IF YOU’RE ANYTHING LIKE ME—and the many, many people I’ve met giving presentations and in my support groups—you may have spent a lot of time beating yourself up and wondering how you could ever have allowed this to happen.
I honestly thought there was a perfect weight that would make me a perfect person.
In my case, there were fifteen young dancers in my class when we were told to lose weight. The others just lost a few pounds and then went on about their lives, while for me the need to lose just continued and continued and continued. Each time I got close to my weight goal, I raised the bar and moved the goal line back. I honestly thought there was a perfect weight that would make me a perfect person. And each time I reached a lower weight, I really believed that when I reached that next new lower number I’d be satisfied. I just chased that rabbit—the illusive, perfect me—down the rabbit hole and found myself in a totally strange world, one in which I actually didn’t have any control even though I had convinced myself that I was in complete control. And then, when I tried to climb out, it was like walking through a hall of mirrors; I couldn’t find the exit no matter how hard I tried.
I just chased that rabbit—the illusive, perfect me—down the rabbit hole and found myself in a totally strange world, one in which I actually didn’t have any control.
Even when I was in recovery, I still kept thinking that I should have been stronger, that I should never have let this happen. I should never have allowed myself to slide down into that hole. Why, why, why did it happen to me?
Genetics—At Least Part of the Answer
One of the most exciting and enlightening moments of my life came when I learned that research indicates there is a genetic component to eating disorders. Some people are born more vulnerable than others to developing an eating disorder, and various researchers have linked the problem to the disruption of serotonin levels in the brain. Serotonin is a neurotransmitter, a brain chemical whose functions include the regulation of both mood and appetite. Some researchers have theorized that increased serotonin levels may leave people in a perpetual state of anxiety, leading them to gain some sense of control by restricting food intake. Low serotonin levels, on the other hand, could lead to bingeing on foods high in carbohydrates, which would temporarily raise serotonin levels and elevate mood.
In a strange way it was extremely liberating for me to read the following statement made by Dr. Thomas R. Insel, director of the National Institute of Mental Health, in an October 5, 2006, letter to the chief executive officer of the National Eating Disorders Association:
Research tells us that anorexia nervosa is a brain disease with severe metabolic effects on the entire body. While the symptoms are behavioral, this illness has a biological core, with genetic components, changes in brain activity, and neural pathways currently under study.
While you might think it would be disturbing for me to learn that anorexia was a brain disease, it was actually validating to know that there was a biological explanation for my problem. And Dr. Insel didn’t leave me feeling powerless, because he went on to say that “most women with anorexia recover, usually following intensive psychological and medical care.” So, it is truly not your fault that you have an eating disorder. Even better, it is possible to recover—and you shouldn’t be expected to cure it all on your own.
Simply telling someone with an eating disorder to “just get over it and sit down and eat” is never going to work. What are you supposed to say to that? “Oh yeah, you’re right. For all those years I was struggling with anorexia the real problem was that I just forgot to eat, but now that you’ve reminded me I’ll remember. Thanks!” No! Initially, I’d actually thought it would be that easy. I thought I could just sit down, eat a meal and not restrict, binge or act out. But, of course, it wasn’t easy. It isn’t, and it’s not supposed to be. But now I have a valid, scientific explanation not only for why I’d developed an eating disorder but also for why recovery wasn’t so easy.
It is truly not your fault that you have an eating disorder. It is possible to recover—and you shouldn’t be expected to cure it all on your own.
Walter Kaye, MD, of the University of Pittsburgh Medical Center, working with an international group of doctors, has collected information from more than six hundred families in which two or more members had an eating disorder. In an article titled “Genetics Research: Why Is It Important to the Field of Eating Disorders?” Craig Johnson, PhD, director of the Eating Disorders Program at Laureate Psychiatric Clinic and Hospital in Tulsa, Oklahoma, states that these results may be nothing short of a breakthrough. They suggest that both anorexia and bulimia “are as heritable as other psychiatric illnesses such as schizophrenia, depression, anxiety and obsessive-compulsive disorders.” And other clinical studies have also supported this evidence. One, conducted at the University of North Carolina at Chapel Hill, reviewed information from more than thirty-one thousand people in the Swedish Twin Registry and determined that genetics is responsible for 56 percent of a person’s risk of developing an eating disorder—with environmental factors determining the rest.
As with almost all diseases and conditions, genetics may predispose us to being more susceptible, but our environment and lifestyle choices either increase or decrease our chances of actually getting the disease. According to Dr. Kaye, “We think genes load the gun by creating behavioral susceptibility, such as perfectionism or the drive for thinness. Environment then pulls the trigger” (Journal of the American Medical Association, Vol. 290, No. 11, Sept. 17, 2003). The problem, of course, is that if we know, for example, that we’re predisposed to developing high blood pressure, we can avoid eating salty foods. But we can’t remove ourselves from the world, and the world we live in is filled with messages and images that hold up thinness as a measure of perfection. All we can do is try to nurture our children’s self-esteem and help them to develop a healthy body image.
As I thought about Dr. Kaye’s words, I realized that when I started down my path to anorexia and bulimia, all I wanted to do was better myself, and I was in an environment that encouraged me to lose weight and be thin. I truly believed that if I lost weight I’d be a better dancer, and that was the most important thing in my life, the only thing I really cared about. So, not only my own perfectionism but also the environment in which I’d immersed myself were working together to put me at risk for developing an eating disorder.
When I ask members of my support groups whether there’s anyone else in their family with an eating disorder, I see a lot of people shaking their heads no. And then I ask, “Well, what about your aunt Suzy or uncle Bob, who will only eat particular foods, has peculiar eating habits or is exercising all the time?” and all of a sudden their eyes light up and hands go into the air.
Looking back on it now, I can see that not only eating disorders but also alcoholism, depression and anxiety run in my family. I remember being a little girl and visiting an aunt, my father’s sister, who worked for a large clothing store in Paris. She was petite and thin, and I recall her telling me that her secret to being skinny was to eat just one fast-food fish fillet sandwich a day. At the time, I didn’t think, Okay, I’m going to do that, but it did reinforce the idea that weight was an issue and that thinness was something to work for. And now, of course, I know that my aunt must have had some kind of eating disorder—or disordered eating—herself.
In addition to what I observed in my father’s family, my mother’s sisters have also struggled with poor body image and have always been extremely conscious of everything they ate. So, in fact, there were eating and body image issues on both sides of my family. For me, the genetic gun was definitely loaded and just waiting for the environmental circumstances that would pull the trigger. I really didn’t roll out of bed one morning and decide to be anorexic! And it’s important for your recovery to understand that neither did you.
Make That Information Work for You
So, now you know you probably have a genetic predisposition that contributed to your developing an eating disorder. Does that mean you should just sit back and use it as an excuse to keep on destroying your health and your life? Absolutely not!
Eating