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Imagine that turkey and fruitcake are your worst enemy this Thanksgiving,
Christmas, and New Year's. Or that sharing a bathroom, where you can't purge what
you've just eaten without someone hearing, becomes your biggest nightmare while
home for the holidays. And that one off-color comment you overhear about your
weight at a party? That's enough to make you binge on the contents of your food-
stuffed purse and throw it all up later,
in the still of the night. Such is what the holidays can be like, according to
recovered anorexics who spoke to ELLE.com for this story. Another truth about
anorexia and similar eating disorders: They are diseases that thrive on the power of
suggestion, a fact that made some who stared down death as a result of anorexia or
bulimia—or a combination of the two—have serious qualms about sharing their
experiences.

"My concern is that women could read some of my—and others'—accounts of
having an eating disorder and come up with ideas of their own. I pray that won't
happen," says Lisa*, 26, a video journalist in recovery from anorexia, who claims that
she, in fact, was "inspired" to starve herself by a made-for-TV movie about an
anorexic. "It starred Tracy Gold, and I think the seeds were planted while I watched
it," she says. "I figured I could do it too. I just wouldn't go as far—or get caught."

Lisa's experience should prove a cautionary tale. She quickly became an exercise-
addicted anorexic who was 5'7" and weighed 93 pounds.

Ashley*, now 35 and also recovered, threw up everywhere: "the sorority house, bar
bathrooms, restaurants, dorm bathrooms—anywhere I could be alone," she says.

Emily*, 22, was finally forced into inpatient care when—after a four-year downward
spiral that included food restriction, bingeing, purging, and eventually a cocaine
addiction—her weight dropped to 96 pounds and her heart rate to 30 beats per
minute. Emily's doctor told her she was in grave danger of having a heart attack.

The point? Anorexia is a complex disease, with myriad causes that range from
culture to environment to—as recent studies have shown—genetics. Having a
predisposition for anorexia means that a simple decision to diet away those last five
pounds triggers something (it's unclear as to what) that could lead you down a
slippery slope. If full-blown anorexia does take hold, it's hard to shake and has a
high mortality rate. And for those who do make a full recovery with the excellent
care that's now out there, the years of semistarvation can continue to wreak havoc
on their metabolisms permanently, distorting the body's ability to know whether it's
full or hungry.

In short, anorexia is anything but glamorous, and we're entering a time of year that
can be particularly hard for anyone afflicted with it, recovered or not. "Thanksgiving
is the worst," says Louise Ousley, PhD, a psychologist in private practice in
California who ran the eating-disorder program at the University of California, Santa
Barbara, from 1984 to 2004. "It's a national binge day. Eating is all people do when
they get together."

It's also a time when a concerned family will, understandably, pay close attention to
what an underweight person has on her plate. "A lot of my clients would pretend to
eat and throw it up later," says Ousley.

When you're accustomed to consuming, say, a banana and maybe a packet of
oatmeal in a day (as Emily was when she was at her most unhealthy), that close
scrutiny can be excruciating because you're already doing so much of it yourself.
Over and over again, anorexics will tell you that it's not about food, it's about
control—a way to manage emotions, events, and whatever is uncertain in their
lives. Food ceases to be seen as sustenance, and consumption has nothing to do
with enjoyment.

"I was never really proud of being anorexic," says Emily, "but one of the sickest
parts of the disorder is that you do get a sense of satisfaction and accomplishment
from depriving yourself. To eat is to fail, and to starve is to succeed."
CONTINUE READING BELOW....
Consequently, she became obsessed with studying labels and nutrition facts.
Anything she ingested was recorded on a Post-it note: "At the end of the day, I
would calculate what I ate, then go to the gym to burn off as much of it as I could."

"Anyone with an eating disorder is a human calculator," says Kelly*, 31, a recovered
anorexic from Raleigh, N.C., who works as a middle-school counselor. "A banana
isn't a banana—it's 110 calories."
Emily's and Kelly's comments speak to what makes treating anorexia particularly
difficult. "It's one of the few mental illnesses where the people who have it feel
great about having it," says Joy Jacobs, PhD, a clinical psychologist based in San
Diego. "The psychological term is `ego-syntonic,' which means the behavior and
results that an anorexic gets from the illness make them feel good." Not eating, in
particular, makes anorexics feel victorious. So rather than seek out help, they'll take
drastic measures to protect the coping mechanisms they've put in place—especially
when the holidays pose a threat to their carefully constructed routine.

Jacobs has treated clients who would run for hours and hours prior to leaving for
holiday celebrations, burning calories in anticipation of anything they might eat.
Some anorexics, though already scary-skinny, she says, would binge and purge.
"They'd hide it and eat secretly during the night," she says.

One very ill patient refused to put lotion on her skin because she was convinced it
contained calories. And thin skin—or not being comfortable in the one you're in—is
a calling card of anorexia. Which means that something we as American women
engage in quite often over the holidays can send someone with disordered eating
into a tailspin.

The term "fat talk" was first coined by anthropology professor Mimi Nichter, who
wrote a 2007 book on the subject called Fat Talk: What Girls and Their Parents Say
About Dieting. Simply put, it's that conversation that tends to play out ad nauseam
whenever a group of females (interestingly, usually white or Hispanic, but not black)
get around food.

"Oh, I can't eat that. I'm so fat!"

"No, you're not. Look at you in that dress. Now I'm the one who really needs to get to
the gym."

"You? You're so skinny! I'd kill to look like you."

And so on.

Fat talk definitely picks up in November and December, and for an anorexic, hearing
it can be akin to being force-fed doughnuts. "That's what bothers me the most," says
Kelly. "It starts right around Halloween with the candy, and then on through January,
with the newscasters going `Lose those last five pounds!' You can't escape it."When
anorexic, Kelly says she would spend all day thinking about a holiday party she was
going to. Moreover, she had so much anxiety surrounding food that the thought of
eating around other people practically paralyzed her. "If I challenged myself to do
something out of the ordinary and got a plate of food—usually vegetables—and
someone talked about what a certain dish would do to their hips, I'd have a
meltdown," says Kelly.

The behavior seems insane to her now, she admits, but Kelly—who today travels the
country lecturing about body image—is right to be concerned about the
phenomenon. A research study Ousley conducted showed that fat talk was
positively related to eating pathology and body dissatisfaction in college students.

"Negative fat talk," she says, "was highly correlated with other diagnostic indicators
of eating disorders, for both men and women." Which raises another interesting
point: There's no such thing as a "typical" profile of an anorexic anymore because
the disease now impacts a wider range of genders, ethnicities, and ages.

"Even though there is a greater amount of prevention and education, we're seeing
a more complex picture," says Jennifer Nardozzi, National Training Manager for the
Renfrew Center, the country's first residential treatment facility for eating disorders.
"Before you would think it's a young person who's maybe Caucasian. And that's not
the picture we see anymore. There are different ethnicities and other
demographics."

Case in point: Ten years ago, Nardozzi saw maybe "one or two" thirtysomething
anorexics admitted. In the past three to five years, however, women in their thirties
and beyond have come to make up just under one-quarter of Renfrew's patients. In
fact, the center recently created a separate treatment track to accommodate the
growing need. Nardozzi chalks late-onset anorexia up to a combination of factors:
later-in-life stressors like divorce and the unrealistic cultural pressure of expecting
thirtysomething women to look like twentysomethings ("You're having to defy the
normal development of aging," she says).

Despite anorexia affecting more women today, Nardozzi says that—on the flipside—
more women are also aware of treatment options. "Someone may have an eating
disorder that was under the radar and now they think, Maybe I can get treatment,"
she says.

Pam*, 59, came of age—and came down with full-blown anorexia—well before the era
of enlightenment. "By the time my doctor got me to the hospital, I weighed not much
more than 100 pounds—in the winter, in a coat, boots, and clothes," she says. After
years of existing on black coffee and not much else, she had developed irritable
bowel syndrome. Then it got to the point where she simply couldn't eat; the stomach
cramping and diarrhea that accompanied digestion was just too severe.

"I went through all the tests for colon cancer," she says. "There was no anorexia
intervention per se, because they didn't seem to know that much about it back
then." Still, she considers herself one of the lucky ones: "I'd be dead if I had kept it
up," she says. "I wrecked my metabolism and now have a hard time with my weight
because it takes almost nothing to gain it, but I'm happy to be here."

And perhaps that's a good thought for anyone—eating-disordered or not—to
remember when life gets trying this time of year.

*Names have been changed to protect identity
SOURCE http://www.elle.com/beauty/health-fitness/advice/a10619/feast-of-burden-
holiday-anorexia-384581/
Things People With Eating Disorders Want People at Their Thanksgiving Table to Know

“I’ll have to run off all these calories tomorrow…”

“I’m going to be ‘bad’ and have a second slice of pie.”

“I didn’t eat all day to get ready for this meal…”

While Thanksgiving is a time to spend with family and be thankful, it’s unfortunately a time when comments like
these from loved ones are the norm. This kind of talk seems so embedded in our “eating culture.” Most people say
self-depreciating or distorted comments without thinking twice.

And while eating disorders are certainly not all about food — comments like these can really hurt a person in
recovery, or in the midst, of an eating disorder. What someone says in passing turns into fuel for the eating
disorder beast, and because of this, holidays can be hard for those doing their best to heal their relationship with
food.

To find out what people with eating disorders need this Thanksgiving, we teamed up with theNational Eating
Disorder Association to ask people in its community: What do you want your friends and family to know on
Thanksgiving?

If you know or suspect someone with an eating disorder is sitting at your dinner table this year, please read what
they have to say:

1. “Please don’t make comments about how fattening the food is, how many calories are in it, the diet you think you
need to put yourself on after the holidays, or anything similar.”

2. “Let me make my own plate and don’t comment on portion size or what I selected. Starting with just a little bit
helps ease the tension of being expected to eat as much as others.”

3. “Don’t ask me if ‘I kept it down’ after we finish dinner. Actually had a family member whisper it my ear one time
and I was devastated. Regardless of whether I did or didn’t, it simply made a tough day worse.

4. “(This might be kind of an odd request but oh well.) Put away the bathroom scales if you can. It’s just too much
temptation for those of us who are basically addicted to weighing.”

5. “Please respect I may need to eat on a different schedule than you or may eat different foods to fulfill my meal
plan. This doesn’t mean I don’t want to participate in Thanksgiving. It just means I’m focusing on gratitude as the
theme of the holiday rather than food.”

6. “Please don’t talk about ‘being bad’ while eating or say ‘diet starts tomorrow’ or any of that to anyone — not to
me, anyone else or about yourself.”

7. “Recognize how much of a trigger this is for me. I agree that conversations should be about anything but what is
on my plate or what I look like… ‘You look healthy’ is devastating and patronizing.’”

8. “Remember I’m really upset with myself during Thanksgiving. I’m mad that one day of ‘overeating’ could risk my
health. I’m mad that, despite my years of treatment, I don’t trust myself to eat like everyone else does on
Thanksgiving. Despite my years in recovery, this day sucks. I have a really hard time with the idea that everyone
around me is actively and openly eating until they can’t eat anymore while I’m trying to not do that, while I try to act
like it’s any other meal. Eating a normal portion on Thanksgiving is nearly impossible, but I don’t have the luxury of
having that extra piece of pie because of the potential for a trigger. I have managed to get through the last two
Thanksgivings without unreasonable potions, but it’s a huge struggle, especially with everyone else eating seconds
or thirds. Sure, I haven’t been ‘symptomatic’ for a long time, but it doesn’t mean it’s easy to watch others binge
while I still measure out my mashed potatoes.”

9. “If the topic of conversation could be less about the food we are eating and more about what we are thankful for,
it’s a lot easier to feel safe eating what I want and need.”

10. “No one needs to ‘go for a run’ tomorrow because they ate pie. And no one needs to prioritize what they eat so
they can eat later. And no one needs to make comments like ‘I feel as big as a whale’ or ‘let’s throw up so we can
eat some more.’ Most importantly — don’t insinuate you can do things like this and I can’t, don’t make me seem like
the alien.”

11. “Unless you’re saying, ‘That looks good,’ or ‘Which is that so I can try it?’ or something similar, donot comment
on what’s on/not on/left on my plate.”

12. “Hearing people talk about how full they are/how ‘bad’ they ate can be upsetting and difficult because, to my
mind, it ‘confirms’ my ED thoughts, so understand if I need to remove myself from the conversation.”

13. “When they do not know what to say, it’s OK to say nothing. Sometimes leaving space for silence is more
profound and meaningful than grasping at trying to say the right thing. I’m not ashamed of my struggle nor the
recovery and neither should they be. Trust the healing process and trust me.”

14. “The hardest part is struggling to be present and enjoy your family while these thoughts about food are trying to
take over your mind. Sometimes all I want to be able to focus on a conversation and it’s impossible because food is
the only thing I can think about.”

15. “This holiday will already be difficult for me so please do not make my body, food or my recovery a part of a
conversation. Let’s focus on something that’s more positive.”

16. “Don’t be offended if I leave the party early. Don’t comment on my ‘willpower.’”

17. “I need to simplify the menu and keep the mess minimal. My eating disorder is not just about the food — it’s
about my perfectionism, control, compulsion, obsession and determining my value based on what I accomplished
(“Oh, look how much work you did! Oh, look how beautiful the house looks!”), not just by who I am. It’s about my
anxiety with the planning, shopping and preparation. About me choosing to not be overwhelmed. It’s about me
working so hard to redefine what this holiday is about — my family — and not wanting to make it all about the food. I
don’t want to spend all my time with the food, I want to spend my time with the family. It’s about me making new
traditions, so I am not triggered by old memories and behaviors, but allowing the recovering me the opportunity to
practice joy, spontaneity and freedom. In order to do all that, I have to be allowed to redefine the holiday, in a
simplified, less stressful, imperfect, not all about me way.”

18. “Understand I struggle with my self-worth and my plate on Thanksgiving. My social anxiety and eating disorder
are screaming at me the whole time. Your criticism or comments can trigger me easier when I’m already on the
edge and fighting so hard to be ‘normal.’”

19. “Don’t say … ‘Oh just have the one,’ ‘You can start again tomorrow,’ ‘You’re not even fat,’ ‘You don’t need to lose
weight,’ ‘When you’re as big as me you can worry.’ This is not a diet, nor is it a lifestyle choice. It’s an eating
disorder and it’s horrific. I honestly wish with all my heart and soul I could enjoy these social occasions like
everybody else, but the truth is I’ve had anxiety about any social occasion for weeks leading up to it because of how
much I’ll potentially eat. The whole time I’m there is a battle between my recovered self and my eating disorder so
please be kind and enable my recovery, not my illness.”

20. “If I don’t show up at all because I just can’t cope with that big of a meal, please don’t be ashamed of me and say
I have the flu. Three years in a row.”

21. “While this may be a fun, celebratory day for you, it is one of the hardest days of the year for me. A holiday
dedicated to the thing I most fear. Please don’t try to force me eat more, I have been in recovery for years, and I
know what portions I need. Please don’t stare judgmentally at my plate or at me while I am struggling to take a bite.
Although I’m able to eat intuitively throughout the rest of the year, Thanksgiving is a hard day because of how much
I build it up in my head when I was sick. It’s hard for me to eat intuitively, when for the past nine years I have made
myself starve leading up to this day, overexercise because of it and refuse to eat the meal with everyone else. If you
want to be of help, instead of forcing another piece of pie onto my plate, ask me how I am doing. Chances are, I’m
riddled with anxiety, my eating disorder thoughts are screaming and
I can’t make them shut up, as the coping skills I usually use aren’t working on this particular day.”

22. “I’m trying. It may not look like it to you, but I am really trying. It’s a constant battle between reality and that little
voice it my head whispering horrible, negative things. Because of this, it may take me longer to decide what goes on
my plate. I will probably pick at it, too. It will probably also take me longer to eat than you. But I am trying. When I
look up from my plate almost in tears, a reassuring smile and nod go a long way. When I don’t want to talk to
anyone after dinner, just sitting by me would mean a lot. And if I don’t want dessert, please be OK with it. Also know,
it’s nothing you did or cooked. This is all me and my head. Not you. Don’t be offended.”

23. “Don’t assume I’m going to struggle. I may have a great day. I don’t need anyone questioning
everything I actually chose to eat or following me to the bathroom. Have faith in me.”

24. “All food is good food! There is nothing ‘bad’ or ‘cheating’ about food made to nourish our bodies. Above all, love
each other and understand that sometimes family members say things without realizing how it sounds to someone
fighting with an eating disorder. Keep communication lines openand, if necessary, give yourself a five minute break
outside or in another room to process your emotions/feelings if a trigger occurs. Happy holidays!”

25. “If you offer me food and I don’t accept it, don’t keep offering — ‘A small slice won’t hurt, just try a bite, one
piece will be OK’ — I have triggers I am fighting so don’t make it harder on me.”

26. “I’ve been preparing for this day for weeks. Months. Small portions to you are huge portions to me. I’m
exhausting every single mental resource I have to keep it together. I still cry when I get home.”

27. “Be patient with me. Understand that Thanksgiving is overwhelming for me, so allow me to go at my own pace.
Try not to comment on the amount of food I have and do not make a big deal that I’m eating. It would be helpful to not
talk about how much weight people gain on Thanksgiving, but I understand that is normal talk for most people —
just try to be mindful when I’m present. All I ask is to be mindful, aware and supportive and Thanksgiving will be a
smooth day for myself and my family.”

28. “Talk to me about what’s going on in my life, not what’s on my plate. Please don’t say things like ‘that’s all your
going to eat?’ or judge the state of my recovery by how much I eat or don’t eat. And please don’t say ‘good job’ when
I have eaten, as my eating disorder hears that as I have eaten too much. Please understand if
I am quiet or anxious it is nothing personal. I am doing the best I can.

29. “Please don’t comment on how I look. Please don’t comment on what I am eating. Please stop talking about
gaining weight around the holidays. Basically, let us all try to enjoy this day with as little anxiety as possible by not
discussing weight or appearances. I’m excited for Thanksgiving for one of the very first times, but I also have a
huge fear that my happiness will be ripped from me the second the food comes out. (Sending strength, love,
and positive vibes to all my sisters and brothers in the ED world. You’ve got this.)”

By Sarah Schuster