From Normal, to Anorexic

I finally finished the book Gaining. It was, for lack of a better word, amazing. Rather than give a review of the book, which is kind of....boring, I thought I'd discuss what I learned from the book and from the stories of others with histories of eating disorders. Before you read this post please take a look at my introductory post about the book, as well as all of your amazing comments in the comment section.


When I started reading Gaining I thought I already knew why I had become anorexic back in high school. I thought it had to do with a combination of my mom always dieting as I was growing up, my domineering and controlling personality, and my eagerness to "be someone" in high school. Simple, right? Not so much. After reading this book I still believe those all played a role, but I no longer believe those were the main reasons for my bout with anorexia. And in fact I want to make it clear to everyone that my mother was, and still is, an amazing women. Sure she talked about weight in front of me, and dieting, but never to the extreme that some of the women in this book described. In fact, I would say her weight talk was pretty typical of how many women talk, and it was interspersed with plenty of "healthy talk", which is actually what inspired me to become a dietitian. So, I wouldn't dare blame my mother for my eating disorder. She has helped build my self-confidence more than I could have ever have imagined. It's just those small comments (usually negative comments, about herself), throughout my life that probably affected me more than she (or I) realized.

Anyway, I digress......the book taught me a lot about the true reasons I developed an eating disorder. A study was discussed in the book that showed there are three distinct temperamental groups into which people with anorexia and/or bulimia tend to fall. Here is a very brief description of the three groups;

1) Overcontrolled; tend to avoid social contact; tightly control their appetites for sex and food; limit their pleasures and withdraw from excitement , sensation and risk

2) Perfectionistic; Worry about the details. Aim to please, excel, and conform.

3) Undercontrolled; intense emotions and impulsive behaviors. They tend to fly into rages rather than expressing their anger passively. They also try to find relationships to soothe themselves.


I fell (and in some ways still fall) into a little bit of each of these groups (which is what the researchers indicated as being normal), but mainly number two. Growing up I didn't really worry much about details, but I always aimed to please, freaked out whenever I'd get in trouble or do something wrong, and always worked so hard in school that my friends would often ask me, "why do you work so hard?!". I always figured it was my ADD that created the "need" to work so hard. It took me twice as long to do things because I would always space out halfway in, but in reality I was so rigidly focused that I took simple assignments and made them twice as difficult. I was never able to finish books on time because it took me twice as long to read them. I'd read one paragraph and then have to re-read it because I'd realize I had been thinking about something else as I read the words, therefore not even paying attention to what the author had written. I was always doing something else in my mind, focusing on anything other than what was in front of me, and mainly that focus was on planning. I was, and still have tendencies to be, an obsessive planner. I may not have been a perfectionist in the sense that I had to make everything look perfect or sound perfect, but when it came to planning assignments, studying for exams, even planning what clothes to wear the next day, I was....perfect.

As I continued to read this book everything was put into perspective for me, and by hearing other people's stories of anorexia and bulimia I really had a more clear understanding of my own. I have concluded that for my whole life I have had Obsessive Compulsive Personality Disorder (OCPD).

Obsessive–compulsive personality disorder (OCPD) is a personality disorder characterized by a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency.^[1]

As you can see from the definition below, this is slightly different from Obsessive Compulsive Disorder (OCD).

Obsessive–compulsive disorder (OCD) is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry, by repetitive behaviors aimed at reducing the associated anxiety, or by a combination of such obsessions and compulsions.

Source: Wikepedia

The author of the book described how she believes she has this disorder herself (OCPD), and studies have shown that many anorexic individuals possess many of the traits that accompany this disorder; mainly perfectionism, rigidity, inflexibility, caution, and need for symmetry. I think about my life as a child and that just about sums it up.

Overall I believe I was an odd case. Unlike many of the people in this book I never actually looked at myself in the mirror and thought I was fat or undeserving. I actually loved myself and my body, for the most part. I was always very happy as a child and adolescent. Sure I had my down times, but doesn't everyone? Now that I know I had/have many traits that mimic OCPD I have figured out the toxic combination of traits and events that produced the perfect storm for my eating disorder. I did a lot of looking back at my life as I was reading this book (mentally looking back and also reading old journal entries) and I can specifically remember one day in high school looking at a picture of myself at my Junior prom, in my prom dress, and noticing the dress was way too tight. I was so angry that no one had told me I looked ridiculous! While I didn't dwell on it a whole lot, I think seeing that picture sparked some serious anxiety about my body that was imbedded deep within me. At the same time I was stressed about the slow decline of a very tight bond with my best friend, and meanwhile my first serious boyfriend had just cheated on me, for the second time. This was in addition to the stress of being at an all girls school where getting into a good college was absolutely critical. The perfect storm had been created. It was too much stress all at once and all of a sudden I felt I had lost control of my life and my "perfectionism". I had never planned for my life to come to this point! To deal with the stress, I literally gave up fat and became obsessed with the control I had over my ability to get smaller, and smaller, and smaller.

Source: iStock Photo

I talked to my dad a few days ago about that time of my life and he said he "remembers that I would come home from the grocery store with all sugar free and fat free foods".

The only thing I remember very clearly is my consistent, repative and controlled breakfast; Kashi cereal mixed with Fiber One, measured in a 3/4th measuring cup with 1 cup of skim milk.


This was so unlike me. I never used to measure my food! But I don't think my parents really thought anything of it at first. After all, this was the 1990's, the decade of the whole fat free craze, so perhaps they thought it was just a faze. I started eliminating fat from my diet and was so good at it that I dropped ten pounds by the time I reached my senior year (that's a lot considering I was already only 110 pounds). Every day I felt the urge to do better at controlling my food, and each time someone told me I was "too skinny" I was pushed even harder to do even better at losing weight and controlling my food intake.

Flash forward to now. I am not going to lie and say that my OCPD traits have completely vanished, because they have not. I am still compulsive about planning/controlling my life, but everyday I get a little better at just living in the moment. I read in the book that, "the ultimate experience of control is achieved, paradoxically, when we are least worried about control". Amen!

I am completely aware of my tendencies to deal with stress by becoming even more obsessed with planning and controlling things. It's crazy how even the simplest stressor will cause me to tense and be compulsive. Stress also effects my eating, just as it does for so many of us. The good thing is that stress makes me eat, and I almost always choose healthy foods to eat because I've learned that's what makes me feel better.

I truly think anyone who has had, or who has dealt with someone with an eating disorder should read this book. In the end I learned a lesson that I will keep with me forever, and that is how to prevent my own children from developing the same poor relationship with food that I did, in such a short period of time. I feel empowered knowing that I have a better understanding of how my personality, behavior, and environment came together, perfectly, to create the life-threatening situation that it did. My parents were completely caught off guard. If my own child shows signs of an eating disorder, I will be ready and eager to help.

I am currently in the middle of writing my autobiography, as I have realized that my story truly is unique. My goal is to have it finished in the next couple years and to really do some more healing throughout that time. Just reading this book has helped me deal with so many issues that I didn't even know I was still subconsciously dealing with. So far, as I write my autobiography, I have continued my journey of healing simply by looking back at my past, reading my journals, and talking to my friends and family.

I've read so many stories of anorexia, bulimia, and other eating disorders on blogs. One of my favorite bloggers, Sophia of Burp and Slurp, has a weekend series of stores about her own struggles with anorexia. Her stories are personal, touching, and completely candid. I encourage everyone to stop by sometime and read her weekend series (or any of her delicious posts throughout the week).

QUESTION: What are your experiences (personal or otherwise) with an eating disorder? Have you read Gaining?

Goodbye Food Pyramid!

Have you heard? The food pyramid is getting taken over by a dinner plate! I read this article yesterday, published by the New York Times, and I was super excited. While I will still use the food pyramid for more detailed information about specific food groups, the dinner plate method is a more simple and effective way to teach portion control and how to make healthier choices. I've actually used this method with my own clients, and I have to say, it works!

*** And here is the new USDA's ChooseMyPlate.gov! *** <---- Check it out! It's pretty fun :)

The whole idea is to use a normal size plate to show that it's important to make half of your plate non-starchy vegetables (broccoli, cauliflower, spinach, etc.) and/or fruit, one-fourth of your plate grains (preferably whole) or starchy vegetables (such as sweet potatoes, corn, beans, etc), and the other fourth of your plate lean protein (3-4 ounces). There is also room for a small glass of milk to drink, or a cup of yogurt (dairy or non-dairy).

Source: iStockPhoto

I think the most important part of the message is the inclusion of the non-starchy vegetables, and the smaller portion of protein (rather than 12 ounces of steak, try 4!). This message may help people take a meal such as the one below, and replace half of the pasta with some fresh veggies; bell peppers, eggplant, mushroom, zucchini, etc.

Source: iStockPhoto

From the article;

The circular plate, which will be unveiled Thursday, is meant to give consumers a fast, easily grasped reminder of the basics of a healthy diet. It consists of four colored sections, for fruits, vegetables, grains and protein, according to several people who have been briefed on the change. Beside the plate is a smaller circle for dairy, suggesting a glass of low-fat milk or perhaps a yogurt cup.

Dr. David Kessler, a former commissioner of the Food and Drug Administration, who said he had heard descriptions of the new plate, suggested that if the symbol succeeded in getting people to eat significantly more fruits and vegetables, that alone would be an achievement.

“The reality is that very few of us eat like what has been suggested” in government guidelines for healthy eating, Dr. Kessler said. “There’s a world of difference between what’s being served and what’s on that plate.”

He called the plate a major improvement over the pyramid. “It conveys the message simply in a way that we all can understand,” he said.

While the idea is to make half of your plate non-starchy vegetables and/or fruit, many dietitians (including myself) would suggest focusing more on the non-starchy vegetables, especially for purposes of weight management (simply because fruit has more sugar). So how would this method work for breakfast? This is a question I often receive from clients. Well, maybe you won't have vegetables at breakfast (unless you are like me and add pumpkin to your oats!) but breakfast is the perfect time for a nice serving of fruit, and a hearty dose of whole grains.

Instead of an all-protein breakfast....

Source: iStockPhoto

....try fruit, whole grain, and a milk or other calcium/protein source. The inclusion of the fruit or non-starchy vegetable, in my opinion, is the most important part of the meal.

Source: iStockPhoto

QUESTION: Have you heard of the plate method? What are your thoughts?