When Anorexics Grow Up

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The last time I tasted my birthday cake was the spring I turned 13, a few months before I discovered the elimination game.

The game went like this: first, stop eating sweets. Second, blot sauces, oils and dressings with paper towels while no one was looking. Third, count grams of fat, reject any food with over 3 grams, and keep a calorie tally in the back of your math notebook (where, if someone found it, they’d assume it was just math).

The elimination game also involved adding. Add the toilet bowl and the sewer down the street to the list of places you could discard food. Add candy bar wrappers and empty full-fat yogurt containers to your bedroom nightstand as evidence that you’re not sick. Finally, add up the pounds you’ve lost that week that signify victory. So easy. Repeat.

At 38, I am a former anorexic in recovery. Over the years, I’ve discovered my strengths — making my two children feel loved, encouraging sources to open up for stories I write as a magazine reporter — but I’ve never been as good at anything as I was at the elimination game.

Growing up in leafy suburban Queens, N.Y., I became obsessed with made-for-TV movies from the ’80s and ’90s about anorexia. All of my early eating disorder role models — a nightmarish choice of words, but when you’re in the grip of this mental disorder, that’s what they are — were scared, sad and relatable. They were also all very, very young.

My stars were Karen Carpenter, Tracy Gold and my favorite, Jennifer Jason Leigh, who, in the 1981 movie “The Best Little Girl in the World,” appeared appealingly helpless in high-waisted jeans.

With one exception, these movies wrapped up anorexia in tidy boxes where therapy, feeding tubes, weight gain, finding release from a controlling mother’s grip and discovering the joys of food led to a happy ending. I was a kid who no longer ate dessert when I watched Ms. Leigh’s character jovially lick an ice cream cone beside her therapist. But even I knew then that ice cream was neither the problem nor the solution.

The only other outcome for anorexics was the one the singer Karen Carpenter suffered — the one that would never happen to me: death at age 32. So old, I remember thinking. How could she let that happen when everyone else found the cure?

The aging anorexic doesn’t make for a compelling movie. Adults with the disorder aren’t represented in pop culture and news outlets, so I assumed we were either supposed to outgrow our eating disorders or die.

But in 2003, one-third of inpatient admissions to a specialized eating disorders treatment center were for people over age 30, according to the National Eating Disorders Association. In an online survey published in the International Journal of Eating Disorders, 13 percent of women over age 50 were found to have eating disorder symptoms. And many older sufferers of eating disorders, some of whom have been battling the disorder since they were young, feel shame at having a “teenager’s problem” and are reluctant to get help.

After decades of therapy — of great days and good years, relapses and starting over from scratch — I realize there’s an ending these movies fail to capture. Some of us are never going to be fully cured.

That doesn’t mean we return to our anorexia rock bottom.

For me, that was when I was 20 and had become so ill that heart palpitations kept me up at night. It was when I walked down Bayswater Road so weak from hunger that traffic sounds and accents blend into a single white noise loop. It was when two photographers stopped me on the same afternoon to ask if I wanted to model while my chest rattled from walking pneumonia.

Living with eating disorder thinking means actively ignoring a voice in my head that tells me it’s dangerous to have a favorite restaurant (Tanoreen in Brooklyn) or to lick my lips while savoring sumac shredded chicken. It’s forcing myself to use positive adjectives to describe my 5-year-old’s mac and cheese after she proclaims it’s the “best thing ever.” It’s never being able to engage in conversations with other women — and, boy are there many — about losing weight or trying out a fad diet. And it’s feeling their eyes on me when I won’t join in the ritual of bashing my own thighs.

They suspect it’s because I think I’m better than everyone else; I know it’s because my weak mind can’t afford dabbling in this sport.

I feel anxiety every time I realize my body is going to change as I age, with or without my consent, whether I weigh 89 pounds or 289 pounds. I don’t trust the body and fear the ways it can turn on you. At an early age I decided that the only way to stall death or pain, or both, is to wield a lion tamer’s whip and keep cracking at the body, change after change.

For me, change is as much an enemy as weight gain and the body itself. Puberty is one of the most frequently discussed risk periods for the development of eating disorders. The frustration I have with the focus on puberty and eating disorders is that it doesn’t address the fact that every stage of life for a person with an eating disorder presents enormous changes.

My triggers have included puberty, leaving home for the first time, and getting pregnant. As I age, they may include watching my own children leave the nest and confronting my mortality.

My heart hurts thinking about a teen anorexic sitting in her suburban bedroom, one change down and hundreds more to go. She may believe that eating dessert one day means she’s saved. That she can then bid farewell to therapy and go enjoy a banquet of delicious foods for the rest of her life. I hope that’s her fate, but for an anorexic, it isn’t always the resolution.

I refuse to call myself fully healed because there is still work to do. Some days it’s easy work, other days it’s work that makes me break down in tears on my husband’s lap. But it’s work that must be done every morning, every evening, at every meal.

This is the way I keep healing.