My friend Kathleen MacDonald shared this on Facebook earlier today, and she graciously gave me permission to share it on my blog. I hope you enjoy.


‎"So how did you turn things around?" is one of the most common questions I get about my recovery-process. I wish there was an easy/short answer...but there isn't. (don't worry --this won't be one of my lonnnnnnnnnnnngggggg-winded status to detail the answer) ~ There were several key components to my final recovery process that led to me becoming recovered...here are a few:

a. I got serious about nutrition and I stopped making me the "exception" to needing to eat
b. I got serious about gaining body fat
c. I learned to be comfortable feeling uncomfortable and I didn't fall back into the disease every time my body image felt like hell or my guts distended/I felt pregnant
d. I got serious about the fact that every purge could be my last
e. I got serious about the fact that it wasn't safe to exercise (I ended up taking nearly 2 years off from exercise --which was really hard to do) when I was under-nourished and under-hydrated
f. I realized that I needed to 'over-nourish' my body in an effort to replenish and repair all the damage done (even if my bloodwork was 'normal')
g. I kept Kitty Westin and Ron & Sally Crist George in my heart/prayers ever day 
h. I put God in the center of my recovery-process (along with nutrition)
i. I did not listen to the doctors who told me that I had to give up gluten and dairy b/c I had "intolerances" -- of COURSE I had intolerances to those foods...I had intolerance to most foods b/c my body was so screwed up from all the years of 'dieting'
j. "suicide is not an option" became my mantra -- no matter what, suicide is never the answer
k. I disconnected myself from unhealthy relationships
l. Recovering became my number one focus --above school, fun, relationships, etc... First Job = recovering
m. I dared to dream that RECOVERED existed and I sought after it with all my heart (it exists, trust me!)
n. I put the emotional stuff on hold until my brain was better healed - (and guess what --after my brain was healed and I was thinking clearly for the first time in 16 years, I realized that the emotional stuff that had caused me so much pain and trauma...it wasn't as bad as my ED brain had convinced me...and I was able to heal from it vs. sink into deep despair)
o. I got rid of life-expectations that I had for myself (ie: I must have my Ph.D. by the time I'm 30)...and I just focused on recovering...and I trusted that Ph.D programs would still be available when I was recovered ;-)
p. I stopped trying to help others and I learned to 100% focus on me
q. Gretz, the Super Setter --enough said.
r. I learned to forgive myself
s. I ate thru the pain
t. I stopped purging
u. I stopped believing that I was ugly
v. I stopped believing that my body is less-than-beautiful when I am healthy
w. I stopped thinking that cellulite is ugly
x. I got rid of my scale
y. I healed my body image issues thru nutrition, 'sitting with it', and thru learning to see myself and everyone else thru the eyes of God --which means that I see every single human being as beautiful.
z. I never gave up on the enigmatic power of Hope.

Laura's post yesterday on eye damage and eating disorders got me thinking.  When I read articles about the health dangers of eating disorders, I almost have to laugh.  Not because it's funny, but because of the tone of many of these articles, as if these straight-laced doctors can knock some sense into us silly ED patients, then the problem would be over.

Here's the thing: we are often well aware of the dangers.  This isn't that we don't think it won't happen to us, or we've got it under control or we're not that bad, because we do.  At least, I know I did.  I was in the ER numerous times for low potassium from purging and dehydration.  What did I do when I left the ER?  Purge.

Yes, there's a bit of a disconnect.  But in the moment, the dangers are irrelevant.  What I always sensed as far more dangerous than heart failure was what would happen if I didn't purge, if I did drink that glass of water, if I ate that plate of food.  Death was far-off.  The food was right there in front of me.

My ability to ignore the medical issues wasn't a sign of how much I valued thinness--I knew water didn't have calories, but I was tremendously afraid of consuming anything.  It added "weight" to my body, and that totally would freak me out.  I took pathology, physiology, biochemistry classes as an undergrad and grad student.  I knew exactly what was going on.  And yet my eating disorder raged, raged against the dying of the light.

Sometimes, over the very short term, minor health scares would shake me up enough to get me to rein in at least the more flagrant of my behaviors.  But these changes rarely lasted.  They did nothing to arrest my illness.

I do think psychoeducation on the dangers of EDs are important, as is learning to deal with a wrecked body.  I still blame myself for my crumbling bones, my uncertain digestive tract, my history of seizures.  I know that I had an illness.  I wasn't being stubborn or stupid or vain.  Yet the pervading medical culture holds that if only I wasn't so freaking dense, I wouldn't have damaged my body.

I need to take charge of my health from here on out.  I eat plenty of dairy and take a multi-vitamin.  I take calcium chews when I remember.  I keep my weight healthy and I take my Prozac every morning.  I am well, now.  Or at least more well than I was.  Rather than wasting time scolding people, help them stop their symptoms so they don't have to face the health risks.

Remember this: we're not stupid. We're scared.  There's a difference.

So a little article in Marie Claire magazine called The Hunger Diaries about online food and health bloggers has raised quite a stir.  The premise of the article is whether these health bloggers might be promoting an unhealthy and obsessive lifestyle.  The health bloggers say that their quotes were taken out of context and the dangers of such health blogs were horrifically overblown.

Generally, I don't read these blogs and really am not interested in these types of blogs, where food and exercise routines are documented in almost pornographic detail.  I think about food and weight quite enough, thank you.  Unless it's specifically helping me with my recovery, I'll pass, thank you very much.  Also, these blogs tend to make my competitive and judgemental side get twitchy.  She exercised more than me, I will think, which then takes me down the path of "She's stronger/better than me" => "I must exercise more and eat less." => RELAPSE.  So yeah--for any number of reasons, these blogs aren't for me.

So I can't really say anything about the accuracy of the article and whether some health bloggers might have disordered eating or an actual eating disorder.  That's not my place, I don't know, so I'm not going there.  But I do have several points to make that have gotten lost in the dust of the kerfuffle.

1) Don't believe everything you read on the internet.  Maybe I've watched a few too many House reruns, but the fact is: everybody lies.  And it's very easy to do so online.  Just because someone says they ran X miles doesn't mean they actually did.  Maybe they ran less.  Or more.  Who knows.  I'm not anti-blogger; after all, I am a blogger.  Yet the fact remains, people are complicated.  Things might get left out inadvertently.  You might have misinterpreted.  And just because someone calls themselves a "health blogger" doesn't mean that they are healthy or that doing what they are doing will automatically make YOU healthy.

2) "Health" is not an extreme.  In a lot of the comments on the Marie Claire website, people talked about these bloggers as being something the rest of us Big Mac chowing Americans would do well to emulate.  Um, hello.  Did you not realize there is a ginormous freaking gap between a steady diet of french fries and marathons fueled by kale brownies?  To me, health is not health without joy, and joy comes from real brownies, not kale ones.  I exercise regularly, eat a very healthful diet most of the time, and I humor my sweet tooth when I can.  You can take steps to improve your life without following the dictates of a health blogger.  Are they healthy?  I don't know- that's between the bloggers and their doctors.  Which leads me to my next point:

3) "Health" is an individual definition.  People have tried to define health for centuries and have really come up with vague descriptions.  What someone else defines as health (such as kale brownies and marathons) might not be healthy for someone like me in recovery from an eating disorder.  I have to take steps to moderate my impulses to exercise.  Ultimately, you have to define health in your life.  That definition needn't be static--it can change with age, circumstance, you name it.

4) Bloggers have an obligation to their readers.  These obligations will be different based on different types of blogs, but, like it or not, bloggers have an obligation to their readers.  I see my obligations as being honest about my own recovery (the struggles and the victories), and not passing along information I believe to be unhealthy or uninformed.  I can't vouch that everything I write about is 100% accurate--no one can.  But I can (and do) refuse to write on subjects that will be obviously misconstrued, not in line with my own authenticity, and not anything I wouldn't tell someone to do.  I try to be careful and say how something (such as a meal plan) has been helpful to me, but a meal plan isn't universally helpful.

5) Your readers are listening.  This goes along with the point above.  If people are reading your blog, then they are listening to what you have to say.  They are absorbing this information.  Remember this.  Unless your blog is completely private, you are writing to an audience.  When you talk about how great your workout routine is (and then describe it in detail), people are going to copy you.  No, you aren't responsible for the fact that they do copy you and that people can be idiots (sorry, too many House reruns again), but you are responsible for being cognizant of what you say.

6) Obsession can masquerade as health.  I'm not saying anything about these bloggers in particular.  Like I said, I don't really read them and so I'm making no judgements.  But I do have to applaud the writer for bringing up the thorny cultural issue of health being used as a smokescreen for any number of obsessive behaviors.  Part of the problem is that most of the obsessed really think they're just being healthy.  They see nothing wrong, and the unending kudos from adoring blog readers probably doesn't make it any more likely that people will see the light.  Many eating disorders have started by a simple effort to be more healthy.  Soon, it becomes a life-threatening obsession, but how can you be sick if you're just trying really hard to be healthy?  It's a fine line and it's hard to find out where to draw it.

So those are my thoughts.  What do you think of health blogs?  Do you read them?  Why or why not?  Share in the comments.

Those of you who are friends with me on Facebook have read updates on my quest to transition to full-time freelance science writing. The major hindrance to going full-time is health insurance. My eating disorder (and accompanying medical issues, such as osteoporosis, epilepsy, a herniated disc in my back, GI issues, etc) would all be considered "pre-existing conditions" and thus not eligible for coverage. Hence my almost too ironic job at the bakery: a group plan under an employer would render me eligible for coverage, even of my pre-existing conditions (after a 6 month waiting period). This fact also tethers me to having some sort of full-time-ish job, which is rather irritating for someone who wants to spend their time freelancing and not slinging bread, wrangling pies, and frosting cupcakes.

Thankfully, my parents have a fantastic insurance agent whose office is right across the street from the bakery and I talked to him about what the possibilities were for me. Presciently enough, on July 1, Virginia adopted the federal high-risk pool insurance program for people with pre-existing conditions that were otherwise uninsurable. The key is that your pre-existing condition cannot be covered under a policy for 6 months. What we came up with was a short-term medical plan that would not cover my pre-existing conditions and a special hospital income protection policy if something catastrophic happened. At the end of those 6 months, I would go into the federal high-risk pool. Since mental health parity also took effect on July 1, I should--fingers crossed--be okay.

What shook me, however, was the agent's comment that without Virginia's adoption of the high-risk pool, I would be uninsurable. That would mean my dreams of freelance science writing were essentially dead in the water. My eating disorder had effectively rendered me untouchable.

That's what breaks my heart: that some bureaucrat somewhere could so quickly and efficiently kill my dream because I have an eating disorder. I realize that paying out more in benefits than you take in with premiums isn't a good business model. I get that. I also get that eating disorders aren't cheap to treat. But to have an eating disorder diagnosis render me unable to get a health insurance policy for the rest of my life? It's depressing.

I feel like I have worked so hard in recovery to try and bring back a semblance of normality and health to my life. Many of my hopes are pinned to the wish that, one day, the spectre of my eating disorder will no longer haunt my every move. Finding health insurance is a stark reminder that some people never forget. I know some of my family members have been unable to forgive me for getting ill, and I had attributed that to human emotionality and fear and frustration. But this cold, calculated move makes me wonder if I'm permanently broken. If a whole, healthy me will ever emerge from the wreckage of anorexia.

I don't want to dwell on this, as I know insurance companies know precisely diddly squat about life. They were, after all, the ones who denied almost all my claims relating to the eating disorder, when I was sick enough that even I knew I would die without immediate treatment.

Although I have some issues with the health care reform bill that finally passed through Congress earlier this year, it has allowed me the chance to live my dream, and for that, I am grateful.

Samantha Henig, an editor at Slate's Double X, sent me the link to her latest video about her experience on the Master Cleanse. After a massive misunderstanding on my part (I thought she was trying to sell me something, and though I apologized on Twitter, I am doing it again here: So sorry, Samantha! My fingers got trigger happy and I jumped the gun!), I finally watched the video and had to share it here:



To me, Henig absolutely hit the nail on the head when she talked about how the Master Cleanse was really just a socially acceptible way to lose a lot of weight very quickly, and that it was the mental effects of the cleanse that were far more dangerous than any physical risks.

What did you think?

Previous "In the Name of Health" blog series:
Part One
Part Two
Part Three

Sometimes I think this series on "In the name of health" could go on ad infinitum (you can read the first episode here). For my own mental well-being, I won't write an endless series of posts about it, but an article I found on Facebook (h/t Libby and Amy) made me realize that I certainly needed to do more than just the two original planned posts.

The name of the article? Throwing out the wheat: are we becoming too tolerant of gluten intolerance?

Writer Daniel Engber takes a long, hard look at the sudden proliferation of gluten-free foods, sales of which have risen an estimated 28 percent each year to make an industry worth nearly $2 billion. Take a look at some of the boxes of Chex cereal these days- many are now prominently labeled "gluten free."Although avoiding gluten, a protein found in wheat and certain other grains, is necessary for those with celiac disease, this autoimmune condition affects no more than 1% of the population (or at least, less than 1% of the population has received an actual diagnosis of celiac disease). And though this proliferation may be beneficial for them, it doesn't seem that such a small segment of the population would drive such a large segment of the food industry.

Engber's hypothesis is that most people who cut out gluten don't actually have full-blown celiac disease. Rather, it's a way to avoid foods in the name of "health" and maybe lose some weight in the process. In other ways, the association is blunt and in your face, as Elizabeth Hasselbeck's latest book The G-Free Diet: A Gluten-Free Survival Guide contains a chapter titled "G-Free and Slim as Can Be!"

Writes Engber:

The fact that "going G-free" means eating fewer cupcakes and less pasta suggests another source of relief. It is, after all, an elaborate diet—and so delivers all the psychological benefits of controlled eating and self-denial. "Once G-free, you are no longer simply robot-eating bag after bag of pretzels," writes Hasselbeck...Gluten intolerance may be a medical condition, but according to Hasselbeck, it's also an approach to eating—like South Beach or Skinny Bitch—that's supposed to make you lose weight and feel good about your body.

One of the most fascinating parts of the article is the graphs that compare the rise in newspaper mentions of "gluten intolerance" with the rise in popularity of the Atkins diet.




Coincidence? Perhaps. But it strikes me as kind of unlikely, especially when you compare the rise in "lactose intolerance" that happened alongside the popularity of the Mediterranean diet.


Engber makes his key point here:

I'm not suggesting that anyone who avoids gluten is secretly trying to lose weight. The purpose of a gluten-free diet is, naturally, to feel better. But there's a complicated relationship between feeling good and eating less. When a restrictive diet becomes an end in itself, we call it an eating disorder; when it's motivated by health concerns, we call it a lifestyle. That's why Hasselbeck says going G-free will make you slim (a sign of wellness) rather than skinny (a symptom of anorexia). It might also explain the relationship between food sensitivities and fad diets: People who are intolerant of gluten or lactose get a free pass for self-denial.

And it's the last one that concerns me. When people say they are doing something for "health reasons," we become automatically less likely to question it. Dietary changes for health reasons can be totally legitimate, and suffering caused by undiagnosed food allergies and intolerances is very real. But I think the new surge in "cutting out..." gluten, corn syrup, dairy, meat, food in general has less to do with an increase in food allergy diagnosis and a lot more to do as a way to avoid food and not get called out on it.

To everyone who says that weight loss is the answer to "overweight" and "obesity," I recommend reading this research article:

Comparing the health burden of eating disordered behaviors and overweight in women

The researchers interviewed a community-based sample of Australian women to determine the effects of overweight and ED behaviors on quality of life, psychosocial functioning, and physical well-being. The researchers found that overweight led to increased physical problems but relatively little impairment in normal day-to-day functioning. However, those women with eating disorders showed some increases in physical problems but a large impairment in psychosocial functioning and quality of life.

Conclude the researchers:

Further, impairment in psychosocial functioning associated with eating-disordered behavior was greater than impairment in physical health functioning associated with overweight, and impairment in physical health functioning associated with eating-disordered behavior was greater than impairment in psychosocial functioning associated with overweight. Overweight and eating-disordered behavior were associated with similarly elevated rates of primary care consultations during the past 6 months and of lifetime treatment from a health professional for an eating or weight problem.

Conclusions: In young adult women, the health burden of eating-disordered behavior may be more substantial than previously recognized. Better information concerning the spectrum of disordered eating that exists at the population level needs to be made available. Eating-disordered behavior warrants greater attention when considering the public health burden of obesity and in developing programs to reduce this burden.

Even if overweight and obesity are associated with health problems, we don't know how to reliably get people to lose weight and keep it off. Furthermore, many extreme diet measures can very well be the beginnings of an eating disorder--or at least really unhealthy. And if "obesity prevention" results in higher rates of eating disorders, the "cure" may very well prove to be worse than the "disease."

I was refreshingly surprised when I saw this AP news article last night: Worry over weight: Poll finds health disconnect. It summarized what I've realized since the days of the Big Fat Loser contest over a year and a half ago now, that women say they're trying to lose weight for health reasons, but it's really all about appearance.

There's a big disconnect between body image and true physical condition, an Associated Press-iVillage poll suggests. A lot of women say they're dieting despite somehow avoiding healthy fruits and veggies. Many others think they're fat when they're not.

"The priorities are flipped," says Dr. Molly Poag, chief of psychiatry at New York's Lennox Hill Hospital.

She points to women athletes as much better role models than supermodels: "There's an undervaluing of physical fitness and an overvaluing of absolute weight and appearance for women in our culture."

Half don't like their weight, even 26 percent of those whose body mass index or BMI — a measure of weight for height — is in the normal range. But just a third don't like their physical condition, even though being overweight and sedentary are big risk factors for Type 2 diabetes, heart disease and other ailments.

The poll found women putting in a median of 80 minutes of exercise a week, meaning half do even less. The average adult is supposed to get 2 1/2 hours of exercise a week for good health.

And just 8 percent of women ate the minimum recommended servings of fruits and vegetables — five a day. A staggering 28 percent admit they get that recommended serving once a week or less.

The ladies I worked with (and most dieters I've talked to) might say they want to lower their cholesterol or blood pressure, but what they use for "thinspiration" isn't an image of an unclogged artery or a blood pressure reading of 120/80. They look at models, those size 8 pants, that skinny chick who works in the cubicle down the hall. Commercials are now telling us to "get in shape for summer" because it's "bathing suit season!" The "get in shape" message is really in the name of looking hot in a bikini.

Eating disorders aside, normal-skinny doesn't automatically mean healthy, stresses University of Houston sociologist Samantha Kwan, who studies gender and body image.

"Someone who is fat or even overweight can be healthy if they have a balanced diet and are physically active," Kwan says. "Our culture really does put a lot of pressure on women to look a certain way," taking precedence over health measures.

Evolutionary biologist Marlene Zuk wrote a great essay in today's New York Times titled "The evolutionary search for our perfect past," in which she focused on the fallacies of assuming that all of today's supposed health woes (specifically those many people relate, accurately or not, to nutrition and obesity) would be remedied by our Pleistocene past.

But the difficulty with using our hunter-gatherer selves as icons of well-being goes much deeper. It is not as if we finally achieved harmony with our environment during the Pleistocene, heaved a sigh of relief and stopped.

In fact, Pleistocene humans might not have been any more in sync with their environment than we were, as the mass extinction of large mammals (megafauna) in both North America and Australia coincided with the arrival of humans.

Nor were all so-called "caveman" diets identical. Zuk points out that the relative ratio of meat to plants varied depending on local resources, making such books as "NeanderThin" all that much more ridiculous. A recent discussion on Shapely Prose further elaborates on this assumption that cave-people were somehow the epitome of thinness and health.

Concludes Zuk:

Instead, evolution lurches along, with successive generations sometimes unchanged, sometimes better suited to their surroundings in some ways but not others. At any one point, adaptations take place: individuals who can endure heat or cold or famine leave more offspring than their less hardy counterparts. But there is no one point when one can say, “Voilà! Finished.”

...We have never been a seamless match with the environment. Instead, our adaptation is more like a broken zipper, with some teeth that align and others that gape apart. The paleontologist Neal Shubin points out that our inner fish constrains the human body’s performance and health, because adaptations that arose in one environment bedevil us in another. Hiccups, hernias and hemorrhoids are all caused by an imperfect transfer of anatomical technology from our fish ancestors.

This isn’t to say that we wouldn’t be better off eating fewer processed foods. And certainly we have health concerns that never struck our ancestors. But we shouldn’t flagellate ourselves for having modern bodies, and we shouldn’t assume that tweaking our diets or our posture will rescue us from all our current ills. That’s just a paleofantasy about the future.

Our bodies are naturally imperfect; evolution works with what exists and builds on it*. Perfect health and immortality are pipe dreams and not rooted in reality. Our bodies are amazing things, no doubt about it, but perfection ain't possible.

*As a staunch evolutionist and anti-creationist/anti-intelligent design-ist, I think this is some of the most powerful evidence we have for evolution- the lack of perfection.

On my last post about my upcoming series on the biology of EDs, Susie asked this:

i'd certainly be interested in medical complications. you never know, i may read something that shocks/scares me into gaining weight.

To be honest (and bluntness is a character fault of mine, so I do apologize if I sound harsh), there are two answers to your question. The short answer and the long answer.

The short answer? Nothing will scare you into gaining weight.

The long answer? Unfortunately, the more you read, the more convinced you become that you can escape the consequences. Or, for me, the longer I was sick, the more I began to experience these medical consequences. And so where I was originally faced with a list of problems A through F that could arise from my ED behaviors, I found that A, B, and C had happened and I had lived to tell the tale. Ergo, I wasn't that sick. So D, E, and F really couldn't be that big of a deal. Then D, E, and F happened and I was still sick and unable to see that I was sick and then I learned about G and H.

You get the drift.

The fact that you have an eating disorder prevents you from understanding the full extent of your illness. It's called anosognosia- a lack of insight into illness. It's not a character flaw, it's just the way starvation monkeys with the brain.

Furthermore, fear doesn't change behavior. It just doesn't. Lasting behavior change really needs positive reinforcement, not negative. Because if fear worked, there would be a lot fewer smokers in the world. And the obesity hysteria certainly has people all worked up over the possible dangers of fat- yet most people tend to weigh about the same. Heroin addicts shoot up despite risks of HIV and Hepatitis C. People gamble knowing they could lose their house.

There are many positive reasons to get into recovery. But your brain needs to heal from malnutrition first, before you can really focus on that. Right now, when you're underweight, you're like a heroin addict, high as a freaking kite. You need to detox (ie, gain back to a healthy weight), and then you can try to find positive ways to stay healthy.

Find someone to help coach you back to a healthy weight. Reading about the medical complications that can happen if you don't probably won't help, though.

This is a question I keep asking myself: where do I draw the line? At what point are certain behaviors healthy (such as exercise, or being careful about what you eat), and when do they tip over the line into obsession and disaster?

Motivation may be a part of it. Are you doing this because you want to, or because you have to? How would you feel if you stopped? But then, we have all sorts of wonderful ways of deluding ourselves that it's often hard for a person to understand the situation from a neutral viewpoint.

Case in point: a man has been on a 30-year running streak. In the past 30 years, he has not missed a single day of running. Period. Ever.

Writes his daughter in a Wall Street Journal article (excerpted in the story above):

When he travels overseas, my dad, who is 66, plans layovers so he can get in a couple miles around the concourse, lest he miss a day to the time-zone shift. During blizzards, he wraps his feet in plastic bags, pulls galoshes over his sneakers and screws in cleats for traction. Then he waits for a snowplow to pass his front door, so he can follow in the freshly cleared path.

My father, Dr. Harvey B. Simon, practices internal medicine in Boston and teaches at Harvard Medical School. Rationally, he knows that running 10 miles a day, every day, for three decades is not great for his ever-more-creaky body. He’d never advise his patients to do it. In fact, he’s written several health and fitness books stressing the virtue of moderation in exercise. And yet….

He’s run with broken toes and the flu and a nasty infected heel and near-crippling back spasms. He goes out before dawn in every kind of weather; he’s become such a fixture in the neighborhood that a couple times when a freak thunderstorm has rolled in, strangers have driven out to find him. They didn’t know his name. They just knew he’d be out there, plodding away, and figured he might appreciate a ride home.

My thinking? This guy has clearly crossed the line. I think he is suffering from an exercise compulsion. The problem is that (if you glance at some of the comments) the voices of people telling this guy to stop and reevaluate--or even the frank "I don't think this is healthy or benefiting you whatsoever"--are drowned out by a "how fantastic that someone at his age is so fit!"

When I was exercising for crazy hours, and even now as I try and figure out what's a healthy amount of exercise and what's not, I was uniformly praised at my "dedication" to fitness. At being a "fixture" in the gym. No one asked, "Don't you have anything better to do?" No one asked, "Do you like all of this exercise?" No one asked, "Are you in pain?" Nope. It was all back-patting and high-praising and I could justify this to myself. How could my behaviors be harmful, I thought, if they're being praised? If they are almost normal? Plenty of other people I knew spent hours in the gym each day- which might not have been healthy, either, but again the praises kept coming.

Our culture isn't helping this. No one raised an eyebrow at my bizarre eating habits when I first got sick or when I relapsed. Or when some of my co-workers have done similar things (and I'm not just referring to the Big Fat Loser contest). I might not say anything because it's none of my business, nor am I in a position to do so, nor can I be entirely sure of the whole situation, but I do NOT praise potentially unhealthy behavior.

Defining "health" and even "obsession" isn't going to be cut and dry, a sort of universal for all of humanity. But having some sort of grip on when you've passed the tipping point could benefit everyone. Our society has passed that point a long time ago- just look at the Holiday Hypocrisy, those interminable stories about how to avoid "packing on" the single pound that most people gain. That's an obsession, and I don't think it's healthy.

It's no secret to most sufferers that eating disorders don't magically go away when a person turns 25. Or 30. Or gets pregnant.

It is certainly possible to get pregnant while deeply engaged in an eating disorder (although situations like this are very unusual). So what does a future mother do? Many people are under the impression that women who are unable to stop ED behaviors during pregnancy are sacrificing the health of their unborn child so that they can "look good," which is frankly BS.

But women with an eating disorder--or even a history of one--are at very high risk during pregnancy. An interesting article titled "Dying to Be a Good Mom" from Brain Blogger examines this phenomenon, looking at risks during pregnancy and after the birth of the new baby. What makes this article stand out is not only its good look at medical risks, but also the conflicting feelings and ambivalence many new mothers with EDs face.

One thing struck me as a little ludicrous, however. "Researchers are now finding that mothers with eating disorders may place their children at increased risk for developing an eating disorder, also." Obviously, environment is important. But what puts the child most at risk is the genes predisposing the child to an eating disorder that were passed down from the mother.

Otherwise, I have to recommend it quite highly.

Are you scared yet? A new study showed that anorexia can shorten your lifespan by 25 years.

Researchers in British Columbia reported that:

"Their number-crunching revealed, for instance, that a woman who develops the disorder at age 15 will live on average to age 56 - 25 years less than the average Canadian female.

"Anorexia nervosa is basically not recognized as a serious disease by society and government, in my opinion, certainly not compared to heart disease and cancer," said Dr. Laird Birmingham, the University of British Columbia psychiatry professor who led the research.

"Most people have a picture of supermodels who lose too much weight because of dieting and think ‘How pathetic is that?' "

The findings might also counter a stigma that has turned the disease into a "modern-day leprosy," he said."

However, Birmingham also noted that those who recovered from the disorder--especially after a short duration of illness--might very well not suffer from a shortened lifespan.

While I think these dramatic statistics are crucial to getting more research funding for anorexia and other eating disorders, I'm not sure of the effect on sufferers.

Of course, when you're in the thick of it, you never think this (osteoporosis, kidney failure, heart problems) will happen to YOU. Even more, "shortened lifespan" is awfully abstract. When you're starving but so afraid of food you can't eat, I might think this knowledge would only make the anxiety worse. I knew, instinctively, that what I was doing wasn't normal or good or healthy. I wanted it to be, and so I convinced myself that it was.

But I felt a necrosis inside of me. I knew I was slowly dying. I probably very well would have responded to the knowledge that if I'm going to die early, I may as well die thin. Ultimately, I was (still am, I suppose) more afraid of living with anorexia than dying from it.

I'm not saying this research should be done because of the twisted psyche of those in the throes of anorexia. But I am wondering whether it will propel sufferers to recovery. It would be nice. I don't think anyone would deny that. Would it be enough?

Mostly, what I think it underscores is the importance of early intervention and early treatment. We need to stop thinking of an eating disorder as a choice and food as a choice. It's not. This is still a life or death matter. Waiting for a sufferer to fear a shortened lifespan may come too late.

I have a nice, shiny bruise on my knee, from smacking it on the turnstile in the subway. I have always bruised fairly easily, but never quite like when I was deeply anorexic. From the knee down, my legs were simply mottled with black-and-blue marks, most of which I couldn't remember receiving.

During my last residential stay, I was given several theories:

I was a klutz. Okay, point taken. I AM a klutz. In fact, I was voted "Class Klutz" in high school, although I'm sure it didn't help that I lit my hand on fire in chemistry lab the day before the vote and got rushed to the ER. With nurses and specialists baffled at my bruising, I was told (jokingly) to "stop running into stuff so much!"

I was Vitamin C deficient. Now, one of the symptoms of Vitamin C (ascorbic acid) deficiency is easy bruising, and in scurvy, the most severe form of deficiency, the most common cause of death is hemorrhage. Your capillaries leak uncontrollably, and your nose and gums bleed horribly. Not pretty. Supplements helped, but it didn't control things completely.

I didn't have enough fat on my body. This was fairly true. Fat is padding, and I basically didn't have any.

It turns out, though, that the lack of fat in my diet was as much to blame as the lack of fat on my body.

With the bruising not really abating, I finally asked my all-knowing psychiatrist about it. I pushed up my pant leg, and he took one look and said, "You're not getting enough Vitamin K." He went on to explain that Vitamin K is a clotting factor (which I knew), and that it is also a fat-soluble vitamin. Most Americans don't have Vitamin K deficiencies, because it is easily obtained from a variety of foods.

My problem, he said, wasn't a lack of Vitamin K in my diet. My problem was a lack of fat. Without fat in my diet, I couldn't absorb the Vitamin K that I was eating. Without fat on my body, I couldn't store the Vitamin K.

His advice? Not supplements, but fat. He jokingly (or maybe not so jokingly) calls lard the ultimate health food. "Eat more fat, Carrie."

When I stared refeeding at home, my bruises literally disappeared within a week or two. I had been in residential treatment, among ED experts, who had failed to crack this mystery. Amazing. It was all about making peace with butter.

I was reading the book "The Ancestor's Tale" by Richard Dawkins (an impressive tome in which the reader goes on a virtual time-travel back through evolution), and I stumbled across this little gem in the section known as "The Salamander's Tale," the excerpt of which has nothing to do with salamanders.*

"Many Western countries at present are suffering what is described as an epidemic of obesity. I seem to see evidence of this all around me, but I am not impressed by the preferred way of turning it into numbers. A percentage of the population is described as 'clinically obese.' Once again, the discontinuous mind insists on separating people out into the obese on one side of a line, the non-obese on the other. That is not the way real life works. Obesity is continuously distributed. You can measure how obese each individual is, and you can compute group statistics from such measurements. Counts of numbers of people who lie above some arbitrarily defined threshold of obesity are not illuminating, if only because they immediately prompt a demand for the threshold to be specified and maybe redefined...Nevertheless...our brains evolved in a world where most things do fall into discrete categories."

Dawkins' stance on size acceptance is really not the point here. Rather, it is the almost innate habit of humans to put essentially anything and everything into one of two categories.

Fat or thin.
Healthy or not.
Tall or short.
Dead or alive.
Rich or poor.
And so on.

Companies and advertising take advantage of this. One of the banner ads at the top of my emails sometimes read: Are you fat or healthy? As if you can't be both. Or neither. The irony is that most of us fall into some middle ground, neither rich nor poor, short nor tall, healthy nor unhealthy.

And not only do we want to categorize other people, we also want to categorize ourselves. We ask: am I normal weight, overweight, or obese?** I saw a book when I was browsing at Barnes and Noble yesterday that was titled, "Eat This, Not That." Very dichotomous. But frankly, I don't like either Big Macs or a Baconator, the two choices of burgers on the cover. I didn't look further in the book, but I got the basic premise.

Even more, one of the two categories is always more highly desired by society. It is also harder to achieve, which is perhaps why it is so highly valued. The harder it is to place yourself in a category, the more a company can sell you products to move yourself into said category. If you're not beautiful, you're ugly. It's very hard to be considered beautiful in our society. Your eyebrows must be perfectly plucked, no wrinkles on your skin, always wear makeup, style your hair, etc.

And how much money is made by selling products to de-wrinkle your skin, find the perfect foundation/mascara/eye shadow, hair dye, hair gel, curling irons?

A lot. A whole freaking lot.

Especially when we're younger, our brains are very black and white. We haven't yet mastered complexities and nuances of such things. Because this drivel is continuously driven into our heads by companies and culture, it gets harder and harder to break free.

This is where teaching kids about "healthy eating" and "healthy body weight" gets dangerous. A 5-year-old is not equipped to know that eating a slice of cake--even on a regular basis--is fine, but a steady diet of buttercream frosting isn't. Cake is bad. Cake is unhealthy. These two things are now considered exactly the same.

If you are either fat or thin, healthy or unhealthy, and thin=healthy and thin=desired, then you will want to be thin. Above all else. Kids aren't stupid. The pecking order on the playground is brutal. Fat is not looked upon favorably.

We could tell our children to eat a wide variety of foods, and to enjoy them. We could tell them that human beings come in an array of shapes and sizes. We could. But we also feel the need to pare information down to the most basic level, at the expense of the message itself. Healthy or not. Fat or thin. If teachers are always talking about dieting and weight loss, kids begin to think it's normal. And if "everyone is doing it," what's wrong with my thinking that?

The issue is first that this is taught at all. Good food/bad food is totally arbitrary. Margarine used to be thought of as "better" than butter because it had less saturated fat. Now "butter is better" because margarine has trans fats. In the 1980s and 90s, fat in general was the culprit of all of society's ills. In the 2000s, it's carbs. The second issue is that it is taught too soon, where your brain can't yet sort out all of the information properly (or that it's so diluted that you don't get all of the proper information). And the earlier kids are brainwashed into thinking this way, the more it is reinforced, and the harder it is to break free.

Even we as adults have a hard time breaking out of this mentality. It has been so reinforced that it seems almost instinctual. And because this dichotomous thinking has been honed by millions of years of evolution, the either/or concepts are quite natural. But if we have evolved speech and calculus, I think our brains are up to the challenge.

*The structure of the book is based on Chaucer's Canterbury Tales- an interesting choice for a hard-core atheist. But I digress...

**These online tests might tell you, after you plug in the numbers, that you are, in fact, underweight, but it never asks you that outright. Just the three choices above.

Apparently, this week is National Public Health Awareness Week. Being out of the field for about a year now, I had no clue. Alas.

The school where I go is very well-known for its public health programs, making it no surprise that student groups wanted to make everyone aware of public health.

You can guess what topic they chose to make people "aware" of: how fat we all are!

A student at an elite college NOT knowing about the "obesity epidemic" seems to me to be quite ludicrous. There are "healthy eating" signs and brochures in the dining halls and eating areas. And every female (and probably every male) knows about the dreaded Freshman 15.* I envy anyone who doesn't know about obesity.

There were the standard "2/3 of Americans are OVERWEIGHT or OBESE!" The caps were on the sign. And the words were in blue glitter glue. The irony is that eating disorders are completely rampant on campus. Way to freak people out, Public Health Student Association.

There was also "Eat More to Weigh Less: Eat Breakfast to Lose Weight." Now, I am all for eating breakfast. It does stimulate your metabolism, which is beneficial in more ways than just weight loss. You feel more awake and less sluggish. You don't want to nibble on your co-worker before lunchtime because you're so freaking hungry you can't stand it. You think better (mom was right). Breakfast is called that because you are breaking the fast that happened during sleep.

The last sign was "Get your 30 minutes of daily exercise: run to class!" Granted, I usually race to class, but not for exercise. Mostly, I'm running late or the elevator is broken, or both. I also have to wonder about the mechanics of this. You have a backpack or tote bag likely full of books. That can't be good for your back. And a herniated disk or pulled muscle is one way to keep you from exercising for several months, as well as create a lifelong back problem (just as me). Secondly, do you really want someone all sweaty and gross sitting next to you in lecture? Maybe if they get some deodorant vending in the bathrooms. And you can't really run in the pouring rain, or the freezing cold, the ice and snow, or the stinking heat.

I can think of many public health issues that should have been addressed: lack of health insurance, access to places to play for kids, access to fruits and vegetables, childhood vaccinations, STDs, you name it.

Even the health sections of most news websites are all about weight loss. It's really sad. Health is NOT about losing weight- unless you want to equate that with losing health and sanity. Girls who diet are more likely to be anemic.** This noticeably lowered their IQ scores, and their energy levels. They were less likely to drink milk, putting them at risk for osteoporosis down the road.

Come ON, people. We can do better than this. Much better. There are so many aspects to health, and weight loss isn't even one of them! Why don't we focus on what we can change? And what will, I don't know, actually make us healthier?

*Although my mandatory health class was kind of ridiculous, one good thing I learned was that women are supposed to gain extra weight around that time, as our bodies finally ready themselves to give birth. The pelvis widens, and more fat is added to sustain a pregnancy. If only she included that girls are also supposed to gain 1/3 of their final body weight during puberty, but alas.

**These were NOT just girls with eating disorders- just your run of the mill middle school and high school dieters.

***That dieting should be considered run-of-the-mill is quite frightening in its own right.

Finally, a scientists who really gets it.

Read the story at the Angry Toxicologist:

There is no safe level of bacon. It all causes cancer.

Read it. All of it. And, in the faint faint noise of the background, you will hear me. Rejoicing.

I was a biochemistry major in college. I sat through many tortuous 8am lectures, and even one Saturday morning lab. Much of it was erased through the haze of starvation and sleep deprivation, but some of it (I hope) stayed with me.

Biochemistry is the foundation of all health sciences (psychology and psychiatry seem to be unfortunate exceptions). You can learn a lot about health in a biochem lecture, provided your professor's accent isn't so strong and handwriting so messy that you begin to drool on your notes. I can tell you about enzymes Co-Q, the citric acid cycle, the aerobic and anaerobic production of ATP. There were many formulas- you get an average of 31 ATP molecules for every glucose molecule ingested. And so on.

The health industry ("thindustry") pounces on the idea of formulas as a way to measure health. Count your fat grams. No, your carbs. What about the glycemic index? Crap! Then wait, no, it's the total number of calories you consume. On top of that, you have to exercise.

So most of these companies (and the federal government) have created little charts telling you how much to eat and drink and exercise to maintain an "ideal" weight.

Now, I'm not much of a fan of our current government, and a cynic by nature, but why the hell should the government be calculating the ideal size of my butt? It makes no sense.

Digging a little deeper.

These formulas are attractive. My little OCD reptilian brain loves to count calories. It latches onto those numbers, stashes them away in a little cerebral filing cabinet where the information can be retrieved upon Ed's request. The thing is, our bodies do not work on math alone. Magazines tell you that if you eat this many calories, run this many miles, do this many crunches and leg lifts, then you will look like this model/celebrity by Memorial Day. I'm assuming, of course, you purchase the issue at least 24 hours before Memorial Day begins. It makes no sense. First of all, I will NEVER look like the person in the picture because I'm probably too short. Secondly, I'm not that person. I don't want to look like a celebrity, and I certainly don't want to be one. I hide at the mall when I see someone I know because it's usually a hassle to talk and explain what I've been doing in the past 6 months ("Oh the psych unit is great...you really should visit. It's so rejuvenating!").

I could get up on my soapbox at this point and do the bra-burning feminist chant of I am so much more than my body, but I won't. I know it's true. That was never the issue.

But formulas. They don't make sense. Your body doesn't burn calories at an equal rate every single day. The same person of the same height and weight will not burn the same calories at the same workout. Formulas give us the illusion that if we can just get things to add up, then we can have whatever someone else has. The whole grass is greener on the other side of the fence deal. Life is messy. Formulas are nice and neat.

Health isn't nice and neat. Health is a little of this, a little of that, some play time, some sleep, some creativity, some love, some annoyance, and so on. A healthy life for me isn't going to be the same as for someone else. I like to go hiking. My mom doesn't like any activity without a flush toilet within 5 minutes walking distance. My cat doesn't like any activity that involves moving. Yet we're all reasonably healthy. There's no magic number or formula.