she was right.  I already understood the damage soda does.  I lived it.

You may recall, dear reader, for decades I struggled with bulimia. The idea of putting solid food into my stomach and keeping it down was both a psychological problem and a physical peril.  My body was no longer accustomed to digesting fodder.

Nevertheless, my conversations with Heather helped.  Again, I progressed at a snails pace.  Still, I did not forget all that Heather taught me.  Ultimately, with much effort I was able to eat normally.  To this day, I chomp on whole foods.  I swallow my meals.  The only fluid I consume, excluding a great soup, is water.

Friends or those we are fond of can truly influence our food choices.  I know of mother and son that are not biologically connected.  Circumstances help to create a unique and friendly bond.  They spend much time together.  They snack, eat supper, and raid the refrigerator together.  Each is obese, and each has health problems.  Nonetheless, emotionally they support the other.

Often, one human does provide reason, a rational for the actions of another.  Interestingly enough, though the adage is “Monkey See; monkey do,” indeed, it man is the species that emulates the behavior of others.  People wish to please their compatriots.  In an experiment conducted by Yale University, graduate student, Derek Lyons scientists discovered, as Victoria Horner and Andrew Whiten, two psychologists at the University of St. Andrews in Scotland did.  Three to four year old children imitate the behavior of their ‘teachers’ even if better options are obvious.  Chimpanzees will only do as taught if they are unable to see other, superior opportunities.

Mr. Lyons sees his results as evidence that humans are hard-wired to learn by imitation, even when that is clearly not the best way to learn.

While researchers in the chimpanzee studies conclude imitation may be glorious, emulating another may also at times be hurtful.  Other experiments tell us that at any age we engage in behaviors in order to accommodate or please others.  Scientists in this novel study realize, we are likely to do as those we love do, even if they live far from us, or if they have habits that hurt their health.

Christakis and James H. Fowler of the University of California at San Diego took advantage of detailed records collected between 1971 and 2003 on 12,067 adults who participated in the well-known Framingham Heart Study. The researchers were able to construct intricate maps of the social connections among the participants, identifying spouses, siblings, neighbors, and both casual and close friends.

Sophisticated statistical analyses revealed distinct groupings of thin and heavy individuals, and found that siblings and spouses had less influence than friends, supporting the idea that the study’s findings were not the result of people eating the same food, engaging in the same activities or sharing genes.

And though environmental factors such as living in neighborhoods with lots of fast-food restaurants and no good grocery stores or sidewalks probably play a role, the researchers found no effect among neighbors unless they were friends, and being friends had an effect, regardless of whether they lived nearby. That ruled out common surroundings as explanations for the findings, the team said.

Fowler, speculating that friends could influence one another just by getting together once or twice a year, said, “We were stunned to find that people who were hundreds of miles away had just as much impact on a person’s weight status as friends who are next door.  This is not due to people eating or exercising together.”

The researchers also found that one person’s weight gain increased another’s risk only if the second person considered the first to be a friend.  If not, there was no effect. If each considered the other a friend, the effect was magnified.

“This shows that this is a social process that goes on here,” Christakis said.  “If it was because you had two people exposed to the same fast-food joint or there was something in the air, then the direction of the friendship should be irrelevant. The fact that it is relevant helps us to exclude spurious or confounding effects.”

That was reinforced by the fact that people of the same sex influenced one another the most.  In same-sex friendships, an individual was 71 percent more likely to become obese if a friend did.  But friends and siblings of opposite sexes had no increased risk.

“People are more likely to copy the actions of people they resemble,” Christakis said.  “What we think is going on here is emulation.”

Imitation, emulation, whatever we wish to call it, doing as those we love do may not be wise.  It could be wonderful.  Perhaps, if we are aware of the human tendency to mirror our mentors we will learn to choose wisely.  We may wish to assess not only what our gurus gravitate to, but also what we make available.  If we know that fast food is not healthy, might we consider not placing it in the path of one person, or his pal.  If we are aware of our unhealthy habits and discuss these with those that care astounding change occurs, at least it did for the person I consider my soul mate.

I often find this tale hard to accept.  However, I have heard it repeated often enough, perhaps I must believe it to be true.  As I stated, I was anorexic, then bulimic for many years.  Although I thought surely everyone knew, indeed, only a very few say they did.  The person I call the yin to my yang, the one that I relate to in a manner I cannot describe definitely was aware of what I was doing. 

Regrettably or perhaps fortuitously, she interrupted my deed one day.  I was “caught in the act.”  Yet, I trusted, she would not judge.  Summer understood my pain, as I did hers.  During a bad bout, Summer considered bingeing and purging.  I am unsure how I knew this with certainty, for deciding to regurgitate food is not something either of us felt a need to discuss.  Nonetheless, I had a feeling.

As with most of my friends in Southern California, we lived very far apart.  We met while working together years earlier.  One night, I telephoned.  Summer did not answer.  I had a feeling, I know not why.  I left a message on her answering machine.  The voice-activated recorder accepted my lengthy monologue.  I believe I went on and on for near forty-five minutes. 

I shared all the trauma I lived as a bulimic.  I pleaded, asking Summer not to begin.  I stated that, while I did not understand the physiology, neurology; nevertheless, I knew that this affliction was far more than a psychological choice.  Once the path was taken, turning back was not possible.  As Robert Frost offered, “The only way out is through.”

Later I learned, Summer was seriously contemplating the possibility.  She was definitely disheartened and thought inhaling and exhaling food would numb the feelings.  My speech took her by surprise.  For whatever reason, perhaps because our friendship is as meaningful as it is, she was able to hear my words.  Summer internalized the sentiment.  She trusted my affection was authentic, as was my fear.  Before she traveled too far, Summer decided to save herself.

I personally believe I did little; yet, in her mind I did much.  If nothing else, Summer and I can give credence to this report.  Friends are a phenomenal influence.  We need not blame them for what we do.  Let us embrace them.  I do not think it dreadful that another can influence my choices.  I consider the possibility glorious.  Friends are forever; with thanks to them we are wiser.  I can only speak for myself; nonetheless, may I say, I am grateful that those I love have the power to teach me.

The Thin, Fat, Fit, and Friendship . . .

  • The Spread of Obesity in a Large Social Network over 32 Years, By Nicholas A. Christakis, M.D., Ph.D., M.P.H., and James H. Fowler, Ph.D.
  • Are Your Friends Making You Fat?  By Allison Aubrey.  National Public Radio. July 26, 2007
  • Obesity Spreads In Social Circles As Trends Do, Study Indicates, By Rob Stein.  Washington Post. Thursday, July 26, 2007; Page A01
  • pdf Obesity Spreads In Social Circles As Trends Do, Study Indicates, By Rob Stein.  Washington Post. Thursday, July 26, 2007; Page A01
  • Barry M. Popkin. University of North Carolina, Chapel Hill.
  • Dr. Nicholas A. Christakis., Harvard Medical School.
  • James H. Fowler.  University of California at San Diego.
  • Find Yourself Packing It On? Blame Friends, By Gina Kolata.  The New York Times. July 26, 2007
  • pdf Find Yourself Packing It On? Blame Friends, By Gina Kolata.  The New York Times. July 26, 2007
  • Children Learn by Monkey See, Monkey Do.  Chimps Don’t. By Carl Zimmer. The New York Times. December 13, 2005
  • pdf Children Learn by Monkey See, Monkey Do. Chimps Don’t. By Carl Zimmer. The New York Times. December 13, 2005
  • Bulimia. Anorexia. By Betsy L. Angert. BeThink.org
  • Overweight Children – Adults Face Widespread Stigma and Strain

    copyright © 2007 Betsy L. Angert

    In America and the European Union Overweight Kids Face [a] Widespread Stigma.  Only days ago, I contemplated this truth.  As I watched a family shop, I was struck.  She was young, perhaps ten years old.  She was very heavy.  I wondered how could one little girl carry so much weight on such a small frame. 

    The lass was sweet, quite petite, although clearly troubled.  She had been shopping with her Mom, her grandmother, and her younger brother.  From appearances, it seemed this family was in Target gathering wares for Grandmamma.  They did not give the impression of being poor; nor did they look to be wealthy.  They were average folks; they could have been you or me. 

    This family did not dress well.  Their clothes were clean, just not stylish.  Were this group more fashion conscious pants, shirts, and shoes would have been color-coordinated.  Patterns might have blended in a manner that was more appealing.  However, I guess they were comfortable in casual apparel.  After all, making purchases in a discount department store does not require a person to dress with finesse.  Simply covering your body is sufficient for such a chore.

    The family of four entered the checkout line.  I was standing behind them.  Their exchanges were pleasant.  The children each chose to purchase an item for themselves.  Grandmother and Mom paid for their goods, as did the boy.  Then the young woman did her transaction.  The cashier rang up the sale.  Dollars passed from one hand to another.  There was change.  The school age girl went to place her pennies, nickels, quarters, and dimes into her tiny purse.  A single nickel fell to the ground.  The coin made a sound as it plunked to the floor.  The girl heard the noise and saw the shiny nickel.

    She looked at the currency longingly.  Then, this lass turned and glanced at her family.  They were walking away.  Her brother, mother, and grandmother had not noticed what occurred.  The group was not far and yet, not near to the girl.  It would only take a moment to pick up the coin and move towards the others.  Pensively, the female child considered the nickel.  She looked down and then up and down again.  Finally, she fled in haste, leaving the lonely coin behind.  She never bothered to pick it up, although she did think too.

    It did not seem to me that this little lady thought a five-cent piece was not worth much.  From appearances, or perhaps I am projecting, recalling my own struggle with excessive weight, her greater concern was the effort involved in bending over to retrieve a small piece of anything.  I remember the days, and not too fondly.  My heart went out to this child.  There, but for the grace of G-d, go I.

    I am reminded of the time when I was obese, not pleasing plump, chubby, or fat; I was corpulent.  I grew into a size that was twice that of normal quickly.  I did not consume gross quantities of food.  The portions on my plate, or in hand were not large.  It was actually quite startling to see the weight pile on.  Pound after pound was added to my body mass.  There was no index to guide me.  Indeed, I was eating less than I had for years before this gain.

    However, my weight gain was not an anomaly.  For me, fighting with my body mass was normal.  My family was substantial mentally and physically.  Many of my relatives are big people, not tall, just wide.  The little girl and I seem to share a family shaping, or might I say out of shape.  Her mother and Grandmother were large.  Her brother was not as rotund; however, he seemed to be ready to tip the scale.

    In my family, some were fit.  My Grandpop walked for miles, each and every day.  He was active and agile; a  few relatives are.  However, it seems on average, the propensity toward plump was prominent in my world.  The younger generations in my own family might have mirrored their elders, or perhaps more accurately did as their parents had.  This is true in most families, even the thin ones.  However, patterns change.  In recent years, Americans are shorter and more stout.  For generations, Americans were taller than those in other nations; however, this is changing.

    [H]eight has been stagnating in the US for a decade, and Americans are now shorter on average than many Europeans, including not only the very tall Dutch and Scandinavians, but even the citizens of the former East Germany, see John Komlos and Marieluise Baur (2004).

    While Americans are not expanding upwards, they continue to expand outwards, and the average American, like the average Briton, is now heavier than the weight that would minimize mortality risk given average height.

    This is troubling for many reasons.  Not only is our health and life expectancy effected, so too is our income.  For years, Economists told us tall persons earn more money than the diminutive do.  An inch can increase your net worth by at least a thousand dollars per year.  However, recent research reveals the height you achieve in adulthood may not determine your income.  Stature may not be the key to financial success.

    Tall men who were short in high school earn like short men, while short men who were tall in high school earn like tall men.

    That pretty much rules out discrimination.  It’s hard to imagine how or why employers could discriminate in favor of past height.  If tall adolescents?even those who stop growing prematurely?grow up to be highly paid workers, it’s got to be because they’ve got some other trait that employers value.  [Nicola Persico, Andy Postlewaite, and Dan Silverman of the University of Pennsylvania] believe that trait is self-esteem.  Tall high-school kids learn to think of themselves as leaders, and that habit of thought persists even when the kids stop growing.

    If, during our younger years we do not think we are worthy, excellent, brilliant, or outstanding than likely we will not believe we are the best later in life.  Often, we trust we are admirable when others act as if we are. 

    For the fatter child, the need for approval weighs on their minds.  Much embarrassment is felt, and experienced early on.

    Overweight children are stigmatized by their peers as early as age 3 and even face bias from their parents and teachers, giving them a quality of life comparable to people with cancer, a new analysis concludes.

    At the age of two, nearly three, I recall sitting in the den with a ballpoint pen in hand.  I drew lines on my thighs designating exactly where I wanted the excess meat removed.  I do not recall being ridiculed at home; nor do I remember peers speaking of my weight. 

    I did attend summer camp at that age.  At two and one half years, I was the youngest camper.  Perhaps, being four years younger than all other campers had an effect on me.  Indeed, I was left out of much.  The counselors were not willing to teach me to swim.  My bunkmates did not wish to include me in games.  Being a person that loathes and avoids competition, and always did, I had no desire to participate.  I was somewhat sedentary. 

    Possibly the situation demanded it.  I could not go off and play on my own.  I needed to stay with the group.  Yet, I was separate.  I sat still for hours while my bunkmates engaged in recreational activities.  My situation, although different, mirrors much of what occurs today.

    Lack of exercise is a major factor in the growing problem of obesity, both for children and adults, according to Dennis Styne, a UC Davis Medical Center pediatric endocrinologist who is a recognized authority on issues of childhood obesity.  “Obesity has become a serious health risk in America, and it is reaching epidemic proportions, even in the pediatric population,” Styne says. “Close to 25 percent of America’s children and adolescents are now considered overweight, and the numbers are increasing.”

    I developed habits that hurt my already hurting heart.  The children ran, jumped, laughed, and enjoyed each other’s company.  I could not join in.  They thought me too young.  At an early age, my less active life took its toll.  The pounds piled on.  Later, as the years passed, I was just lethargic.

    They say obese children are victim to teasing, rejection, bullying, and other types of abuse because of their weight.  I was fortunate, I did not experience much, if any of this in my youth.  However, when I reached the age of sixteen, and added a few more pounds, a phrase was used by a loved one to describe me, “butterball.”  To this day, every year from Thanksgiving to Easter when the company with the same name advertises their turkeys, I cringe.

    “The stigmatization directed at obese children by their peers, parents, educators and others is pervasive and often unrelenting,” researchers with Yale University and the University of Hawaii at Manatoa wrote in the July issue of Psychological Bulletin.

    The paper was based on a review of all research on youth weight bias over the past 40 years, said lead author Rebecca M. Puhl of Yale’s Rudd Center for Food Policy and Obesity.

    Research determined the heavier child exposed to such pressure is two to three times more likely to report suicidal thoughts.  Frequently, the young and hefty suffer from other health issues.  High blood pressure and eating disorders are not uncommon.  Yikes, there I am.  I was anorexic, then bulimic.  My eating was out of order.

    I have long been certain that my bingeing and purging was not related to my weight.  Indeed, doing as I did, did not help me maintain a stable mass.  The process stressed my body and my mind.  Anorexia and bulimia are burdensome.  They are as obesity in many ways.  There is great shame associated with starving oneself.  Over-eating and puking do not leave one feeling proud.  People judge those that do not appear perfect or act in a manner that pleases others.  We all criticize ourselves.

    “The quality of life for kids who are obese is comparable to the quality of life of kids who have cancer,” Puhl said, citing one study.  “These kids are facing stigma from everywhere they look in society, whether it’s media, school or at home.”

    Even with a growing percentage of overweight people, the stigma shows no signs of subsiding, according to Puhl.  She said television and other media continue to reinforce negative stereotypes.

    “This is a form of bias that is very socially acceptable,” Puhl said.  “It is rarely challenged; it’s often ignored.”

    In a time when children are growing fatter, we can no longer avoid an issue that is pervasive.  We must consider that they way people treat us when we are young has an effect throughout our lives.  Height and weight evoke a response.  That reaction stays with us.  At a time when childhood obesity overwhelms the planet, we must consider the effect of this epidemic.

    By 2010, almost 50 percent of children in North America and 38 percent of children in the European Union will be overweight, the researchers said.

    While programs to prevent childhood obesity are growing, more efforts are needed to protect overweight children from abuse, Puhl said.

    At times, we as a society must shield children from those that love them most, us.  Sadly, parents, teachers, and friends do not realize how they hurt a fragile heart and soul.  Teasing is thought to be just in fun.  Expecting less of a fat child is considered realistic.  Reacting to personal guilt for not caring for a child as you thought best, in a moment, might seem reasonable.  However, the harm we do is immeasurable.  Children internalize their pain.

    A growing body of research shows that parents and educators are also biased against heavy children.  In a 1999 study of 115 middle and high school teachers, 20 percent said they believed obese people are untidy, less likely to succeed and more emotional.

    “Perhaps the most surprising source of weight stigma toward youths is parents,” the report says.

    Several studies showed that overweight girls got less college financial support from their parents than average weight girls.  Other studies showed teasing by parents was common.

    “It is possible that parents may take out their frustration, anger and guilt on their overweight child by adopting stigmatizing attitudes and behavior, such as making critical and negative comments toward their child,” the authors wrote, suggesting further research is needed.

    Lynn McAfee, 58, of Stowe, Pa., said that as an overweight child she faced troubles on all fronts.

    “It was constantly impressed upon me that I wasn’t going to get anywhere in the world if I was fat,” McAfee said. “You hear it so often, it becomes the truth.”

    Her mother, who also was overweight, offered to buy her a mink coat when she was 8 to try to get her to lose weight even though her family was poor.

    “I felt I was letting everybody down,” she said.

    Other children would try to run her down on bikes to see if she would bounce. She had a hard time getting on teams in the playground.

    “Teachers did not stand up for me when I was teased,” McAfee said.

    A study in 2003 found that obese children had much lower quality of life scores on issues such as health, emotional and social well-being, and school functioning.

    “An alarming finding of this research was that obese children had (quality of life) scores comparable with those of children with cancer,” the researchers reported.

    Sylvia Rimm, author of “Rescuing the Emotional Lives of Overweight Children,” said her surveys of more than 5,000 middle school children reached similar conclusions.

    “The overweight children felt less intelligent,” Rimm said.  “They felt less popular. They struggled from early on.  They feel they are a different species.”

    Fat children are distinct.  They stand out in a crowd.  Actually, in their own mind they are often larger than life.  I know I was.  I was so surprised years later when I saw photographs of myself as a camper.  I was not obese then.  I only thought I was.  For me, it was as Lynn McAfee stated, “You hear it so often; it becomes the truth.”  Even if the words were heard only in my head, they were repeated routinely.  The belief that I was fat became my reality.  In my teens I grew into the person I long thought I was.  I became obese.

    Anyone that has ever struggled with their weight knows, trying to take off a few pounds can be a challenge.  Eliminating the weight of years of mistreatment takes more effort than most can imagine.

    Heavy children are insulted, ignored, rejected, and ultimately resent themselves.  They misuse food.  The weighty wonders may not appear malnourished; however, they are.  The obese do not eat well.

    [P]oor nutrition remains an impediment to health in much of the world today, Much less obvious is the idea that nutritional deficits are an important part of the health story in the rich world today.  Yet there is a good deal of evidence, even?and in some cases particularly?in populations whose most obvious nutrition-related problem is obesity and over nutrition.

    Such mass consumption does not serve our children well.  Nor do our eating patterns benefit us as we age.

    “Obesity rates are increasing fastest among children, and they will carry obesity-related health risks throughout their lives,” Ludwig says.  “An adult who gains a pound or 2 a year through middle age will be at increased risk.  But that is much less dire than the overweight 4- to 6-year-old who gets diabetes at age 14 or 16 and has a heart attack before age 30.”

    Ludwig — director of the obesity program at Children’s Hospital, Boston — says the childhood obesity epidemic has three phases. The first came in the last decade, when child obesity became common but the public health effects weren’t yet felt. Phase two is right now, as we begin to see serious complications such as type 2 diabetes in very young people.  Phase three, Ludwig predicts, is coming soon.

    “But we still have a little time before these children become young adults with diabetes and start to have heart attacks, stroke, kidney failure, and increased mortality,” he says. “It is a massive tsunami headed for the United States. One can know it is coming. But if we wait until we see the ocean level rising over the shore, it will be too late to take action.”

    Sadly, some of those that were heavy as children are already adults.  Older persons, for the most part, do as they did in their childhood.  Even if individuals lose the “baby fat,” the feelings and ill effects associated with obesity often linger.  Lifestyle, habits, health problems are more difficult and daunting than poundage.  There are infinite influences on our body and mind.  The marketplace matters. 

    The advent of processed foods altered the physique and psyche.  Motor vehicles and machines have an effect,  A commuter and computer culture counts.  The number of calories we consume and do not burn off as earlier generations did effects our overall well-being.  There is ample cause for concern.

  • Poor nutrition and lack of physical activity are responsible for an estimated 300,000 to 600,000 preventable deaths each year.

  • An estimated one third of all cancers are attributable to poor nutrition, physical inactivity, and being overweight.
  • Today, we stunt our growth upward and expand our girth outward.  Perhaps, we need to advance our awareness for what motivates us.  Why do we torment the portly?  How easy it is to ridicule and judge.  Frequently, the tall, the thin, those that appear healthy blame the obviously wounded one.  These saintly souls think obesity is a choice.  People are not born fat.  Perchance that is, in part, true.

    It was once thought diabetes or the tendency for this illness was inherited; however, there is ample to reason to believe that is not always true.  Might we imagine that nothing occurs in isolation.  If we are to cure what ails us, we must be open to options that are not easily observed.

    Might we assess why those that gain so easily gravitate to food.  I believe for too long we have presumed the answers are simple.  It is often claimed obesity runs in families.  The genes prime the pump.  Numerous researchers prefer placing the blame on parents.  Habits are learned.  Mothers and fathers are our primary teachers.  Schools receive their fair share of culpability.  Surely if educational institutions supplied more nutritious fodder children would not eat as they do.  Restaurants, food manufacturers all can claim an ounce of responsibility. 

    We too bear a burden; each of us decides what we will eat and enjoy.  We believe we can easily forego exercise.  We all are as the little girl.  Bending down to pick up the nickel is not a simple task.  Our mind may wish to do what we think wise; yet our body says we cannot.  The two work in unison.

    I believe, too often we do not honor the mind body connection.  Possibly, we all are vulnerable to whatever affliction inhabits our bodies.  In recent years, we are realizing that many ailments, once thought to be the result of natural causes are related to diet.  What we eat has power; it effects the brain and bulk.  Might we consider victuals feed us in ways we rarely explore.

    To learn how to work with your appetite center, you must first understand it.  It’s time for you and your brain to become better acquainted.

    As soon as you bite into any food, sensory stimulation of nerve endings on the tongue leads to the release of a number of chemicals, including opioids, into the bloodstream.  You release more opioids — the body’s natural versions of drugs like morphine — when you consume foods high in sugar and fat, creating a powerful, neurochemical drive to overeat those foods. 

    These opioids and other chemicals enter the bloodstream and carry their messages to the hypothalamus, which sends out yet another set of chemicals to regulate appetite.  The more flavors your taste buds register, the more stimulated the hypothalamus becomes, releasing the hunger-promoting hormone neuropeptide Y.  When you taste a lot of flavors at once, the brain releases a lot of neuropeptide Y.

    Meanwhile, in response to the smell and taste of food, your stomach produces the hormone ghrelin, which also stimulates appetite.  It continues to produce this hormone until you eat enough food to literally fill your stomach and stretch the stomach wall.  Farther down the line, in your intestines, levels of several hormones rise to varying degrees — depending on the nature of your meal — either inducing more hunger or turning off hunger..

    Perchance, we might empathize with the chunky little lass.  She is you and me.  Might we consider that our culture provides us with foodfare that harms us.  Society teaches us habits that hurt us.  Some lessons are learned subliminally.  Others are fashioned at the dinner table.  Possibly, we all would be wise to teach and treat the children well.  If we do not attend to the biological, physiological, intellectual, and emotional needs of our progeny, they will suffer as will we all.  If one man, woman, or child is diminished, we all are.  Little girl, may I help you reach for more than a nickel.

    The thick of it . . .

  • Why We Overeat, By David L. Katz, MD, MPH, with Catherine S. Katz, PhD., Authors of The Flavor Point Diet: The Delicious, Breakthrough Plan to Turn Off Your Hunger and Lose the Weight for Good
  • Overweight Kids Face Widespread Stigma By John Christoffersen.  The Associated Press.  The Washington Post. Thursday, July 12, 2007; 3:54 AM
  • pdf Overweight Kids Face Widespread Stigma By John Christoffersen. The Associated Press.  The Washington Post. Thursday, July 12, 2007; 3:54 AM
  • Poor Nutrition and a Sedentary Lifestyle. The 21st Century Plague. 2001 Community Health Needs Assessment
  • The Great Escape: A Review Essay on Fogel’s The Escape from Hunger and Premature Death, 1700?2100.  By Angus Deaton. Princeton University. April 2005
  • Hey, Gorgeous, Here’s a Raise! As For You Fatties, We’re Cutting Your Salaries. By Steven E. Landsburg.  Slate. Monday, July 9, 2001, at 9:00 PM ET
  • Sedentary children Less active kids a weighty problem, UC Davis Health System. October 2000
  • Will Obesity Shorten the American Life Span? Study: without action on child obesity, U.S. life span to get shorter.  By Daniel J. DeNoon. WebMD Medical New. March 16, 2005
  • I Am An Anorexic, Bulimic, A Person!

    copyright © 2008 Betsy L. Angert

    Once you label me, you negate me.

    ~ Soren Kierkegaard [Danish Philosopher]

    An article in the New York Times grabbed my attention instantly.  It appeared in the health section.  The title, “One Spoonful at a Time.”  This writing was heartfelt.  Author, Harriet Brown tells a gripping tale.  It took me to memories of my own struggle with anorexia and bulimia and how these affected my family.  In this exposé, the dilemma of how to treat the condition was thoroughly discussed.  I wish to share my response to this situation and story.  My personal experience of this is vast.  I hope my thoughts, realizations, and rejoinders on this topic will be helpful to those grappling with similar issues.  I trust that the effects of anorexia and bulimia are trials and tribulations for all those afflicted by these.

    The subject of weight alone is a sensitive probing.  An individual need not starve, binge, or purge in wrestling with weight.  On the same day another New York Times essay loomed large entitled “Big People on Campus.”  This commentary contemplated the plight of being “fat.”  I was once that too.  Many may muse in this moment, all anorexics believe they are chubby, and while that may or may not be true, I actually was at times in my life.  My weight rarely was stable; nor was I when reflecting upon it.  However, my weight was never the issue; it was a distraction, a symptom of what was within.  

    As I read the articles mentioned above, when I turned on the television and saw a report on the increasing male bulimic and anorexic population, and as I listened to a discussion focusing on the media, and the message of being thin, I wondered.  Why are Americans obsessed with their weight and avoiding the truer concern?

    Americans spend billions of dollars on books, diet programs, professional weight trainers, and behavioral experts that might deliver them from “evil” otherwise known as “eating disorders.”  Some recount, “I eat too much,” others muse, “I eat too little.”  There are those that think they do not make healthy choices, those that believe themselves fine; their family worries about their physical condition.

    I lived in a plump body; a buff body, a slender body, and one that was sickly thin.  As a child I over ate.  It was what most members of my family did.  As an adolescent, I dieted.  That is what teenagers do.  However, weight was not the trepidation it appeared to be.  My problems with body image were not pressing; nor did my peers influence me.  It was my life at home, in my heart.  Much was disquieting.  My parents were together; yet, they were not.  My natural father was rarely home and when he was, it was not fun for me.  My sisters were close in age and seemed to have a connection with me; however, it felt incomplete.  For me, school began at an early age.  I love learning and welcomed the opportunity; still, there were demands, those I placed on myself.  Life progressed and it seemed perfect.

    I had goals, visions, and dreams.  In my late teens, I wanted to lose my virginity.  That seemed the natural progression, at least in my neighborhood, or among my peers.  Oddly enough, a young man began paying attention to me.  This may not seem unusual; yet, it was.  Those that are closely familiar with my ways and thoughts recognize that this was quite striking.  

    I was never “boy crazy.”  I had no thoughts of marriage or even being in a relationship.  I was and still am extremely comfortable with my own company.  Perhaps, I am a little too independent.  While I have always had very close friends, I was not one to seek physical intimacy.  I did not need company or companionship.  It could be imposing.  I needed time to be me.  Nevertheless, this gentleman delighted in my presence.  

    Yes, we did “connect;” we did the deed; still he wanted more!  Imagine that!  Eric wanted a real relationship, with all the bells and whistles.  I later learned Eric wanted to marry me.  Years, before realizing that his intention was to wed, I freaked.  When confronted with the fact that he wanted us to spend all our time together I panicked.

    Eric was and is an extraordinary man.  Physically, he is quite the “looker,” not my type.  I love brains; brawn does little to warm the cockles of my heart.  He is kind, tender, and evenly tempered.  Eric is infinitely considerate, and amazingly enough, he does love to learn.

    Women fell for him, flocked to him, and fought for his attention, all but me.  Initially, I just saw him as a vehicle for losing my virginity.  I never expected he would fill my mind.  I did not plan to take time and be with him beyond the bed.  I never imagined he would enter my heart.  Yet, he did and that scared me.  I put on weight, lots, and lots of pounds.  I did this as I do most things.  I am exceptionally thorough.  If I am to do a job, I will do it incredibly well.  I grew fat!  Perchance, obese might be a better word.  Eric said nothing.  He still wanted to be with me.

    Now, what was I to do?  All this weight, I wore poundage that poured over the edges of my clothing.  I was uncomfortable in my body.  I needed, no wanted to loose all this excess mass.  I began dieting.  I did it well depending on your standard, and not well, if health is a main concern.  At first, I only wanted to lose what I had gained.  I did this.  Then as the pressures of life grew, my apprehension for food and what would follow were I to eat it grew.

    Years passed, as did my obsession with weight and food.  After a time, apprehension for my impending graduation from college consumed me.  The more I thought about this the more I struggled.  Careers, professions, being more a part of the “real” world, more responsible for my self, it all seemed a sacrifice.  What was I to do or be now?  

    While attending the University, I never hesitated.  I chose my majors and pursued each discipline with zeal.  My course of study never changed.  However, I never expected to graduate.  That was not part of my plan.  I had no desire to leave the sanctuary of school.  I first enrolled in classes at the age of two.  Academia was the world I knew.  What next?

    Next, or soon, I would become a statistic.  Not unlike the “Kitty” in the tale her author mother, Harriet Brown tells.  I was anorexic.  Ultimately, that lifestyle was too difficult.  Starving my self was such a struggle.  I chose bulimia instead.  I “thought” that would be an easier avenue to pursue.  It was not.  I had no control over my life, my weight, my worries, my ways.  A person such as myself that prefers infinite tranquility, found herself in a world of chaos, chaos I created!

    For decades my family deliberated, what would they do?  What could they do?  Some pondered what had they done.  Who was at fault and would the circumstances ever change?  There was much guilt, theirs, mine, and ours!

    I share this revealing story with reason.  Harriet Brown, the parents, the professionals in her tale all do as people customarily do.  They look for facts, quick fixes, simple solutions, thirty-second spots, immediate gratification, and spontaneous change.  I acknowledge the year or more this family invested in re-parenting and feeding their child; one spoonful at a time was overwhelming.  Yet, in the end, wonderment still fills the void of not knowing.

    Ms. Brown discusses in depth the niche, a role, the pondering, the play, the place, and the label each person holds.  Yet, for me, she misses the nuances.  The world within will determine whether Kitty again chooses an addiction with food or the lack of it.  I believe and experience that our compulsions cannot be broadcast through numbers.  I understand the fascination with facts, the need to look for answers.  Nevertheless . . .

    Programs may not be profound no matter what they cost or what their supposed success.

    we asked Kitty’s pediatrician where her other anorexic patients went for treatment.  “When they’re this sick, they go away,” she said, referring to inpatient eating-disorder clinics, where people often stay for two or three months.  The nearest was an hour away and cost $1,000 a day, most of which would not be covered by our HMO.  

    There is ample reason for alarm.

    Anorexia is one of the deadliest psychiatric diseases; it’s estimated that up to 15 percent of anorexics die, from suicide or complications related to starvation.  About a third may make some improvement but are still dominated by their obsession with food.  Many become depressed or anxious, and some develop substance-abuse problems, like alcoholism.  Almost half never marry.  It is thought that if anorexia is not treated early on, during adolescence, it tends to take an average of five to seven years for the person to recover – if it happens at all.

    There are behavioral modification plans and they tout great success.

    Among the few studies done on anorexia treatment, I came across one from 1997, a follow-up to an earlier study on adolescents that assessed a method developed in England and was still relatively unknown in the United States: family- based treatment, often called the Maudsley approach. This treatment was created by a team of therapists led by Christopher Dare and Ivan Eisler at the Maudsley Hospital in London, in the mid-1980s, as an alternative to hospitalization.  In a hospital setting, nurses sit with anorexic patients at meals, encouraging and calming them; they create a culture in which patients have to eat.  The Maudsley approach urges families to essentially take on the nurses’ role.  Parents become primary caretakers, working with a Maudsley therapist.  Their job: Finding ways to insist that their children eat.

    The two studies showed that 90 percent of the adolescents recovered or made significant gains; five years later, 90 percent had fully recovered.  (Two other studies confirmed these results.)  In the world of eating disorders, I was coming to understand, this was a phenomenally high success rate.

    Yet, I think it is essential to consider what works for one person may be the kiss of death for another.  I personally, would have rebelled and reacted more overtly had my parents spent their every waking hour with me, as the Brown’s did.  

    I would not have felt loved, quite the contrary.  I would have felt as though they did not trust me.  I grew up in a family whose primary principle was “No one has the right to tell you what you “should,” think, say, do, feel, or be!”  Granted coupled with this was the belief, “Do whatever makes you happy, as long as it does not hurt anyone” and of course, my reactions were hurting everyone; nonetheless, they were mine to choose.  In my mind and in the family I was raised in, it was accepted, in order to learn we must error.  It is part of our evolution.  To force another to be, as we believe is best gives them no room to grow and discover for themselves.

    Harriet Brown acknowledges that

    The idea that parents should be intimately involved in the re-feeding of their children can be quite controversial, a departure from the conventional notion that the dynamic between parent and child causes or contributes to the anorexia.  Many therapists advocate a “parentectomy,” insisting that parents stay out of the treatment to preserve the child’s privacy and autonomy.  They say that a child must “choose” to eat in order to truly recover.

    However, she chose to believe as Maudsley advocates “no one else knows the child as well or has the same investment in the child’s well-being.  She states, “That felt right to us.”

    As I read Ms. Brown’s re-counting, I was continually struck by the specifics of the feeding process and the lack of luminosity.  There was so little of Kitty’s feelings expressed.  While I trust that her parents spoke to her of her fears, apprehensions, and worries, the details of these discussions were not shared with the reader.

    As I reflected on Kitty’s approaching entrance into high school, my own memories flooded my mind.  I knew while living through anorexia and bulimia, it was never about the weight.  It was the wait, the anticipation of the unexpected, unknown, unidentified, and unfamiliar.  It was the strange, the strain, the mysterious, and the mystifying musings that strangled my soul!

    I do understand the dynamic; the habit becomes the pattern etched into the brain and physical memory.  I comprehend the ever-present question, which comes first the chicken or the egg.  I recognize the theories

    Over the last few years, most eating-disorders researchers have begun to think that there is no single cause of anorexia, that maybe it’s more like a recipe, where several ingredients – genetics, personality type, hormones, stressful life events – come together in just the wrong way.

    What I think is in error is the prospect presented by

    Maudsley practitioners say that focusing on the cause is secondary, ultimately, because once the physiological process of starvation kicks in, the disease takes on a life of its own, unfolding with predictable symptoms, intensity and long-term consequences. Anorexics become almost uniformly depressed, withdrawn, enraged, anxious, irritable or suicidal, and their thinking about food and eating is distorted, in part because the brain runs on glucose, and when it has been deprived over a long period of time, when it’s starved, it goes haywire.  It’s important to get the patient’s weight up, fast, because the less time spent in starvation, the better the outcome.  Adult anorexics who have been chronically ill for years have much poorer prognoses than teenagers.

    In my own life and search for a cure, I found professionals that believed as these do.  I contend, the obsessions of medical professional almost killed me.  Killing with the kindness of tough-love, prescribed by parents or physicians has the potential of doing a person in.  It certainly would have taken a toll on me.

    Thankfully, I located others, those that treat with love, just as my parents did and do.  I discovered “experts” that acknowledge they are not.  They understood the notion that a person that has never experienced an illness cannot fully understand it.  Thus, they turned to me.  My parents and physicians reflected on who they knew me to be as a person.  They thought me wise.

    I was trusted to resolve the situation for myself.  I was given only potassium and talk therapy to keep me alive.  Those in my life trusted my intelligence, my reflective nature, and my ability to be introspective.  The professionals, my parents, and my peers believed in me when I did not.  This was confusing, though extremely meaningful to me.

    Those close to me knew of the tens of hours I devoted daily to eating, isolation, and purging.  They hoped, based on their history and knowledge of me that I was not simply doing binging and purging, but that I was also thinking.  I was working through my concerns and circumstances.  Indeed, I was.  When I finally, she says with great exasperation, found myself, discovered what Harriet Brown might refer to as my demons, I met them with delight.  I no longer; nor did my family or friends need to contemplate the possible impending doom.  I would not, will not return to those trying days of old anorexic or bulimic beckoning.

    Four months after the “change of life” [no, not menopause] giving up my ways, I was thrown into a situation that truly tested my will.  I was in a serious accident.  Unexpectedly, my life went topsy-turvy.  I was badly injured and unable to walk.  The prognosis was grim.  It would be half a year before I could again return to a standing position.  I had perfected the bulimia process through many a situation, and in the past, I would have found a way to again engage.  I had the will and there was always a way.  However, on this occasion I did not return or resort to my decades old pattern.  I did not consider the option.

    Ms. Brown, I share this with you for you are questioning, anxious, what might the future bring.  I myself think behavior modification programs such as the Maudsley plan may be nice.  Their success rate may seem comforting; however, I caution, it is my experience that unless or until the cause is addressed, the emotional effects are evaluated the likelihood that there is true resolution is “slim.”  Many experts say anorexia and bulimia are chronic conditions.  Years after my coming of age, I still do not experience sweaty palms.  I do not white knuckle my way through stressful situations.  I think the emotional, intellectual work is essential.  Kitty may have done the work that you did not speak of.  I know not.  Nonetheless, I worry.  I think “cures” and certainty come with more than one spoonful at a time.

    Please weigh your options.  Read the references.  Reflect who you are, more than your mass.

    Dear reader, you may wish to peruse Chapters One through Six, of my life as an anorexic, bulimic, a person.  Please do.

    A reader asked that I share this information.  

    The National Eating Disorders Association’s “Every BODY Is Beautiful” Online Fundraising Auction currently running through Wednesday, December 6th!  There are some unique holiday shopping (jewelry, handbags, clothing, celebrity-autographed collectibles – featuring customized jeans from The Sopranos’ Jamie-Lynn Sigler and singer Sarah Evans – and much more) while at the same time contributing to an amazing, life-saving cause!

    You may wish to read of the artist in an LAWeekly essay, The Art of Spooning, By Caroline Ryder, or of the fundraiser at SpoonFed Art on MySpace.com.