Why do people have eating disorders?

By Liesel Haskell, 17, Louisville High School
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Liesel Haskell couldn’t understand why her friend was dieting so much.

Being friends with "Isabel" in the third grade was so simple. Our biggest worries were over who would be "it" in freeze tag or whose house we would sleep over at next. Neither of us could imagine then that our lives would become so complicated.

It all began to change at the beginning of junior high. We had a really catty class. Twenty-five in all, we knew everything there was to know about each other. In the morning before school, I would go through a mental checklist: "Is my hair not right? Are my shoes okay? Did my mom put something weird in my lunch today?" Even the slightest mistake could make one the object of ridicule. The worst was being branded with a nickname. No one ever seemed to shake those. "Conan" was the title with which I was honored because I beat the boys at a game of mercy in the sixth grade. Isabel was dubbed "the horse" because she was hungry without fail and would always manage to finish off everyone’s leftover lunch.

On top of this, Isabel had troubles to deal with at home. Her father was diagnosed with cancer and eventually was unable to work. I was worried about her.

"How’s everything?" I would ask.

"Fine," she would say. I had an inkling that maybe everything was not fine, but I had no way of knowing how deeply it was affecting her.

Then came the teenage years. Isabel and I were both a little overwhelmed entering high school. But it was comforting having someone to share worries with, someone who really understood. She would call and say, "Oh no … Mrs. So-and-So gave me a dirty look today … she must have given me a bad grade on my project."

That would be my cue to say, "Don’t be ridiculous, your project was perfect and you know she loved it."

We each wanted to keep up with the other

Slowly, an unspoken competition began to surface between us. Our class schedules were identical so we were keenly aware of each other’s academic progress. She would get a 98, I would get a 96, and a little voice in my head would say, "Why didn’t I get a 98?" At the time, this mini-contest over who could be the best seemed harmless. In fact, I was almost grateful for it. It brought out my competitive side and kept me on my toes, always pushing me to try a little bit harder.

Illustration by Kristin Luke, 16, North Hollywood HS

In September of my sophomore year of high school I noticed a slight change in Isabel. She was not eating nearly as much as before. I noticed her carefully picking out the chocolate chips from a granola bar or secretly scraping the crust off the outside of a Fig Newton. I would offer her my last graham cracker and she would say, "No thanks." She also seemed to notice how skinny everyone was at our all-girls high school … that is, everyone except her. Deep down, I felt that something was wrong and it gave me a funny feeling in the pit of my stomach. So I attempted to push it to the back of my mind, brushing it off as a delusion of my overactive imagination.

As time went on, there was no denying it … my friend had dropped weight. Our classmates would say to her, "Wow, you look fantastic!" or "You’ve got to tell me how you did it!" I felt a twinge of jealousy—was she thinner than I was?

Then Isabel injured her hip. She had previously been on the cross-country team and running up to six miles every day. Her injury prevented her from running and Isabel hated that. "I cannot stand sitting up in the bleachers watching everyone else run," she fretted.

She began to eliminate certain foods and restricted her diet to "safety foods." Oatmeal was OK. Salads were OK. Fat-free calorie-reduced yogurt was OK. Water was OK. Suddenly, she seemed to develop an aversion to any food containing over 100 calories per serving. I watched my best friend become obsessed with what she put into her mouth, or more accurately, what she did not put into her mouth.

‘Aren’t you hungry?’

Mysteriously, Isabel never seemed hungry. It was interesting how busy she seemed to get around lunchtime. She had to talk to teachers or make copies or go to the library. Even when she was around, it seemed that food dominated our conversations. There didn’t seem to be much else to talk about. Lunchtime became a medley of excuses and avoidances.

One day I called Isabel and she seemed upset. "What’s the matter?" I asked.

"Nothing," she replied. After prodding, she finally came out with it. Between sniffles and soft sobs, she told me she had eaten two bowls of Cheerios and now her mom expected her to eat dinner, too. A silence followed her telling me this. I did not know what to say. "What’s wrong with you?" I thought. I wanted to shout at her, "You have lost it! Please, get a grip." But instead, I told her to stop being silly.

After that, she started lying to me. She would carry on about the enormous breakfast she had just polished off or the dinner at her aunt’s house after school where she had gorged herself. My best friend since the third grade—why was she lying to me? I was hurt and angry. She tried to hide her bony limbs under baggy sweats, but I knew how skinny she was. Trying to understand what she was doing and why exhausted me, and just thinking about the whole situation made me nauseated.

School let out for summer, and I did not see Isabel once over vacation. We did not call each other. We hardly seemed like friends anymore … she certainly was not acting like my friend. I attempted to forget what was happening to her, hoping with all my heart that I would return in September only to find that she was her normal self again. No such luck.

The first day back at school, my eyes scanned the hallways, searching anxiously. Then, I saw her in the corner facing my direction with a meek smile on her face. An indescribable feeling of horror came over me. I stared at this skeletal figure with sunken cheeks, dark circles under her eyes, pale skin and limp hair. I wanted to burst into tears. My friend was starving herself to death. My worst fear had become a reality and I felt I was partly to blame for standing by and watching it happen. So then and there I made a decision to do all in my power to help her.

I tried everything, but I couldn’t get through to her

The following weeks were completely frustrating. Inside, I was a jumble of anger and fear. One day I saw a movie about a girl who had bulimia and died of heart failure. It was a true story and it scared me. I did not want Isabel to die. In desperation, I employed every conceivable method and then some. At first, I was kind: "Please, you are my friend and I hate to see you hurt yourself like this." Then I tried to evoke fear in her: "Do you really want to die this way?" I even resorted to cruelty: "Do you honestly think that guys find emaciation attractive?" or "Do you know that people are talking about you? You don’t look normal." But no matter what I did, my friend refused to listen. It seemed that the more I tried, the more she retreated into herself. She seemed to view me as some evil fiend trying to make her fat.

I decided to talk to my school counselor for advice. "What can I do?" I pleaded. She told me that some of the faculty had also expressed concern regarding Isabel. The school was in the process of contacting Isabel’s mom. The counselor said that the best thing I could do was be supportive and suggested I learn more about eating disorders. The better informed I was, the better I would be able to help my friend. I researched anorexia on the Internet. Isabel’s behavior matched exactly with that of an anorexic. Putting a definite name to Isabel’s problem was a comfort. Once I understood the problem, I also understood that there were ways to fix it.

Fortunately, my friend soon began to make changes in her life for the better. It began when the counselor at school contacted Isabel’s mom. Isabel’s mother, preoccupied with her husband’s illness, had been in denial about the seriousness of her daughter’s problem. My mom had spoken to Isabel’s mom numerous times and she would casually brush it off saying, "I dieted a lot when I was young too." I think she was hoping it would just go away. But finally Isabel saw a doctor. She told me later that the doctor threatened hospitalization if she did not gain two pounds within two weeks. Though Isabel was terrified of gaining weight, she also dreaded missing school. She thought it would cause her grades to slip and ruin her chance of attending a good college.

Slowly my friend is finding her way back to health

Gradually, she began to make baby steps towards healing. The doctor put Isabel on a diet. I expected her to start eating cookies and candy and stop drinking diet soda all the time, but that is not what happened. She stuck to her diet meticulously. The process was painfully slow and it took months for Isabel to gain a noticeable amount of weight. I felt somewhat helpless, but I was happy that Isabel was finally making progress. I no longer was pushing Isabel. I was merely holding a hand out to support her when she needed it most.

Isabel’s struggle with anorexia is not over yet. My counselor at school explained to me that this is something Isabel will have to deal with for the rest of her life. "I am so afraid of slipping back," Isabel told me. "It would be so easy."

Sometimes when Isabel’s emotions get out of control, she feels like not eating. It is not easy to let go of old comfortable habits. But it does get easier with time and each day her self-confidence is restored a little more. Now she understands that anorexia does not have to control her as long as she never gives up. She knows that she is not alone, that there have been others before her who have conquered this disease, and that she can conquer it, too.

Looking back on my experience, I realize the extent to which Isabel’s illness affected me. Emotionally, I went through so much. I was confused and hurt by a friend who no longer acted like my third-grade best buddy. I was angry and disappointed to lose a trust that had seemed so strong. I felt the weight of responsibility on my shoulders and the guilt of not taking it on sooner.

I now understand what it means to be a true friend, to stick by someone even when it stops being fun, even when it starts to hurt. Being friends is about giving and taking. Sometimes it is necessary to give and not worry about getting something in return.

One of the most difficult concepts to grasp was that friends cannot control each other. I could not force Isabel into recovery. I do not have the power to change her, but I do have the power to support her—and that is what true friendship is all about.

Resources for people with eating disorders

For further information, check out the National Association of Anorexia Nervosa and Associated Disorders Web site at www.anad.org. Or you can contact the organization at Box 7, Highland Park, Ill. 60035 or call (847) 831-3438. People who cannot afford the long-distance phone call can telephone the organization and mention that right away. Someone will return the phone call. The assn. offers referrals to counseling and self-help groups in out-of-state locations.

You may also want to …

Call Eating Disorder Awareness and Prevention at 1 (800) 931-2237 or go online and see American Anorexic Bulimia Assn. at www.aabainc.org.