My Reply

Like I said, I emailed Michael Dow of the Pen and Paper Diet about his press release in which he said that his diet (basically count all your calories plan) was a good solution for anorexia and bulimia because:

"If a person consumes the appropriate amount of calories for one's height, age, sex, activity level and weight, then one can maintain their ideal weight," says Dow. "This diet will be ideal for those that struggle with anorexia and bulimia because it can enable these individuals to maintain their weight at the low end of BMI like they would prefer while digesting their food," Dow says.

Someone with anorexia or bulimia is not granted some special dispensation by their diagnosis that they get to magically choose their own weight. I was sufficiently tweaked, as Laura might say, so I emailed Dow, who replied in the comments on my last post.

Here (in all of its shining, happy, long-winded, pissed-off glory) is my response:

Mr Dow,

While I do appreciate your responding on my blog, I think I'm going to have to essentially disagree with you.

The easiest way to "manage your weight" is called intuitive eating: eat the foods you find enjoyable/palatable, eat when you're hungry, stop when you're full, and move your body for fun. In fact, it's about managing diddly squat. It's about responding to the natural hunger cues your body is sending you anyway.

Your friend in high school who was anorexic may have seen herself as starving to lose a few pounds- I know I did. Right until I landed in the hospital on heart monitors. That's the problem with eating disorders: we don't know there's a problem so we can't stop. People with eating disorders already count every calorie and every fat gram and every single calorie burned. I would have hour-long debates with myself as to whether it was okay to chew a stick of sugar free gum, and if so, how long I would have to chew it in order to burn off all of the calories.

Furthermore, people who are in recovery from anorexia often need vastly more calories than other people of their age/height/weight/activity level. At one point, I was eating 4500 calories per day to gain about 2 pounds per week. Obviously my metabolism had gone haywire. And it tends to *stay* a bit haywire as the body repairs itself. The paper is here: Abnormal caloric requirements for weight maintenance in patients with anorexia and bulimia nervosa.

You said: "[Anorexics and bulimics] instinctively know that if they control what they consume then they can help control their weight."

Let me be super clear about this: eating disorders are biologically-based mental illnesses. They are NOT about controlling weight. In fact, they are NOT about control. When I was 50 lbs underweight and living in a haze of ER visits and hospital stays, when I was blacking out several times a day and my lips were blue and my fingernails were blue and there was this strange fur growing all over my stomach, I was still being asked for diet tips. So you're not alone in thinking that eating disorders are about controlling your weight. But it's just not true.

And here's the really paradoxical thing: as you approach your healthy weight (not the one you plucked out of the air because you liked the number or how it felt, but the one that your DNA says you will be the healthiest at), the need to control your weight loosens a bit. It's a disease driven by neurochemicals and malnutrition and horrific anxiety and fear. The need to control your weight and calories and such are symptoms of anorexia, not causes of the disease.

The predisposition to anorexia and bulimia does not, incidentally, involve a sudden, burning ability to control one's weight through calorie counting and exercise. The predisposition involves differences in serotonin and dopamine levels, as well as higher rates of anxiety and mood disorders.

Oh, and the "disposable income" we should spend on research? I don't have any. I've spent all of it trying to recover. My treatment has cost almost *half a million dollars* over the years. Besides the numerous hospitalizations, residential stays (at $1,000 per day, and not covered by insurance, I might add), day treatment programs, therapists, psychiatrists, dieticians, medications, and gas for appointments, I also had major ankle surgery due to a trimallelar break from anorexia-induced osteoporosis, ER visits for dehydration and seizures, MRIs and EEGs for seizures, neurologist visits, doctor appointments, missed work, not to mention the food needed to restore weight and get well. And I didn't have a lot to start with. People with eating disorders come from all economic groups, not just those with disposable income.

Yes, I am frustrated and annoyed because these beliefs are all too common. And I often feel I am beating a dead horse. It's just that every now and again it whinneys, and I once more pick up my stick and start whacking away.

Is it just me, or is it really freaking ironic that one of the most famous horses is named Mr. Ed?

posted under |


Anonymous said...

Yep, yep, and yep. Can't think of anything to add, except that I'll never think of Mr. Ed the same. :)

Tiptoe said...

Good ranting :-) I agree with what you said.

Anonymous said...

*Claps furiously*

That is all. said...

OMG, I remember counting calories in a stick of sugar-free gum and my lips being blue. You wrote an awesome letter. Some people just don't get it. I used to have teachers ask me for diet tips, too.

Anna said...

I've sat here for a long time wondering what the eating disorder IS about. When I'm crying because I delude myself into believing a pair of jeans is tighter than yesterday, it feels like it's about the weight. But when I used sit there counting calories and total out far under what is remotely reasonable for sustaining human life, it felt like control.

Now? Now that I'm in recovery, I know that there is no control involved whatsoever in an eating disorder. I still don't feel like I was sick, and it doesn't help that I never dropped below a BMI of 22 - "normal" by most standards. Outwardly, I look fine. It's the inward damage that I've found the hardest to deal with.

Calorie counting does not help. It was what got me started restricting in the first place.

Boo on that guy!

Abby said...

I'm a bit nervous to comment on strangers' blogs, but I really want to thank you for letting us know about this and for writing the email to the book's author.

I started reading something online about this book yesterday, but I had to leave the computer before I'd investigated it much, and I was still sincerely hoping that this whole thing was some sort of hoax. The book's on Amazon, though... so I guess it's probably real.

Okay, I think I'll maybe go write my own rant about this... or maybe I shouldn't! I don't think of myself as the sort who gets super upset about things easily, but I must confess that I think my heart rate has gone up quite a bit in the last few minutes. Augh!

brie said...

Um...not only do I have a major blog crush on you, but you might just be my new hero. Thank you for speaking for the masses...for saying what needed to be said in an eloquent and firm manner.

Also - Mr. Ed? AHAHAHAHA!!!


fighting_forever said...

It might be true that training people a bit more about healthy ways to control their weight might prevent some of them from developing eating disorders. I'm certain mine started because I was trying too hard to diet and then couldn't resist the natural instincts to eat fatty, sugary foods because my body didn't have enough energy. If the people who might develop disorders are shown a way to be healthy without starting the extreme diets that set the problem off, it could (I stress the word could, I'd like to see some medical backing of the idea) prevent some of the susceptible from becoming disordered.

However, it is a complete load of bull that it could help people trying to recover. This guy needs to do his research.

Anonymous said...

Thank you.
This is awesome and reading your blog is one of the most refreshing parts of my day.

Sarah said...

Well done Carrie. Thank you.

Lisa said...

Great post! Keep up the fantastic work.

(I used to let myself get away with sugar-free gum, because I figured I burned enough calories chewing it that it came out even. Altoids, though, were another story.)

Carrie Arnold said...

Oh wow, people. I'm seriously blushing. That I spent 2 hours cooped up on an un-air conditioned commuter train (deodorant is a civic duty, people!) immediately before I wrote this no doubt helped with the profound level of pissiness I felt.


In people who are susceptible to eating disorders, the kind of dieting you describe often accelerates and amplifies itself. Part of it is personality (perfectionistic- I'm going to Diet with a capital D!) and part of it is changes in brain chemistry that happens as you deprive yourself of nutrients. I see the parallels between obesity and dieting, and I have to wonder if the cause and effect is different. Rather than more obese people trying to diet, that more dieters led to more obesity because natural hunger cues became whacked out.

Just my two cents.

disordered girl said...

It has already been said, but you are seriously awesome!


Katy said...

GREAT letter. I just read the guy's response on your other post...and...well, I'm trying really hard not to say anything mean or inappropriate, but mean & inappropriate are running through my mind & I'm sure you can all fairly accurately guess what those thoughts are.

Anyway. PEOPLE WITH EDs ALREADY KNOW ALL ABOUT CALORIES, DAMN IT!!! I don't need a BOOK to tell me anything about caloric content or how much I need to eat to lose I'm pretty sure I could figure out on my own how to maintain some specific bullshit weight that is totally inappropriate for my body. But the idea that I could "control" my ED that way is utterly ridiculous--people with EDs are NEVER satisfied with ANY number--it's part of the freaking ILLNESS!!!

And he clearly lacks any understanding of what biologically BASED mental illness is--it doesn't mean that there's a simple on/off switch & in any environment someone w/ a "gene" for an ED will get it! There are genetic PREDISPOSITIONS that are activated by ENVIRONMENTAL TRIGGERS--social, biological, whatever. It's not a single gene disease--most diseases aren't. You could have a genetic predisposition for lung cancer & not get it if you live in a society where cigarettes don't exist & someone w/ the same predisposition in a society where everyone smokes would get it. That doesn't mean the "culture" gave it to you, it means the culture triggered a behavior that triggered the illness.


This guy should SO not be allowed to masquerade as an authority on ANYTHING.

Rant over...not nearly as good as yours, but cathartic nonetheless!

atsie said...

hey.. thanks for the information, it helps me a lot :)

Anonymous said...

Way old. But I've just read it and I applaud your words. I struggle self diagnosed with ednos. And have to say, where even to me it is all consuming about my weight, calories, ect. I know it's not. The thing is I can't stop those obsessions. I know I'm not fat. I know it's okay if I eat 1000 calories. But I can't stop obsessing. In fact I tell others about how to stop obsessing over it by I can't myself.

This guy is a );tard

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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