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A glimpse into life with anorexia

San Mateo County Times (CA) - 10/1/2014

Sept. 30--This essay was written by Nicole Schlesinger for the UC Berkeley medical journal "Issues" during her last semester at Cal in the late 1990s. Schlesinger, who suffered from anorexia, died of heart failure in 2003. Her mother, Debra, has become an advocate in the fight against eating disorders.

ANOREXIA AND I

by Nicole Schlesinger

3:30 AM: GET UP. GO TO GYM. RUN 6.50 MILES. BURN 600 CALORIES

4:30 AM: DO 800 SIT-UPS. DO UPPER / LOWER BODY STRENGTH TRAINING.

5:30 AM: GO HOME. TAKE A SHOWER. TAKE A NAP.

9:00 AM: WAKE UP. STUDY. DRIVE TO SCHOOL. ATTEND CLASS. DRIVE HOME.

3:00 -- 9:00 PM: EAT A LITTLE. STUDY A LOT. EAT A LITTLE. STUDY A LOT.

9:30 PM: TAKE A BATH. GO TO BED.

The above scene is a typical day of my life with an eating disorder. I have lived with this "commander" who tells me what I have to do, what I can eat, and how much I must exercise, for almost five years. In the summer of 1997, when I was formally diagnosed with Anorexia Nervosa, I decided to give this voice a name: I call her, appropriately, Anorexia. It is necessary for me to give Anorexia a title in order to distinguish her from me, Nicole. I am the healthy person who, although hates having to share space with Anorexia, has learned to accept her presence; at least for now.

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During my first semester at UC Berkeley, in the fall of 1994, Anorexia slowly began to suck me into her world. At five feet six inches tall, and 139 pounds, I decided to avoid the "freshman 15" by joining Weight Watchers with my mom. It was to be a mother / daughter "bonding" experience. Unknowingly, however, Weight Watchers was to become the fuel that fed Anorexia (no pun intended). Instead of following the plan sensibly, I took it to the extreme: I counted every calorie, exercised intensely, and wrote everything down in my journal religiously. The program had to be followed EXACTLY. At this time I didn't realize that my behaviors were the early signs of an eating disorder.

After leaving Weight Watchers three months later, weighing only nine pounds lighter, Anorexia became louder; she started to take over my life. I drifted through school between 1995 and 1997, not only convinced that eating an apple and carrots during the day was sufficient, but also that I had to purge those calories through vigorous exercise before I could eat dinner. Although I didn't weigh myself as a measure of my progress (a common practice amongst anorectics), I was losing weight at a rapid pace. When I dropped below 112 pounds I stopped my period. This is a condition known as amennorhea and is one of the diagnostic criteria in the DSM IV for Anorexia Nervosa. I also developed gastrointestinal problems due to the lack of food in my stomach and the subsequent build up of acid. Even though my weight plummeted to 95 pounds, Anorexia blinded me; I literally could not see how thin I was despite the fact that my family and friends expressed great concern about how skinny I looked. In some ways I actually thought I was still too fat. The distorted body image that I had (and still have) is another warning signal of an eating disorder. As I began meeting the criteria for Anorexia Nervosa my physician referred me to a psychiatrist for therapy.

In the course of my treatment I was hospitalized five times, beginning in August of 1997 and ending in January of 1998. It was during this period that I began to hear Anorexia's voice inside my head. Prior to this I had no idea what or who was driving my behaviors; nor did I think that they were abnormal. When Anorexia came out of the closet, so-to-speak, I thought I was going crazy. However, I have learned that people with eating disorders often hear "voices" that battle each other in their head. Someone described her life with anorexia as a 24 hours a day seven days a week war, that never seems to quiet down -- not even during sleep. Peggy Claude -- Pierre, a mother who has helped her two daughters recover from anorexia, titles her book The Secret Language of Eating Disorders. Anorexia definitely has her own speech: The following journal entry depicts the battle between Anorexia and Nicole: (Anorexia's voice is in italics) 11-25-97: I had breakfast and forced lunch down my throat. I can't believe I ate lunch. I have to run. I can't throw up so I have to run! No, you can't do this. You must fight. Just give in Nicole. That is what you want. Anorexia also twists words around so that any positive statement turns into a negative one all in her quest for absolute perfection:11-25-97: "Dr. Norman, Blanca, and Marisol all said that you look good. You know what that means don't you? That you're getting fat! You are such a piece of shit. It's pathetic!" She also has her own view about the scale: 1-1-98: 100 pounds is FAT. The scale says I weigh 89 pounds! I don't believe what the scale says nor do I believe what my clothes show or people say. I know that I am fat and refuse to weigh 115 pounds. 8-14-97: I want to be skinny. Skinny. Skinny. I want to lose weight and get to at least 80 pounds, if not lower!"

This lifestyle, full of monotony, demands, and rituals, can be so frustrating that sometimes I want to jump out of myself and become someone else; just to get a little peace. To give you an idea of how bizarre some of these rituals are, I asked a friend how long it takes her to eat an apple. She said it takes her about 15 minutes and added that she bites into it (as opposed to slicing it) because it tastes better that way. I, on the other hand, eat an apple quite differently: I first cut one thin slice, cut that slice in half, and then cut each half into four equal size pieces. Not five, not three, but four. This "process" usually takes about two hours. As a side note, cutting food into small pieces and taking hours to eat is very commonplace among those with anorexia. I was also curious as to why my friend exercises. Her answer was quite normal for a college student: To maintain her weight and to stay fit. My reasons for exercising, however, have nothing to do with being healthy; that is, I MUST exercise before I eat anything so that I can "pre-purge" the calories that I will eat later.

Having Anorexia as a part of me is probably one of the most difficult things that I have had to live with. My daily rituals clearly show that she still holds a tight grip on me. In many ways my life is not really my own. I don't have the freedom to do what many college students do. I don't go out to eat nor do I socialize with friends at a cafe. However, as strange as this may sound, I often thank Anorexia for her presence. She gives me insight into myself and also into the world of eating disorders. Eating disorders, in general, are addictions such as smoking or drug dependence. They all serve as coping mechanisms for the stresses of life. When I escape into Anorexia's world of food, weight, and exercise obsession, I numb out the pain, anger, or sadness that I feel. However, I know that Anorexia's life is a false reality and I am trying to find the key to unlock the handcuffs that tie me to her. My struggle changes from day to day, hour to hour and sometimes minute to minute. However, if I have learned only one thing from my experiences, it is what I value most in life: It is NOT getting straight A's, or doing research, nor is it volunteering just to get into the "best" medical school. Rather, it is stopping every once in while to "smell the roses". For me this is as simple as coming home and spending time playing with my two cats, Alex and Baxter.

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