book reviews, healthcare

Repost: A review of Almost Anorexic, by Dr. Jennifer J. Thomas…

Sorry… one more repost as I try to decide on today’s fresh content. I wrote this review for my original blog on August 30, 2016. It appears here as/is.

When I was younger, I went through some pretty disordered eating rituals.  I was obsessed with my weight and how it looked on me.  You’d never know it to look at me then or now, but I engaged in some behaviors consistent with eating disorders.  I was not really a binge eater or a purger, but I did sometimes stop eating.  There were a few times when I was younger that I’d actually stop eating for several days.  My weight would go up and down, along with my moods.  I could be funny, goofy, and almost manic, or very depressed and angry.  Some people thought I was so moody that more than one person asked me if I was bipolar.

It took many years, but I finally quit obsessing so much about my weight.  Sure, I’d love to be a lot thinner than I am now; but I no longer obsess about my weight.  I don’t starve myself or force myself to exercise more than I want to.  I do engage in some behaviors that might be considered disordered to some people, though, and that’s one reason why I decided to read Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem? (The Almost Effect).  I also read this book because I myself have studied public health and social work and this book might be considered professionally relevant to me if I actually practiced.

Published in 2013, Almost Anorexic was written by Dr. Jennifer J. Thomas, who is (or was) an assistant professor of psychology at Harvard University in the Department of Psychiatry, and Jenni Schaefer, a singer, songwriter, speaker, and author who suffered from eating disorders and managed to recover.  This book is the fourth in Harvard Medical School’s “Almost Effect” series.    

Dr. Thomas goes by the name Jenny, so in order to make things less confusing for readers, she is referred to as Dr. Thomas in this book.  Jenni Schaefer is referred to as Jenni.  My name is also Jenny, so I felt like I was part of the club!  In any case, Dr. Thomas and Jenni keep their writing conversational and personal as they explain why they wrote about a condition called “almost anorexia”.  Basically, what they mean is that there are many people out there who are eating disordered, but don’t quite qualify for a formal diagnosis of a specific eating disorder.  

The book is called Almost Anorexic, but it’s actually about a spectrum of eating disorders– everything from orthorexia (an obsession with clean, healthy eating) to binge eating disorder (binging on food, but not purging).  My guess is that they chose to call the book Almost Anorexic because anorexia is probably the most dramatic, the most recognizable, and is certainly the most lethal of recognized eating disorders.  I think it also has more of a fascination factor and less of an “ick” factor than, say, bulimia does.  

This book is for anyone who “flirts” with eating disorders.  The authors offer insight into what eating disordered behavior is.  Eventually, toward the end of the book, there are some strategies offered to help combat the behaviors that can lead to full blown eating disorders.  I got the sense that preventing full blown eating disorders was what the authors were really after, though they did recognize that many people suffer for years engaging in behaviors that make them miserable and can ruin their health.  

One thing that I appreciated was that the authors point out how eating disordered behaviors, even if they aren’t bad enough to qualify for a diagnosis of anorexia nervosa or bulimia, can do a lot of damage to a person, physically, emotionally, and mentally.  Aside from that, life is short and obsessing about calories, food, exercising, what others look like and what you look like to others is a serious waste of precious time.  It truly doesn’t lead to anything but self-destruction and makes life much more difficult than it needs to be.  The authors recognize that their readers who might be struggling with disordered eating should strive for moving beyond those “almost anorexic” behaviors, but they also know that actually doing that is very difficult for most.  So they offer some good strategies and encouragement, along with anecdotes that make the reading more interesting.

I have read a lot of books about eating disorders over the years.  It started when I was a teenager and got to a fever pitch when I was a young adult.  Lately, I don’t read as much about eating disorders as I used to.  The topic just doesn’t interest me as much.  However, I did notice that the authors, particularly Dr. Thomas, whose voice seems to be the principal in this book, mention a lot of books that I’ve read.  I was really impressed when she mentioned Fasting Girls, which is a really great book about the history of eating disorders that I remember reading when I was a college freshman in 1990. She also mentions Cherry Boone O’Neill’s classic anorexia memoir, Starving For Attention, which I read for the first time in 1986.  

So, not only has Dr. Thomas got a lot of professional experience and training, she’s also read some of the best books.  But she also includes a lot of the latest research in a way that will speak to younger readers… the ones who are addicted to pro-ana or pro-mia Web sites or refer to their eating disorders as “Ed” or some other name.  “Ed” is the little voice in your head telling you you’re too fat or that you look awful in your favorite jeans.  “Ed” is the voice that tells you to engage in unhealthy and obsessive behaviors.  Dr. Thomas and Jenni explain strategies as to how to get “Ed” to shut up and go away, even as they acknowledge how difficult and scary it is to do that.

A lot of people struggle with “eating disorder not otherwise specified” or EDNOS.  That is essentially what “almost anorexic” refers to– having subclinical signs of an eating disorder that don’t quite qualify for a diagnosis.  Not being full blown anorexic or bulimic doesn’t mean you aren’t suffering or doing damage to your health.  That’s really what this book is about, as well as encouraging readers to take care of themselves and get healthy.  I think it’s an excellent read for a lot of people… many of whom never talk about “Ed”, but hear from “Ed” every day.  I give it five stars and a hearty recommendation, especially for those actually suffering.  I think it’s slightly less helpful for family members and friends, though it’s probably worth a read by them, too.

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book reviews

Reposted: An updated review of Marya Hornbacher’s Wasted…

I read Marya Hornbacher’s landmark memoir about her experience with anorexia nervosa many years ago. In 2015, I re-read it and wrote an updated review, which I am reposting here as/is.

Back in 2003, when I had just started writing product reviews on Epinions.com, I posted a review of Marya Hornbacher’s groundbreaking book, Wasted: A Memoir of Anorexia and Bulimia.  This book was originally published in 1998.  I remember that very clearly, because at the time, I was working at a restaurant and didn’t have a lot of money to blow on books and music.  I really wanted to read it.  So did everyone else that used the local library.  I finally checked it out months after it was first published, then bought my own copy.  Marya Hornbacher’s storytelling blew me away.  She’s close to my age, too, so I could relate to some of the cultural references she made during her coming of age years, even though she’s from Minnesota and I’m from Virginia.

I recently decided to re-read Marya’s book, even though I read it a few times years ago.  It’s been a long time since I was last diet obsessed.  Though no one would believe it to see me now… and they probably wouldn’t have believed it then, either… when I was a teenager, I used to diet obsessively.  I never made myself throw up or binged, but I did used to restrict food and would, on occasion, go without eating for days.  It’s been many years since I last did that.  I find that now, if I try to starve myself, I can’t really function very well.  I get pale, shaky, confused, and extremely short tempered.  Though it’s been awhile since I last fainted, I imagine if I went too long without food, I probably would.  I used to faint all the time when I was younger. 

As a teen and college student, I would starve myself all the time.  I did it, in part, to lose weight.  I probably also did it for attention, and because I had very low self-esteem and hated myself.  Some of my friends knew, but my family never did.  If they had known, I doubt they would have cared that much, since I have never been thin.  Either that, or they wouldn’t have believed me, unless they had seen it for themselves.  I do remember my mom yelling at me once when she hadn’t seen me eat in awhile, but it seemed to be more out of annoyance than alarm.  I have since come to realize that a lot of times, my mom is annoyed about being concerned.  The two conditions go hand in hand for her.  If I’m honest, I’m kind of the same way.  I get worried, but it annoys me when I feel worried.

So anyway, I just finished Wasted yesterday.  I can’t say I’m as blown away by it as I was in the late 1990s, though I still think it’s a damn good book.  She starts at the beginning, explaining that her parents, though still married at the time the book was published, were a very dysfunctional couple.  They had weird food habits.  Marya would have friends over and there would be “nothing to eat”… or, at least nothing that kids would like.  Her mother didn’t keep sugar in the house, so there was no chocolate, no sugary cereals, no Cheetos or potato chips… 

By the time she was in fourth grade, Marya was a full blown bulimic.  She later progressed into anorexia nervosa and was deeply entrenched in it by age 15.  As a teen, she was hospitalized three times.  The first time, it was for bulimia, so she had fewer restrictions than some of her fellow patients, who were there due to anorexia nervosa.  She gained and lost weight repeatedly, eventually reaching a low of 52 pounds in 1993, while a college student.  She very nearly died.  In fact, doctors once gave her a week to live.  She managed to rebound and recover, though she was eventually diagnosed with Bipolar Disorder with atypical features.  I read about her experiences being bipolar when I picked up her book, Madness: A Bipolar Life, published in 2008.

Marya Hornbacher definitely knows what she’s writing about, though her experiences were very extreme.  She’s also a very vivid writer who has a relatable voice.  Her eating disorders, while bad enough on their own, were mixed with alcoholism and drug abuse.  She got involved with males… guys she didn’t know well and didn’t care too much about.  At the same time, she was extraordinarily talented.  She spent a year at Interlochen, a Michigan private high school for artistic teenagers and, according to Hornbacher, a hotbed of eating disorders.  Her health suffered so much there that she had to leave after a year, yet she still managed to achieve a lot.  She won a scholarship to American University in Washington, DC, Bill’s alma mater as well as my older sister’s.  She did not graduate from American, though, because once again, her eating disorders got in the way. 

Throughout the book, Marya offers “interludes”, passages written after she had supposedly recovered.  She explains what it’s like to read her files, written by medical and psychological professionals who took care of her.  She also writes about physical damage she did to herself and how it affected her circa 1996.  I have no idea if she still has physical issues nearly twenty years later.   I would guess she does. 

I suppose if I had to offer a criticism of Wasted, I’d say that it may be dangerous reading for some people.  Those who have struggled with eating disorders may find it triggering or “too informational” on how to maintain the disease.  For example, Marya writes that many bulimics eat certain brightly colored foods so they have a marker when they vomit to see what’s come up.  That’s a trick that may not have occurred to those reading her book for “thinspiration”.  Some people recovering from an eating disorder may feel compelled to try some of Marya’s methods themselves. 

On the other hand, I don’t know how in the world Marya could have written her story without describing the disease and what she did to maintain it.  While being more vague about the extremes of her illness– for example, not telling readers that she got down to 52 pounds– might have made this “safer” for people who have anorexia nervosa, it also would have made for much less compelling reading.  People who don’t understand eating disorders and don’t know why they are so dangerous should know about the more dramatic aspects of the illness.  Aside from that, people with eating disorders are forever looking for “thinspiration” anyway and they’ll find it wherever they think it exists.  An Amazon.com underwear ad could be triggering to someone with an eating disordered mindset.  I don’t think it’s possible to completely protect people from themselves.

In any case, Marya Hornbacher’s first book, written when she was just twenty-three years old, is brilliantly composed, full of candor, and uses vivid language.  I do recommend it to those who wonder what would compel someone to starve themselves, binge, and purge.  Those who struggle with eating disorders may do well be be cautious.

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book reviews, mental health

Repost: A review of Safety in Numbers: From 56 to 221 Pounds, My Battle with Eating Disorders — A Memoir

Here’s a repost of a book review I wrote on January 15, 2017. It’s been copied as/is.

I finally managed to finish reading my latest book yesterday, while caving in out of the falling snowflakes.  I bought Brittany Burgunder’s 2016 book, Safety in Numbers: From 56 to 221 Pounds, My Battle with Eating Disorders — A Memoir, in August of last year. It took awhile to start reading it, and once I got started reading it, it took a long while to finish it. I think I was attracted to this book by its rather provocative title and many good reviews on Amazon. Now that I’ve read it, I’m ready to add my own thoughts.

Brittany Burgunder is a young woman who grew up battling several eating disorders. She spent several years suffering from anorexia nervosa and compulsive exercising. She has suffered from binge eating disorder. She’s also experienced bulimia. Burgunder grew up in San Luis Obispo, California in a two parent household. She has a younger sister named Kasey who gets a couple of mentions at the beginning and end of the book. Burgunder’s parents are clearly financially well off, or at least they are better off than many people are. Burgunder grew up playing tennis and showing horses. She enjoyed success in her sports. Having spent my adolescence riding horses, I know how expensive being involved in riding can be. Tennis is probably not as expensive as riding is, but it’s also not necessarily a sport for the impoverished. I get the sense that Brittany is quite privileged.

At the beginning of the book, Brittany Burgunder is beginning her college career at the University of California, Davis. She is suffering from anorexia nervosa at the time. Her health is very poor and the doctors at the university fear that she’s in danger of dying. She eventually gets forced to leave school and go into a treatment program. Most of the book consists of Burgunder’s journal entries and experiences in a variety of different eating disorder programs in Arizona, Utah, and California.

The most compelling part of the book is the year during which she went from weighing 56 pounds as an anorexic to 221 pounds as a binge eater. She gained 165 pounds in the course of just one year. The idea of that is unfathomable, but there are pictures and the physical transformation is incredible. Throughout all of her experiences, “ED”, the eating disorder, is in charge.  ED is pretty much the same voice in Brittany’s head, even though the disorder manifests in different ways.

One thing I did not like about Burgunder’s book is that it mostly consists of journal entries, many of which are very similar. I think this book would have been a lot better if it had gotten a couple of passes with an editor. It probably could have been slimmed down by 50-100 pages, which would have made it easier to digest. I understand that this is Brittany Burgunder’s story and she probably felt it was important to include everything. From my perspective, the continual journal entries made for dull and repetitive reading. I think I would have gotten more out of this book had Burgunder simply written her story and included some of the more important journal entries. She probably could have determined which ones were most important with the help of an impartial editor.

There are some insightful passages in Safety in Numbers.  For instance, at one point, Burgunder lists what she misses about “being sick”.  Her list struck me as very honest and I think she was brave to share it.  She confesses that she misses the attention she got from others when she was sick.  She enjoyed shocking her doctors and worrying her parents.  She liked wearing extra small clothes.  I also think her descriptions of what eating disorder treatment centers are like are interesting.  

On the other hand, at one point Burgunder writes that “recovery is selfish”.  While I think I understand what she means when she writes that– one must focus on themselves in order to recover– I disagree that recovery is selfish.  Constantly wanting attention and getting it by deliberately engaging in eating disordered behavior is selfish.  Worrying your parents and shocking your doctors is selfish.  Getting well is not selfish.  It’s difficult and brave, but it means you can get on with your life and so can your loved ones, who no doubt have their own life issues to worry about.  I also think Burgunder comes across as a bit conceited at times.  She often writes about how gifted at riding and tennis she was and how she’d thrown it away by having an eating disorder.  

People develop eating disorders for a variety of reasons, but it’s not quite like developing cancer.  Ultimately, the power to get well from an eating disorder resides with the person who is suffering from it.  That doesn’t mean that a person with anorexia can simply decide to eat normally, nor does it mean that a person with an eating disorder won’t have physical problems that will require recovery.  What it does mean is that he or she must decide that recovery is doable and worthwhile.  In that sense, it’s not unlike when Dorothy in The Wizard of Oz learns that she always has the power to go home.

Anyway… while many Amazon reviewers gave this book five stars and pronounced it “powerful”, I was less impressed with it.  I do think it could have been a better book if it had been pared down a bit.  Readers struggling with eating disorders of their own may want to proceed with caution.  Parts of this book may be triggering.  I think I’d give Safety In Numbers three out of five stars.

As an Amazon Associate, I get a small commission from Amazon on sales made through my site.

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