Where it all begins, nobody knows.

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Yet I do know.

Sort of.

How my issues with food and body started, that is.

I was 3 or 4, standing in the kitchen after a lazy summer’s dinner on our screened-in porch. My sister was still a baby, my dad the breadwinner, and my mom a happy and (so I’d like to think) fulfilled stay-at-home mother, catering to the needs and attention spans of the ever-jolly Hannah, age 2, and myself, soft-spoken and introverted.

I stood then in the kitchen, bare feet planted on the linoleum floor that never quite shone, watching as mom and dad went through the motions of putting away the remainder of the meal. Potatoes, fresh corn, steamed broccoli, chicken– it was a typical weekday meal, a medley of wholesome flavors and textures heightened with a shake of the garlic salt my parents couldn’t do without.

Hands at my side, wearing my summer uniform of cotton T-shirt and shorts, I experienced suddenly a feeling more painful than any I had felt before. The feeling was not a physical pain, not the stabbing hurt of a skinned knee or a stubbed toe, but rather something deeper. It was, I imagine, in a way akin to a newborn crying out for nourishment or for warmth; an integral need presenting without warning.

I felt this hurt as it spread from finger to finger, from limb to limb. It coursed powerfully through me as I stood there, paralyzed by its resolve.

In that moment, I understood what I had hitherto not known– that I, Sarah, was an ugly, awful being. “Fat” had yet to be incorporated into my vocabulary, but I felt at once too much. Experiencing in that moment the sensation of my flesh and body, I felt profoundly too “too”– too big, too wide, too expansive.

I was at the time of normal size, having grown from a narrow 5-lb. baby to a round toddler, all cheeks and thighs, and subsequently into a gangly child with long, tapering fingers and toes. This revelation of being “too much” held little basis, it would seem, in reality. I was tall, yes, for my age, but neither my height nor weight would have met with anything more than a “normal” rating from my pediatrician.

Still, I experienced in that moment that painful “too”-ness, and desired suddenly to be small and helpless, once again at the mercy of my mother and father for all manners of care.

I remember looking then to my sister, absorbed in her play, and wishing to be like her. Two years, one month and eleven days younger than me, little Hannah was still dependent on my parents for most things. While mom and dad might still have prepared meals and outfits for me, Hannah remained the baby of the family, living in the perpetual land of “not knowing better.” I, I realized, did “know better,” and would from then on be counted on to apply maturity and learned wisdom to daily tasks. I had crossed the threshold from toddler to child, and there would be no turning back. I was a little adult now, for better or for worse, and I hated this.

I wanted to be small, and I wanted to be held. To be nurtured, to be reassured that I deserved, even as I reached the age of 4, of 5, of 6, to be loved as I had been at age 2, at 1, at six months.

This feeling did not last forever, its “too”-ness evaporating after a few minutes, and I soon forgot about it.

But the feeling returned the following year, again without warning, and the year after that. Uncomfortable and just as painful as that first time on a summer’s evening, the feeling would then disappear from whence it came, leaving me to wonder when it would strike again.

The beginning, perhaps, of my self-criticism? My self-loathing?

That’s the theory so far, folks.

As always, to be continued.

And now for some Grub…

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I’ve always been a reader, so it makes sense in retrospect that when I was first diagnosed with an eating disorder and put on medical leave, I spent much of my newfound free time reading everything I could about my “condition.”

While I had always been interested in the etiology of eating disorders, having sensed I suppose my own vulnerability to them, I had at age 18 finally earned my place within the stories and academic inquiries into what it was that would induce a person to develop such behaviors and rituals.

I was, despite my frequent protest that I was simply experiencing a “quarter-life crisis,” an anorexic, leaning on starvation in times of crisis. Starvation afforded me an otherworldly calm that nothing before had, and I was proud of my ability to control tightly my stress by abstaining from food.

So I chose books from the local library that promised to shed light on us “fasting girls,” that might explain what I suspected to be the case– that starving was no different than heroin or alcohol abuse, offering me respite from negative thoughts and emotions.

I began with the early works on the subject– German psychoanalyst Hilde Bruch’s “The Golden Cage”, Steven Levenkron (notable, in addition to his scholarly work, for his work with client Karen Carpenter), then moving on to Joan Jacob Brumberg’s “Fasting Girls.” From there I sampled Geneen Roth’s collection on overcoming overeating and other eating disordered behaviors, seeing myself in the Geneen she described at my age; a person wholly consumed by her body and her hunger.

Perhaps I should have pushed further with this material, pushed myself to write my own version, because I emerged from this exercise in literary immersion not terribly changed than when I had begun. To be sure, I now understood just how pervasive these issues were, and that I was by no means alone in my struggle. But I took a great deal of (unhealthy) pleasure in these books. They fed the connection I did not yet wish to sever with my eating disorder, allowing me to fantasize about restrictive measures that might have been, had I not been stopped by family and the college health center.

I compared myself to the girls and women described by Bruch, Levenkron, Brumberg and so on, holding myself always to the dimensions that these women had reached prior to treatment. I had earned in my flirtation with anorexia the coveted size zero jeans, but many of these girls had met thresholds I never got a chance to pursue– double digits, lanugo*, hospital feeding tubes. I was a straight-A student, relentless in my pursuit of most things, yet the success I might have had as an anorexic had been stymied by college officials and policies. I had been prevented effectively, I later articulated to my nutritionist, from becoming the “best anorexic I could be.”

Learning by way of osmosis everything I could on the subject of anorexia, I was able au moins to eliminate some of the shame I felt regarding my behavior. I was still entirely unsure how to respond to classmates when asked where I had spent my first semester of college, but I had the makings of a vocabulary to describe what I had experienced in that time. A gain not simply in weight, but in self-awareness.

To be continued…

* lanugo= “the fine white hair that grows on anorexics when they have no body fat left to keep themselves warm” (eatingdisorderexpert.co.uk)

A narrow place: Revised

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A narrow place

* mizraim: the Hebrew word for the land of Egypt. In the Passover story, the term is used to describe the constraints and boundaries of the enslavement of the Jewish people.

 

Cold, shivering bones at 18, a narrow splinter of a person

I wondered how far I could take this campaign against my flesh.

 

I made friends on the basis of this skeleton,

friends who wanted for me this existence

this always, enduring mizraim*; a narrow place.

 

Shunning riches of sweet and savory,

I fell into and against the narrow,

clawing at the walls, the boundaries of the place.

 

Now:

“This is nourishment,” I am told;

to meet hunger with open hands, a heaping portion

of self-love and accept myself, broken,

full and hurting in all the wrong places.

 

Then:

Fist to palm, palm to hand outstretched; this I grant myself, reluctantly

finding in the depths a seed, I am pulled from the narrow, and draw myself from its folds.

 

This place has become too slender, and I am at once saturated with its reality,

so trading, helping for helping, what has been for what will be: a continued push outward and upward.

On Doing Without

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Another something to share– I was recently asked by Smith alum Caitlin Scafati ’05, whom Active Minds brought to campus last spring to share her photographic exhibit (as seen on the Today Show!) of women in recovery from eating disorders, to write something for a project she is working on with psychologist and financial advisor Kathleen Burns Kingsbury. The project is entitled “Women, Weight and Wealth” and, according to Kingsbury’s website, aims to explore the often-troubled relationship between women, their bodies and their finances.

Cait put my piece up on the project’s Facebook page (“Women, Weight & Wealth”), where you can read it on the discussion board and see other articles and information she and Kingsbury have posted. Otherwise, here’s the text version:

On Doing Without

Like many women who have struggled with eating disorders and disordered
eating, I can easily point to the period of time in which my struggles
began.

I was 16, about to embark on a year-long exchange program in Western Europe,
where I was to live with a host family and attend the local high school. The
goal was to assimilate as much as possible, to adapt to the foreign customs
and culture that would surround me.

Cognizant of my female body as an entity that needed to be contained and
monitored, I assured myself with great conviction that adopting new ways of
eating and living would not prove impediments to maintaining my current
weight. I would not, I promised myself, gain an ounce while abroad, no
matter how much buttered bread and fatty sausages was pushed upon me.

At orientation camp weeks later in what would become my home for the next
year, I relied on a narrow and ill-informed understanding of proper
nutrition when selecting food from the buffet. Butter and margarine were
out, I had decided, but chocolate was not. Poultry and fish was to be
consumed in moderation, but pork and beef were off-limits.

And so, with only the slightest understanding of what was happening, I
became implicated in what would become a long-term struggle between myself
and my hunger. My desire for sweets, for savory– this became my enemy.

As I met anxieties about “fitting in” with a restrictive approach to eating,
I similarly and unconsciously applied such restrictions to my spending
habits, finding it increasingly hard to dispense money on non-essentials.

While frugality is by no means a negative quality, my thrift became
progressively handicapping, and by the time my family joined me at the end
of the year for a week-long vacation, I found myself a veritable scrooge.
Shelling out several Euros for entrance to the Van Gogh Museum felt too
much; trips to buy essentials at the grocery store resulted in tears. I
couldn’t understand why my mother insisted on buying two varieties of bread
when one would do just fine, and felt myself growing more and more anxious
as I imagined funds wasted.

Returning to the U.S. for my senior year of high school, money became less
of a tense affair, and food as well. By the time my eating disorder emerged
with a vengeance the following year, however, I found myself once again
battling a desire to scrimp and save at all costs. Rich pasta dinners with
friends at a local restaurant were off-limits calorically, but I similarly
eschewed any opportunity that involved an “unnecessary” purchase. Though I
had plenty of money in my bank account, spending dollars felt as impossible
a task as “spending” calories on a latte or piece of bread.

My disordered eating habits have yet to be entirely resolved, but I have
continually found that my attitude towards food is correlated with that
towards money. As I deprive myself of flour and sugar, I similarly deprive
myself of the ease with which to spend a lazy Saturday with friends, sipping
coffee and sharing exquisite pastries.

As I mend my relationship with food, however, I find myself easing up on
restrictions about what purchases are and are not appropriate. Buying a
beautiful book for a friend’s birthday is okay, as is the occasional
cappuccino at my favorite coffee shop.

There is, after all, a time for all things– sweets and trips to the museum
alike.

How ’bout some poetry?

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I haven’t written any poetry in a long time, but I’m trying to work something up to enter the Montpelier-based “Poetry Alive” competition. It needs to be trimmed, but here’s draft one. Comments as always appreciated!


A narrow place


Descent:

Cold, shivering bones at 18

a narrow splinter of a person

I wondered how far I could take this campaign against my flesh

 

I

made friends on the basis of this skeleton

friends who wanted for me this existence

this always, enduring mizraim*; a narrow place.

 

Shunning riches of sweet and savory,

I fell into and against the narrow

clawing at the walls

the boundaries

of the place.

 

Redemption:

This is nourishment, I am told

to meet hunger with open hands, a

heaping portion

of self-love and accept myself, broken,

full and hurting in all the wrong places

 

I am, always

and forever

too much.

 

Ascent:

Fist to palm, palm to hand

outstretched

this I grant myself, reluctantly.

 

Finding in the depths a seed

I am pulled from the narrow,

and extricate myself from its folds

 

This place has become too slender

and I am saturated with its reality, so trading, helping for helping,

what has been for what will be:

a continued push outward and upward.

* mizraim: the Hebrew word for the land of Egypt. In the Passover story, the term is used to describe the constraints and boundaries of the enslavement of the Jewish people.

Another article…

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Appearing today in the Sophian, as a Letter to the Editor:

Fat and fit?

Rachel Johnson’s Nov. 18th opinions piece on the burgeoning “Fat Studies” movement brought up some good points about the challenges of supporting a group marginalized not because of race, religion or ethnicity, but because of size.

As Johnson wrote, the movement strives to eliminate some of the stigma and discrimination that often come with being overweight or obese, as the 66% of Americans that fall into these categories can attest to. Furthermore, as Johnson noted, the field aims to promote the understanding that obesity is not simply the product of indolence and a lack of willpower, but rather a factor of “a range of social, economic and genetic factors.”

While Johnson supports the aim of Fat Studies to rectify the historic mistreatment of those Americans “of size,” she is critical of the notion attributed to the movement that the health community is biased and favors an alarmist agenda with regard to preventing and addressing obesity. While it is certainly legitimate to critique the nascent Fat Studies movement, I believe that Johnson’s criticism does not acknowledge the growing scientific understanding that weight is not necessarily correlated with health or lack thereof.

It is my opinion that public health agencies like the NIH, CDC and others do in fact approach the complex issue of obesity with an alarmist zeal, and perhaps some of that alarmism is warranted. After all, the NIH, CDC and so on have as a goal a reduction of risk to the general public, but their alarmism has done little to curb the growing numbers of Americans with a Body Mass Index of 25 or higher i.e. who are overweight.

What then is the basis of my disagreement with Johnson and others who see Fat Studies as promoting the faulty notion that being overweight and obese does not in fact put a person on a direct path to Type 2 Diabetes and other markers of poor health?

I believe that there is in fact sufficient evidence to suggest that overweight and obesity is not in and of itself deadly/a burden to society/etc. etc., and that some of the deleterious health consequences associated with obesity can in fact be attributed to the stigma that society attaches to carrying “excess” weight.

One avenue of research that has yielded such evidence has focused on the so-called “fit and fat” debate. That is, is it possible to be both “fat” (overweight or even obese) and physically fit? Moreover, is it more important to be thin, or to be fit?

University of South Carolina Professor of exercise physiology, epidemiology and biostatistics Steven Blair has made his life’s work to examine this very issue. Blair is himself an overweight and active individual who, after running almost every day for more than 30 years, is “still short, fat, and bald.” Although his daily activity has not resulted in weight loss, Blair maintains that he is in “much better shape than I’d be if I didn’t run.”

One notable study Blair conducted in 2007 investigated the relationship between fitness, weight and mortality. Fitness was found to be strong predictor of longevity in the participants, all adults 60 and older, while obesity was found to have little influence on risk of death. Especially in older people, Blair reported, obesity is “not as important a determinant of mortality as it is in younger people.”

Synthesizing the study’s results, age, low fitness levels and having multiple risk factors for heart and vascular disease were independently associated with death risk, and better fitness was associated with a lowered risk of diabetes, high cholesterol and high blood pressure.

As for fitness, death rates for those with the highest levels thereof were less than half that of the physically “unfit.” Being overweight and obese, however, was not an independent predictor of death, and among the physically fit, death risk was similar for normal weight, overweight and obese people. Blair also specified that 46% of study participants with a BMI of 35 or higher (“extremely obese”) did not fall into the lowest two tiers of fitness level.

The take-away message? Fat and fit can coexist, and fit is more protective than thin.

Blair is of course not the only researcher to examine the subject. A 2009 systemic review of the literature on the interaction of physical activity, fitness and “fatness” concluded that “the risk for all-cause and cardiovascular mortality was lower in individuals with high BMI and good aerobic fitness, compared with individuals with normal BMI and poor fitness.” These results did not apply to the very obese (BMI greater than 35), for whom risk of Type 2 diabetes and cardiovascular incidents was greater. In a similar vein, individuals who are underweight i.e. on the other extreme of weight, have been found to have a greater risk of mortality.

My point in highlighting this research is not to discount the evidence that a greater BMI may be associated with greater health risk, but rather to suggest that the relationship between weight and health is by no means a simple and straightforward one, and that I believe is where Fat Studies can play a crucial role. By challenging the “x leads to y” hypothesis, Fat Studies can help remind the public that measuring and predicting health is never a simple matter.

When glands are (maybe) to blame

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Read all about it on the Examiner.

Please note that having a BMI of greater than 25 (red alert according to many medical officials) does not inconvenience or even “bother” everyone; that is to say, many people are perfectly happy and healthy at a larger-than-socially-acceptable size. Just pointin’ out that being “of size” is oftentimes not a problem that merits “blaming.”

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