If you have anorexia, you hate fat (maybe even fear it) and deny yourself the right to eat the way most people do. You may ban red meats and processed meats (such as bologna and hot dogs) from your diet altogether and restrict yourself to eating small amounts of white meat, poultry, and non-fatty fish. You cut out foods such as mayonnaise, peanut butter, hard cheeses, butter and margarine, and avoid sweets and desserts, processed breads and sugary cereals. If confronted, you justify your food choices by saying you know a lot about nutrition and you're just "eating healthy" by cutting down on fats and cholesterol in your diet. You probably allow yourself certain "safe" foods such as low-calorie vegetables, crunchy fruits such as apples, salads with vinegar (balsamic is a favorite) or no-oil salad dressings, plain popcorn, unsalted rice cakes, low-fat cottage cheese, and nonfat yogurt, but only in limited amounts.
Many of you say that you are vegetarian; so many, in fact, that a study published in 2001 found adolescent vegetarians as a group are more likely than their non-vegetarian peers to be weight and body-conscious, to have tried unhealthy weight-control techniques such as diet pills, laxatives, and vomiting, to have contemplated or attempted suicide, and to have been diagnosed as eating disordered by a doctor (Adolescent Health 2001;29:406-416).
To be anorexic doesn't mean you're not interested in food, though. Quite the contrary—you're involved in (and maybe obsessed with) every aspect of food: what to purchase, how to prepare it, and who should eat it, as long as the "who" is not yourself.
When I was at my very worst—I think I got down to 82 pounds and I'm 5'7"—I bought my mom two cookbooks and an encyclopedia of Japanese cooking. I also charged a $250 meat order on my mom's credit card from a mail-order beef company's Christmas catalogue. For two months I prepared every single dinner at home and made all the brown-bag lunches for my little brother and sister I wouldn't let them near the refrigera tor I felt like the kitchen was all mine. I ate no more than 250 calories a day and kept a notebook about what I ate. I must have really wanted to torture myself. When we were in family therapy one evening, my mom said I was like a drug pusher, only I was pushing food.
Sometimes you lose your self-control and start to binge, flipping into a bulimic pattern that makes you feel guilty and scared. So you purge, the way a bulimic would, and then go back to your anorexic habits. This is so common that DSM-IV-TR (American Psychiatric Association), the medical reference book used by health care professionals to help them diagnose mental health problems, has distinguished between a "restricting" type of anorexia in which the person basically doesn't eat, and a "binge-eatirig/'purgirig" type in which the person regularly binges and purges and then goes into an anorexic phase, only to binge and purge again (p. 589). This seesaw routine can go on indefinitely.
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