Getting Your Body Back or Losing It? Some ABC's

You will pretty much feel like this.
Battered and out of control and, yes, naked.

As you go through weight gain, self-appointed or supervised, the semiotics of weight rears its Gorgonian head in a serpentine dance with your eating disorder, which appoints itself boa constrictor of your brain.  Low weight and weight loss are celebrated and idolized in our culture.  Especially as you near the point of officially not being underweight anymore, letting your weight inch up can provoke any or all of the following feelings and behaviors:

Anger:  You want to strangle not only yourself, but also anyone who has the gall to notice that you have a body and that it looks good/bad/okay/like a body.  You will want to dump a crock pot of lava down their throats until they shut up.  Even if, say, they're a therapist or nutritionist who's following CBT techniques for treating an eating disorder and not actually talking about your body.

Buffoonery:  You will burst out in public tears over some piece of some kind of food or drink.  Trust me.  It will happen.  Maybe more than once.

Chagrin:  All those people who have watched you lose weight and stay at a low weight are going to wonder what's going on, why you're losing control.  Even if they don't, you're going to remember every compliment they gave your low weight every time you see them or anyone you associate with them.

Defeat:  You are sacrificing achievement by choosing a higher weight.  You are giving up the accomplishment you present to the world, and to yourself.

Ephecticism:  You will totally suspend judgment and the ability to make a decision.  Should I eat the Goldfish?  Should I not?  Am I hungry?  Am I not?  Should I just go back to eating only xyz food?  Every piece of food, every twitch of physical activity will take on innumerable meanings, and you will be on your own as far as picking out the correct one.  Your brain will be a whirlpool, nay, a maelstrom of decisions you are expected to make all the time, WTF?

Fear:  You feel trapped, like you've lost your brakes, totally out of control of where this stops, and fairly certain that no matter what you do, your weight is going to keep going up, and up, and up, and up, and...

You could definitely go through the whole alphabet, and probably the Greek and Cyrillic alphabets, too. And Thai, just for good measure.

The Truth About Weight Gain

La Vérité
Jules Joseph Lefebvre

Over the past 4 weeks or so, I have managed to put and keep on about a pound of fat.  Not water (definitely not muscle, LOL), but fat that doesn't fluctuate one way or t'other, and stays right where it is thankyouverymuch.  I've done this by adding little things (an extra banana here, a matzoh ball instead of no starch there) and suffering through the immediate mood-related consequences.

I want to claw my way out of my skin from my bell button.  I want to lace myself into a corset and meld it into my biology so it belongs there.  I want to jump maniacally on a trampoline until parts of me fly off into the ether.  I feel  so.  uncomfortable.

Although it's antithetical to the philosophy behind decoding and curing eating disorders, I've been making a habit of looking at pictures of me at higher weights, and making myself acknowledge the truth that world didn't end all those pounds higher, during that rounder time.  That I was, truthfully, just fine, more or less.  Not comfortable, still uneasy and squirmy, but fine.  No more unhappy than now (the reverse, of course).   And although one is not meant to assign values of good, bad, better, worse to weights or shapes, it does help to remember that I've come back from a lower weight than I'm at now, to a higher weight than I'm at now, and that I survived, and that after I adjusted back to letting my body do its thing, I wasn't abjectly miserable, as I am now after the banana, or after the matzoh ball.  Or just any time, really, that I notice any perceived change for the larger.

I got through it once, and I can get through it again.  My body is literally built to get me back up there, and fighting nature just makes for misery.  And ain't that the truth?

In the News: Television Eating Disorder How-To's

I've been a busy bee this week, so I thought I'd head to Google News and search "eating disorders" and see what popped up.  It wasn't very hard to find something that caught my eye.

Breaking News - E! Explores Eating Disorders In The New Series "What's Eating You" proclaims E!'s 8/18 press release.  The release promises to be "riveting" television that shows levels of eating disordered behavior "never before seen on television," which is pretty disturbing, when you consider that one of the final scenes on the HBO documentary THIN showed one of the women purging the day she got home.  As in, it showed her bending over the toilet as she vomited.  Intervention had an episode that showed a bulimic vomiting into a sink, in profile.  So I really don't want to know what E! means by "never before seen on television."

On the one hand, productions like this E! miniseries and like THIN do spread the word about eating disorders.  On the other hand, they also function as repositories of tips and tricks.  So do most of the "resources" in this vein.  I've had countless conversations with fellow patients about how we literally learned some of our behaviors from articles about anorexia or bulimia in Seventeen or YM.  The memoir Wasted is also practically an anorexia handbook.  You don't have to be a pro-ana or pro-mia site or blog to teach people how to do it, if they're lookin'.

When I was at the Atlanta Center for Eating Disorders in 2003, there was a policy in place that prevented us from discussing or describing symptoms.  Now, while I think the levels they took that policy to were silly (we couldn't use the words "purge," "restrict," "over-exercise," etc., even if we weren't talking about something we had actually done), I have always understood how the policy came about.  It came about for the same reasons this E! show will be lauded as brave television by some, and studied subversively by some others.  Sad.

om nom nom nom nom nom nom

Oh yeah.  School's starting again.  So not only is it ten years to the week that I've been living in New York, it's time for parents to start getting themselves in mental gear to screen for their collegiate children developing eating disorder symptoms.  (Of course, by the time a symptom is noticeable even to a parent, the disorder has already been in gear for a while.  But we can always hope.)

And for the love of chubby toddlers, people - don't harp on the supposed "Freshman 15" if your daughter or son comes home for winter break looking a little more callipygian.  If I see one more "news" item about How To Avoid The Freshman Fifteen!!!! I am going to hurl, and I don't mean that in a bulimic way.  I mean that in an "I will hurl a brick through the news organization's front window" way.

Thoughts on Maudsley

La Comtesse Marzie sent me this link to a Miami Herald article on Maudsley treatment with the following commentary:  "Kinda scary.  It has the potential to be so abusive and coercive, no?"

The above article calls Maudsley little-known, but I'm at least a little familiar with it, by way of Harriet Brown.  I just don't know if it would work long-term in any but young cases, and while this piece states that later on, along with paying lip service to the idea that some parents really do contribute to EDs, this Miami Herald article kind of gets my ears steaming.  The problem isn't so much Maudsley as it is the article reading more like a press release than a piece of journalism. 

For instance:  the focus on refeeding and weight restoration is a cornerstone of all anorexia treatment, so this article does traditional therapies a disservice by suggesting this initial focus is unique to Maudsley - and outright stating that refeeding is ignored in "traditional therapy," in place of blaming parents for the disorder.  It is accepted medical fact that emotional and psychological repair can't occur in a state of starvation, and anyone who knows anything about ED treatment know that "traditional" therapy is a more intelligent construct than to ever suggest something as simple as, "the parents did it, the end."

Another fallacy the Miami Herald article blithely tosses in: "traditional anorexia therapy often excludes parents from treatment."  No!  No, no, no!  Not unless you redefine the word "often."  Not often!  NOT often!  Family therapy is an integral part of the best-known and more traditional U.S. treatment centers.  Renfrew, Remuda Ranch, Cornell - they all employ family therapy for many patients, as do dozens of smaller centers whose approach is based on those big three.   

Finally, later in the piece, the Miami Herald writer notes that Maudsley has its highest success rate with younger patients whose anorexia has been of relatively short duration.  There's about a two-paragraph concession to journalistic footwork toward the end of the article, with one quotation from a patient whose relationship with her parents was damaged by Maudsley and who didn't feel treated "as a whole person."  Then the piece moves back to Maudsley worship.

Again, I'm not convinced that the problem is Maudsley itself.  (However, it's hard to imagine - from an older patient's perspective - a treatment course in which refeeding is literally not explained or discussed while it's going on, at the hands of professionals, much less parents.) 

In a perfect world, the basic steps make sense.  But most families that produce eating disordered children are not perfect little worlds.  (Is any family, even one with perfectly adjusted children??)  In more dogmatic and controlling families, especially, the warped sense of self that is at the root of so many eating disorders is NOT going to be repaired while the child is immersed in only the environment that produced the warped sense.  Similarly, if a child has learned eating disordered behaviors from a parent (as children so often do, whether or not the parents will acknowledge it), then the parents had damn well better have training about and insight into their own behaviors and how to modify them.

The success rate of Maudsley for younger patients is impressive, especially at five-year follow-ups.  If that statistic reflects reality, it's great.   But you'd have to be one seriously open-minded parent with a penchant for being brutally honest with yourself about yourself to execute Maudsley in an emotionally responsible manner.

Women's Perception of Women: "Skinny Whore"

Never mind.  I do have something to say.  But please continue to the post below and the Gratuitous Kitteh Picshurz.

As usual, there are all stripes of post-BlogHer roundup posts floating around the ol' BlagoWeb this post-BlogHer week.  They range from ruin-your-keyboard-with-Perrier funny, to dry lists of activities, to fabulous gluts of pictures to... well... to totally gobsmacking.

A post to which I will not link* recounts a meeting in a Hilton elevator.  The blogger is asked by a fellow elevator rider if she is, in fact, a blogger.  When answered in the affirmative, the stranger tells our blogger that she "fits the bill" and elevator chick will leave something with the concierge for our blogger.  We get no description of elevator chick, other than that she is "this very interesting chick."  Later, picking up her gift, our blogger discovers that elevator chick left her a large bottle of humidity-control hair product.

At this point, elevator chick ceases to be elevator chick and becomes a "skinny whore."  

This transition:  I have issues with it.

How is her body size relevant?  Is she a whore because she's skinny, or was she being paid by some guy in the elevator while he was zipping up his trousers?  Is she a skinny whore because she has inadvertently (and admittedly in a really gauche way) insulted our blogger?  What if the gift had been free eyeshadow?  I'm guessing she would have remained in the realm of interesting elevator chick.

One of the Comtesses asked me if there is any insult for a marketing shill that wouldn't have rankled.  Sure, I can think of a few.  "Graceless marketing shill."  "Marketing shill who needs to think about how she'd react if someone approached her with those words."  "Girl who really wanted to go to BlogHer but couldn't make it without sponsorship from a brand willing to pay her way."  (Except I that last one's not an insult.  BlogHer is expensive.  Sure, there are more subtle ways to fulfill your sponsorship duty, but why should money prevent you from the experience?)

Can you imagine if elevator chick had been labeled "fat whore"?  How about "ugly whore"?  But because elevator chick is "skinny" (whatever that means), we can criticize her body and roll all our feelings about her momentary lack of social grace into a perception ball, implying that because she looks a certain way, she is a certain way.

Any time I see body shape or size being used against someone in an arbitrary and, basically, uncalled for manner, I will protest.  Most people have at least one thing that they just don't find funny, that others will suggest they lighten up about, and this is one of mine.  I don't think making malicious assumptions about someone based on their body shape or size is acceptable, in jest or no.

Sometimes I'm just no fun.

* It's not that I don't want to send traffic her way.  It's that I have never read her blog before.  Therefore, I don't want to give the impression that my thoughts on this post are My Thoughts On This Blogger.  I don't have any thoughts on her yet, other than that she seems very outspoken in her humor.

Playing the Part: The Urge to Prove It

It is a common fear in the eating disorder treatment process that if a patient is not at a low enough weight, then her disorder will not be taken seriously (translated to a more basic and generally accurate level, that no one will give a shit about her).  The fear isn't entirely baseless; there is a wide-ranging misconception that if someone is not gaunt, she is not sick, and the misconception isn't confined to those who are unfamiliar with eating disorders.  A fellow patient of mine once said to me, "What do you think about Paris Hilton?  I don't think she has an eating disorder.  I mean, she's never looked emaciated to me."

I spent the weekend of BlogHer with some of my best friends, all of whom are aware of and well-versed in the basics of eating disorders.  If there's anyone on the planet who will be concerned about my well-being regardless of my weight/shape, it's these women.  But from the word "go," any time we were around food I was distracted from the conversation and the experience of just being with them by whether or not I was eating - I kid you not - too normally.  Friday lunch I was horrified to find that I'd finished the perfectly healthy protein portion of a salad because I was paying attention to my hunger and satiety cues.  Thursday night I did my usual weird food ritual where I remove all the protein/dairy from a salad and eat it last (Friday lunch I ate it first!  Because I wanted to!  How hideous!), and then I actually finished the protein and dairy which were, again, not huge portions.  You'd think I'd be glad to be eating in such a way that wouldn't leave me starving and distracted later, but no.  On some level I was always preoccupied with whether I was playing my part and proving my disorder.  To women who had ALL seen me eat multiple times before, and who couldn't care less, in the best possible sense.

So it shouldn't have surprised me that Saturday was a Bad Day.  At lunch I felt acutely uncomfortable with - again - a salad and some protein.  I could feel the stirrings of anxiety, but set it aside and tried to invest myself in the company instead.  A cab ride later, I was awfully car sick, and I did the only thing that works to alleviate my motion sickness:  I got some sparkling water and some crunchy snacks.  It worked on my nausea, but I began to get very concerned with how much cracker stuff I'd just consumed.  By the time we got to dinner I was feeling pointedly squirmy, and when the waitress made kind of a thing about what I wanted to order, that was it.  I ate my house salad and was able to get through about half a sushi roll and maybe a dozen pods of edamame.  (For reference, the nutritionist's take on appropriate sushi consumption is "two rolls and two pieces, in addition to vegetables and/or other protein, depending on the composition of the rolls.)  I had a rolling panic attack later, which is exactly what I didn't want to happen on our last night together.

So over the whole weekend, I missed out on being fully with my friends multiple times, and I enacted a sort of self-fulfilling prophecy of twitchiness.  Since it was an event whereby I can measure concrete time (like a holiday or a birthday), I was all too aware that last year I had no such attacks or severe preoccupations.  I considered what I ate in Chicago, but I didn't let it consume me (pun intended, har har har).

This week I have a call set up with an intake counselor for a program of support groups.  (Free ones!)  If I needed evidence that it was time to make this call, I certainly have it now.

The Public Body and Extempore Expressions

Were you at The People's Party or Queerosphere on Thursday night before BlogHer?  If you saw the chick in the turquoise wig and the red silk corset, that was me.

I got a lot of comments on the costume (all the Comtesses did, though we were missing our Empress and not whole without her), most of which were some variation on, "I love it!" or "What are you guys dressed up as?  It's so fun."  

One woman approached me twice.  The first time she said, "Look at your waist.  It's ridiculous!"  Later it was, "And your waist - we're just not even going to talk about your waist."

I couldn't do much other than crack a flustered and probably slightly psychotic smile and stammer, "Uh, ah, well, uh."  Being in a bathroom full of strangers it felt appallingly rude to say baldly, "I write an eating disorder blog," though that did occur to me after the second comment the woman offered later.  I certainly didn't want to say, "Hey, thanks!" because the idea that my body (and by extension myself) is only worthy of notice if I'm a certain size is exactly what I'm trying to train myself to back away from.

If I'd bluntly described my blog in response to what was superficially a compliment (and a dig at her own body), it could have been perceived as unspeakably rude to make her feel embarrassed by her comment, or it might have opened up a dialogue about parsing and commenting on other people's bodies.  Don't know now, since I didn't speak up.  Regardless, while I did tell people who asked that I blogged about eating disorders, I wasn't up to doing so in front of a bathroom full of strangers during what was otherwise a pleasant conversation.

The problem, of course, is that without someone speaking up in the moment and saying, "I'm not sure you realize that you've just reduced my body to my waist line, and I know you don't realize how that gets into my head," no one who isn't already aware of the problem will learn to examine the way they think about bodies, and the way they speak about them.

It was an unguarded duo of moments for this woman.  She was the only person the whole night who commented on my body, rather than on the costume.  That she was is actually incredibly heartening to me.  But aside from the other Comtesses (who heard both the remarks, and one of whom actually exclaimed, "Are you serious?!" after the first one), I have no idea whether the other women who heard the comments thought them at all unacceptable or unfortunate.  They were both of those things, though I don't believe she said them with any malice.

I didn't get the sense that it occurred to her to analyze her words.  "Your waist is ridiculous."  "We're not even going to talk about your waist."  I realize they're colloquial expressions, but they have meaning, and they were coming out of the mouth of a tipsy gal, so, ya know, in vino veritas.  Ridicule and shunning, applied to a body part.  Not what she intended, but what so many people do countless times a day without even realizing it.  We reduce people to their waistlines or their legs or their breasts, and to us they become subsumed by the body part.  This process is nakedly apparent in unguarded or spur-of-the-moment exclamations and interjections.  Hopefully at some point I will develop the social grace to handle these things in the moment.  But I'm certainly not there yet.  I'm still at the deer in headlights stage.

Well.  It's good to have goals.

Placeholder: Eating Disorders and Orthodox Judaism

Still unspeakably busy.  There's so much I want to blog about lately (especially the Girls Gone Wild lawsuit discussed by Fannie, among others), but there is no time!  Here's another placeholder link, this one on the intersection of eating disorders and identity.  Hopefully later this week (or next week? or the week after?) I can come back and deal with this one in more depth.  Lots of inneresting stuff at work here.

Eating disorders a hidden problem for Orthodox Jews
by Eleanor Goldberg, for Religion News Service

Two pieces that are of particular interest to me:

“It’s not this evil thing anymore,” Hart shared of her relationship with food. When she toils in the garden’s acre of produce, she often thinks, “this is what a zucchini looks like—it’s beautiful. It’s magical.”

and

The problem is as much cultural as kosher, experts have learned. They discovered that a skinny bride in her early 20s is often idealized as the ultimate prize, as well as her quick evolution into a mother of a large brood.

“I speak to boys who tell me they want someone who’s a size zero or size two,” said Frank Buchweitz, director of community services and special projects at the Orthodox Union.

Such issues are now incorporated into Renfrew’s group therapy sessions and Jewish-themed classes, starting with the text of a traditional prayer sung by husbands on Shabbat.

“There’s many things your wife is supposed to be—gracious, kind and wise,” Hahn said. “Thin is not one of them.” 

I will endeavor to put some thoughts together later in the week.