My Turn: The Real Burden of Eating Disorders

I remember sitting in the waiting area, where "lucky" bamboo grew in glass pots on the receptionist's desk, nervously swinging my platform-sandaled foot and fingering my great-grandmother's locket. I could hear the voices of the other girls, but even if I stretched my neck, I could only glimpse one angular elbow—the rest were blocked from view. All I wanted was to see them, and I only wanted to see them so I could compare myself to them. I was so afraid that I would be the fattest girl at McCallum Place, an eating-disorder treatment facility in St. Louis. I wanted desperately to be a "legitimate" anorexic.

Within a week of being at McCallum Place, I realized that how the other girls' bodies looked didn't matter: the severity of illness was in their minds. Starvation of the spirit cannot be seen on the scale or in the bottom of a toilet bowl. It lurks in the hollow eyes of a person who is slowly giving up on life. If I learned one thing at the clinic, it is that the greatest damage eating disorders do is mental: they are a cancer of the soul. It's not about how much you weigh, even though that's what you think about constantly. Emaciation is really just a symptom—the sickest person is not always the skinniest. Like addictions, restriction and purging are used to numb the pain, to gain a sense of control, power and relief. The depression, fear and hopelessness ache far more than a bony body.

Eating disorders are abusive, selfish, vacuous and deadly—but the media glamorizes them by giving them attention, even when showing a skeletal model on the verge of death. I have seldom come across a truly honest article about the emotional and mental burden of anorexia and bulimia. Instead, it's a freak show: look how skinny so-and-so got, look at the bones and the loose clothing and the sad feeding tubes snaking through their noses or into their abs. "Horrible," we say when we hear about self-induced vomiting or weeklong fasts, but later I overhear the vapid conversations in the girls' bathroom: "I wish I had that kind of willpower." It's sick. In America, we hold up weight-loss, rather than health, as achievement.

Articles should be written about the triumphs of those who strive to become healthy, not the depths of their disease. In treatment, I met beautiful, funny, caring people: the least interesting thing about them was their eating disorder. Oh, don't get me wrong, it was a house of freaks in many ways. We all had weigh-ins, "vitals" checks, bathroom observation, and mandatory meals and snacks together. There was a whole new vocabulary to learn: triggers and add-ons, processing and psychodrama. Girls cried over cheese on their sandwiches. But outside of the disorder, each of us was pretty normal and fun. We played Scattergories, made bracelets, watched "Laguna Beach," got into petty arguments, and laughed about the trials of treatment. Most importantly, we shared ourselves and supported each other as we struggled to recover our lives.

Each week, someone presented a timeline of her life to the whole group. Some patients were in their early teens, and couldn't see why their behavior was harmful. Others were in their 20s, telling stories of broken families and unsuccessful stints in treatment. The story that most profoundly affected me, however, was that of a 40-year-old woman who had spent her life grappling with anorexia. She was no longer skinny: her eating disorder had caused a thyroid condition that made her overweight. She had lost everything to her illness. She migrated from one treatment facility to the next, with stints in the hospital in-between, searching for something to make her whole. She had a very successful career, but she spent every night alone. She was smart, kind, funny and vibrant, but anorexia masked these qualities and sent her into despair. Now she sat among young girls just starting life, but already stymied by sickness. "I am your worst nightmare," she told us. "Don't be like me."

A simple question brings me back to reality when I'm tempted to return to the company of my old "friend" Rexi (we were taught to personify our eating disorder to externalize them—most girls called theirs Ed, but mine is distinctly female). One day our therapist asked us, "What do you want on your tombstone?" The responses mentioned roles like sister, daughter, mother, wife and friend, coupled with adjectives like beloved, kind, caring and honored. Nobody wanted their disease engraved on their headstone, and yet we continued to live lives devoted to it. Even the oldest among us still had a chance to try to break away from the isolation of illness, and leave behind the companion who desires our death.

Anorexia and bulimia kill, but the decay of the soul and mind and personality is the worst part. Beyond the magazine covers and Twiggy bodies lie damaged people, hoping for a new life. An anorexic is a paper doll, a cardboard cutout of a human being. Look for the person crouched behind the false front, and give her a hug. She needs it.