Gaining: The Truth About Life After Eating Disorders

Gaining: The Truth About Life After Eating Disorders

by Aimee Liu
Gaining: The Truth About Life After Eating Disorders

Gaining: The Truth About Life After Eating Disorders

by Aimee Liu


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If you've ever suffered from an eating disorder-or cared for someone who is anorexic or bulimic-you may think you understand these illnesses. But do you really understand why they occur? Do you know what it takes to fully recover? Do you know how eating disorders affect life after recovery? Now, nearly three decades after she detailed her first battle with anorexia in Solitaire, Aimee Liu presents an emotionally powerful and poignant sequel that digs deep into the causes, cures, and consequences of anorexia and bulimia nervosa. Aimee Liu believed she had conquered anorexia in her twenties. Then in her forties, when her life once again began spiraling out of control, she stopped eating. Liu realized the same forces that had caused her original eating disorder were still in play. She also noticed that other women she knew with histories of anorexia and bulimia seemed to share many of her personality traits and habits under stress-even decades after "recovery." Intrigued and concerned, Liu set out to learn who is susceptible to these disorders and why, and what it takes to overcome them once and for all. With GAINING, Liu shatters commonly held beliefs about eating disorders while assembling a puzzle that is as complex and fascinating as human identity itself. Through cutting-edge research and the stories of more than forty interview subjects, readers will discover that the tendency to develop anorexia or bulimia has little to do with culture, class, gender-or weight. Genetics, however, play a key role. So does temperament. So do anxiety, depression, and shame. Clearly, curing eating disorders involves more than good nutrition. Candidly recalling her own struggles, triumphs, and defeats, Aimee explores an array of promising and innovative new treatments, offers vital insights to anyone who has ever had an eating disorder, and shows parents how to help protect their children from ever developing one. Her book is sure to change the way we talk and think about eating disorders for years to come.

Product Details

ISBN-13: 9780446694827
Publisher: Grand Central Publishing
Publication date: 01/02/2008
Edition description: Revised
Pages: 336
Product dimensions: 6.00(w) x 9.00(h) x 0.74(d)

About the Author

Aimee Liu is the author of a groundbreaking account of anorexia nervosa, Solitaire. She has also written three highly acclaimed novels, Flash House, Cloud Mountain and Face. Liu is the former president of PEN West, and lives in Los Angeles with her husband and son.

Read an Excerpt


By Aimee E. Liu

Wellness Central

Copyright © 2007 Aimee E. Liu
All right reserved.

ISBN: 978-0-446-69482-7

Chapter One


When I write of hunger, I am really writing about love and the hunger for it, and warmth and the love of it and the hunger for it ... and then the warmth and richness and fine reality of hunger satisfied ... and it is all one. -M. F. K. Fisher

MY FRIEND CAROL CALLING FROM SANTA FE, sounded elated as she told me her news: after thirty years, she'd finally located our high school classmate Candy Lunt. The last time either of us had seen Candy was at graduation, when she weighed less than 80 pounds. Shortly thereafter, her family left Greenwich. The possible implications of her continuing absence from our alumni directory had haunted both Carol and me.

"You should be a bounty hunter!" I said. "Where is she?"

"I spotted her name on the masthead of Forbes


I called her. Aimee, she still talks in that half whisper from the back of her throat, low and deep - you remember?

Barely. What I remembered more, at least at the end, was her silence.

"She's an editor," Carol raced on. "She lives in Manhattan with her daughter. Somehow, she's okay"

I wondered. As I'd recently discovered, there was a big difference between survival and well-being. "Was she glad to hear from you?"

"She and Ruby are coming to the ranch for a visit next week."

Can you come, too?"

"You couldn't stop me," I said.

Such invitations were characteristic of Carol. She had been diagnosed with non-Hodgkin's lymphoma fourteen years earlier, at thirty-four, and during her first remission she'd launched a personal campaign to track down as many as possible of her "disappeareds" - friends she'd lost through the passage of time. I'd been back in Carol's orbit for twelve years now, and between her life with cancer and my marital separation four months earlier, we were closer than we'd ever been in school. But I was surprised by Candy's quick response after all these years.

"By the way," Carol said before hanging up, "she calls herself Candace now."

So, I thought as I packed for the trip from Los Angeles, Candy's taken a grown-up name. I found this disorienting. I didn't know Candace Lunt, whereas I'd first met Candy in third grade, when we were nine years old. We joined the Beach Boys fan club together. At my house in those preanorexic days, we baked coffee cake. At hers we ate hot dogs. I remember even as a child finding her ranch-style tract house forbidding. My childhood home was like a museum, filled with Chinese heirlooms - my father's ancestry - and temple rubbings, carved icons, and brass work acquired during my family's two years in India. While these treasures reflected my parents? pride of possession, dust did tend to accumulate. The Lunts, too, had lived abroad - in Mexico - but in their house you could see the vacuum tracks in the white carpets, hear the click of the wall clock bounce off the spotless kitchen Formica. Candy's mother and mine both worked, which in suburban Connecticut in the sixties was unusual. Mine imported hand-loomed textiles from India. Hers, a trim, prematurely white-haired woman whom I never once saw smile, was a dental hygienist. My father commuted Manhattan to run the guided tour service at the United Nations, while Mr. Lunt was a senior vice president with Ford Motors. Candy had two older brothers to my one. And she was smaller, freckled, quiet. Even before she had braces, she always covered her mouth when she laughed.

By senior year Candy was one of the most withdrawn girls in our school. That was 1970. More than three hundred thousand American kids weren fighting in Vietnam, and that spring the National Guard opened fire on antiwar students at Kent While Kate Millett had just published Sexual Politics, most of the girls in our class still wore miniskirts and painted their lips with Yardley Slickers. Candy, however, shunned makeup. She used her long ginger-colored hair as a screen. She avoided both our school's peace protests and the senior prom.

I arrived a day ahead of Candace at the restored adobe farmhouse Carol shared with her husband, Wayne. Carol and I had known each other since sophomore year in high school when I was just starting my modeling career. Carol back then lived in peasant blouses, blue jeans, and clogs. She always seemed to be baking a carrot cake or making joyous, boldly hued silk screens styled after the artist Sister Corita. She also knew how to fly a Cessna and shoot her dad's Smith & Wesson. Naturally slender and small-boned, Carol had never so much as flirted with anorexia nervosa, but she held a unique attraction for those of us who did. This was partly because she never seemed to judge us, but mostly because we wished we could be like her. Now, at forty-seven she was an accomplished graphic designer, painter, and horsewoman. She lived in cowboy boots and kept paints and pastels in her kitchen next to the sugar and olive oil. She was still my favorite role model.

We brought each other up-to-date on the respective states of my marriage and Carol's illness, both in flux with uncertain outcomes. Then Carol said, "Candace's divorce was just finalized" The two of us, she intimated, should find plenty to talk about. And since Carol was weakened from her latest round of chemo, I would be making the hour drive to pick up Candace and her daughter at the Albuquerque airport.

As I hovered by the security checkpoint I wondered what I was looking for. I'd gained more than thirty pounds since high school, and current friends seeing my old modeling pictures would bluntly ask, "That's you?" Surely Candy would be equally transformed. But my thoughts kept sliding back to my last images of her. Seventeen years old, she sat alone in the corner of the cafeteria making a half hour meal out of a six-ounce container of plain yogurt. Though in many ways her mirror image, I rarely spoke to her. By then, we pitied each other. We also admired each other. We knew each other's secrets without knowing the details, and so, on a subliminal level, we feared each other.

"Aimee?" The voice came softly from my right. I turned and immediately recognized my friend from third grade. She still wore her hair long and straight, no makeup to hide her freckles; and her eyes were that same cerulean blue: quiet, steady, yet voracious.

When we hugged, her grip felt healthy, her body trim but solid. She smelled like Breck shampoo. So did her daughter, Ruby - a wary, dark-eyed child still sleepy from her nap on the plane. Ruby was the same age Candy and I had been when we first met.

On the drive to Santa Fe, Candace told me she and Ruby had moved to lower Manhattan three years earlier from San Francisco and were only now settling in. She glanced toward the backseat. Ruby, she said, was one of those kids who have just three friends and know everything about them from how they arranged their socks to what they muttered in their sleep. It hadn't been any easier for Ruby to find such friends in New York than it had been for her to deal with her parents? divorce.

"How long were you married?"

"Fifteen years." Her ex-husband, Candace explained, was her opposite: he'd voted for Bush, attended church, had workingclass parents who drank, and was happy to cruise for a year between jobs - largely because Candace covered the bills. Before disappearing, he'd cleaned out her bank account. Candace had nearly lost her own job while fighting her husband in court - to little avail. She'd also lost twenty pounds - the first relapse into anorexia since college."

"The divorce diet," I said, not joking.

She nodded. Five years later, she'd regained the weight but was still struggling to sort out what had gone wrong in the marriage. "I tried to tell him, 'I'm like a plant and you're overwatering me,'" she said. "But he was too needy, and when he couldn't have all my attention, he turned vengeful."

It seemed to me she was giving her ex more credit than he deserved, but I knew from my own experience there had to be more to the story. "It falls into the category of 'be careful what you wish for,'" I said when Candace asked about my separation. Superficially, my marriage had all the right ingredients. My husband was generous, smart, devoted to our sons, and more attractive to me with his silver hair at sixty than any man I'd dated in my twenties. Maybe the problem was the fourteen-year age gap. Maybe it was his latest business deal, which had turned him into a workaholic. Of course I'd never cared about the Lakers, and he couldn't stand to socialize, especially with my friends. Worse, we'd do anything to avoid honest confrontation ... But all these were evasions. "I'm still sorting out my role in all this," I admitted. "But I guess the important realization is that I played one."

"You're ahead of the game," Candace said. "I didn't realize that until it was too late."

When we reached the ranch, the afternoon turned into a blur of activity as Carol showed off her painting and photography studios, and we played with the horses and dogs. We didn't settle down until evening, when Carol brought out a set of easybake mugs for us to paint at the large wooden table in the middle of her kitchen. As everyone got to work I felt like I'd landed back in art class in elementary school - the more so when I glanced up and saw Candace covering her mouth with her hand as she smiled at something Ruby had said. Carol drew hearts and horses, a miniature of the view from her window, with printed words of love. Ruby made free-form swirls, letting herself go. Candace created a meticulous, pointillist ocean of fishes. I stared at the surface of my cup.

I applied the marker. I erased the mark. A picture was supposed to present itself, but my mind was as blank as the clay. I stole another look at Candace's impeccable sea as Carol's husband, Wayne, strolled through the kitchen. He took one look at me and in his amused, laid-back way said, "Aimee. It's only a mug."

Candace threw me a look of sympathy. Carol frowned at Candace's mug. All those compulsively ordered dots. "This is supposed to be fun," Carol said.

Ruby grinned and held up her abstraction. "I'm having fun!"

We laughed, and I loosened up enough to deface my mug with a maze of inked leaves, but it wasn't fun for me.

When we talked about it later, Candace told me she often drew in points, trying to make pictures out of the negative space. "I guess it goes back to my failed attempts at therapy," she said. "They never connected the dots."

"What do you mean by dots?"

"You know. Weight and men, my body, my family." She described her longing to let loose. She felt she needed to make some enormous, meaningful gesture through her work or music. "But it's as if this impulse is gridlocked by the compulsion to always behave."

I felt this gridlock, too. In my bones. In that silly mug drawing. In my lifelong habit of biting my nails. I glanced across the table. Yes, Candace also chewed her nails, although, tellingly, she had succeeded in restricting herself to her left ring finger.

Was anorexia nervosa merely another symptom of this internal constraint? The more Candace and I talked, the more we did seem to have in common. Our similarities went way beyond where and when we were raised: we both dreaded making a mistake; both hated being the center of attention, even though we craved praise and needed to excel; we didn't laugh easily or openly or trust ourselves to relax. I imagined the two of us standing side by side, question marks tattooed on our foreheads.

That night I said to Candace, "If we went back and talked with the other women we knew who had eating disorders in high school and college, I think we'd find we all have more in common - even today - than we have with the rest of our classmates."

But Candace was not so sure. "Don't you think people change?"

"I think they can when they know what needs changing. Gaining weight was only a first step - for me, at least."

She studied her hands. Something I'd said seemed to pain her. But when she looked up, she said only, "I'd be interested in knowing ... in hearing those stories."

I thought about asking to interview Candace right then, but Carol and Ruby pulled us in other directions. Besides, I was not yet sure what questions to ask. The skeptic in me warned that women who'd had eating disorders constituted a broad and diverse group. Their lives were affected by a multitude of factors, and if they appeared similar it was as likely because of shared culture as any innate parallel. But Candace's phrase "connect the dots" stayed with me long after I was back in LA. I kept remembering that look she'd shot me as we labored over our mugs, the two of us still holding back in a way no one else in the kitchen that night could understand.

In 1979, when I published Solitaire, anorexia nervosa was generally considered a recent phenomenon, and bulimia had just that year been named - by British psychiatrist Gerald Rus- sell, from bous, meaning "ox" (read: "beastly") and limos, "hunger." In fact, neither disorder was new. In Phthisiologia, or, A Treatise of Consumptions, published in 1694, British physician Richard Morton wrote of a twenty-year-old girl who refused to eat, studied all the time, and looked "like a Skeleton only clad with Skin." Anorexia was named from the Greek an, meaning "lack of," and orexis, "appetite," by French physician Charles Lasègue in a paper documenting eight cases of willful fasting in 1873. And countless girls before 1979 practiced bulimia. Jane Fonda, for instance, learned this "secret" from a friend in boarding school in the 1950s: "We assumed we were the first people since the Romans to do this," she recalled in her memoir My Life So Far. Diana, Princess of Wales, admitted in 1997 that she'd begun bingeing and purging in the early 1970s; and her sister Sarah was hospitalized with binge-purge anorexia in 1975. Yet because the true scope of eating disorders wasn't recognized until the 1980s, most doctors treated such cases back then as mystifying oddities.

In 1978 in The Golden Cage, Hilde Bruch had painted the typical anorexic as a birdlike child "too plain and simple for the luxuries of her home, but also deprived of the freedom of doing what she truly wanted to do." Anorexia nervosa, Bruch suggested, was a symptom of arrested development caused by lack of parental encouragement. She identified overconscientious, overstudious, and compliant performance as a warning sign and noted that when patients first came to her, "they looked, acted, and sounded amazingly alike" even though they had widely differing backgrounds and included several boys. She rejected, however, any possibility that these kids might have looked, acted, or sounded alike before they got sick. The medical similarities, she argued, were due to the fact that these patients were all starving organisms. And the psychological and behavioral parallels were the result of coincidentally parallel family dynamics.

To explain why anorexia nervosa seemed so lopsidedly to affect middle- and upper-class girls, Bruch pointed to "the enormous emphasis that Fashion places on slimness" and the message delivered through advertising that women can be loved and respected only when slender. She also worried that the women's liberation movement of the 1960s, while expanding their opportunities, had intensified the pressure on teenage girls to prove themselves in arenas such as physics, soccer, debating ... and bed, before they were ready. All this new freedom threatened to overwhelm the overconscientious, Bruch suggested, and some turned to hunger as an obsessional escape.

Feminist social critics deflected the blame by broadening it. In 1978 Susie Orbach declared that "Fat Is a Feminist Issue." In 1981 Kim Chernin described "the tyranny of slenderness" as "The Obsession" that our society imposes on women, primarily through the marketplace and media. The true villain in the feminist portrait of eating disorders was not the mother figure, and certainly not women's liberation, but our image-obsessed, patriarchal society. Anorexics and bulimics were merely mirroring cultural attitudes that encouraged women to use unnatural measures to subjugate their own physical appetites to a warped beauty ideal of prepubescent thinness.

Both Bruch's indictment of family and the feminist analysis sounded logical, but neither theory made sense when compared with eating disorders statistics. Although about half of American women and men are on a diet at any given time and virtually everyone is exposed to advertising, the lifetime rate of anorexia and bulimia nervosa combined is less than 7 percent of the U.S. population. This amounts to nearly twenty-one million people, without doubt a significant problem. Yet while the rate of anorexia has remained essentially unchanged since 1991, the rate of obesity has tripled, to include more than 30 percent of all Americans. So when I read Caroline Knapp's declaration in Appetites that all "white, affluent, and highly educated" women suffer from self-deprivation akin to anorexia, I was more than a little skeptical.


Excerpted from Gaining by Aimee E. Liu Copyright © 2007 by Aimee E. Liu. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Table of Contents

Author's Note     ix
Introduction: To Gain Is Good     xi
Know Thyself: Temperamental Truth
Connecting the Dots: A Genetic Link     3
Portrait of a Hunger Artist: The Face of Fear     24
The Laws of Perfection: Obsession and Compulsion     40
Wanting for Nothing: Avoidance     67
Good Bad Girls: Shame     90
The Physics of Normalcy: Personal Relationship
A Certain Self: Identity and Independence     115
Terms of Endearment: Family Dynamics     139
Growing Children: Parenthood     163
Love and Other Terrors: Honor and Intimacy     184
A Wider World: Consumer Society and Body Image
Consuming Passions: Competing for Health     211
The Wisdom of Age: Maturity in a Youth Culture     228
Gaining Power: Becoming Agents for Change     247
Acknowledgments     261
Resources for Information and Activism     265
Suggestions for Parents     270
Selected Bibliography     273
Index     283
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