I’m not the only girl at my school who pukes after she eats, and I know that for a fact. It’s not a disease — it’s a diet strategy. Some girls take diet pills: I stick my finger down my throat. What’s the big deal?
– Janie in Purge by Sarah Darer Littman
National Eating Disorders Week is February 24 through March 2. This year’s theme is “Everyone Knows Somebody.” You probably do know at least one person affected by one of the three major eating disorders, anorexia nervosa, bulimia nervosa, and binge eating disorder. Statistically, it’s probably a girl between the ages of 15 and 19 years old, but boys are not immune. As Janie demonstrates in the passage above, persons afflicted with an eating disorder can be adept at self-deception. There is always another pound to lose, to “diet” away.” To be called “too thin” is considered a compliment, even an achievement. Eavesdrop on a group of teenage girls and there’s a good chance the conversation will contain the words “I’m so fat.”
The incidence of anorexia nervosa has increased each decade since 1930. Recovery options are covered by few insurance plans. Despite the plethora of information about eating disorders, a stronger message is sent by media images. We know that many of these images are photoshopped to present unattainable degrees of thinness. And yet these artificial bodies are everywhere.
Young adult literature includes many novels that focus on eating disorders, such as Purge, quoted above. Janie’s bulimia is grandly exposed at her sister’s wedding, resulting in a stint at a rehab hospital. Janie feels stuck and regards her situation with sarcastic humor. Her therapy group includes a mix of fellow patients with eating disorders, including a couple of boys. One of the boys is gay, which is supported by research that shows gay men are more likely to suffer from eating disorders than straight men. As Janie goes through therapy she develops a sense of urgency in overcoming her bulimia. Perhaps it can be forgiven as a literary contrivance that she recovers quickly. This quick turnaround allows the author to extend hope to readers, if not realistic expectations.
No novel conveys the torturous world of anorexia more beautifully or terrifyingly than Laurie Halse Anderson’s Wintergirls. Selected as both a Best Book for Young Adults and Quick Pick for Reluctant Young Readers in 2010, Wintergirls is told in the voice of eighteen year-old Lia, who shared her obsession with starving and cutting with her best friend Cassie. Now Cassie is gone, and Lia is left with a punishing guilt: On the night of her death, Cassie called Lia thirty-three times. Lia never picked up. Anderson structures the book to include Lia’s merciless replay of Cassie’s death, running between lines.
“…body found in a motel room, alone…”
Lia’s suppressed thoughts appear as crossed-through text. She thinks of the past as “…When I was a real girl.” The prose never backs down, never lessens its intensity. The reader is thrust inside Lia’s head, spiraling down, forced to focus on losing the next pound, unable to stop the punishment.
A book as agonizing as Wintergirls seems like it would dissuade sufferers of anorexia from continued destruction of their bodies. Unfortunately, the mind of the anorexic is able to evade reason. For many, stories of other anorexics can serve as a trigger to increase their commitment to drastic weight loss. A New York Times blog post discussed this briefly after Wintergirls was released. Imagined images of thinner girls can rouse a sense of competition. The sense of a shared vision of emaciated beauty creates an unfortunate support system. Availability of such support is increased through “pro-ana” and “pro-mia” web sites, which are dedicated to the opposite of healthy eating.
In addition, memoirs of recovered anorexics and bulimics are full of “how to” tips for losing weight and hiding weight loss. Marya Hornbacher’s Wasted: A Memoir of Anorexia and Bulimia, with its powerful language and honesty, has been cited as “full of triggers.” Images of ultra-thin girls, calorie counting, and fitness magazines can all serve as triggers. A person in the early stages of recovery is challenged to honestly identify and avoid their personal triggers.
As librarians, our service is to embrace open access to information of all kind. One person’s trigger may be another sufferer’s “a-ha!” moment — a moment when the degradation of continual starvation finally sets in. A moment when a particular symptom — rotting teeth, hair loss — brings the severity of the disease into focus. A moment when the reader shares the writer’s determination to live a healthy life.
Some additional novels that address eating disorders:
- Tyranny by Lesley Fairfield (Tundra, 2009)
A furious cloud of tangled lines called “Tyranny” follows Anna in this graphic novel, choking her when she tries to eat and screaming that she is fat.
- Looks by Madeleine George (Speak, 2009)
Meghan is a nobody at school because of her heft, while Aimee is so thin she might be invisible. The two girls find common ground in their outsider status, as well as the way food dominates their lives.
- Zoe Letting Go by Nora Price (Razorbill, 2012)
To Zoe, her own mother had made an absurd mistake leaving Zoe at Twin Oaks Institute, a place that treats girls with eating disorders. Her only solace is to pour her heart into long letters to her former best friend.
- Skin by Adrienne Maria Vrettos (Margaret K. McElderberry Books, 2007)
In Donnie’s messed-up family, his older sister Karen has always looked out for him. When Karen stops eating, Donnie is helpless to save her from starving herself to death.
In 2010, Popular Paperbacks for Young Adults composed a list titled “Bodies.” Several of these books deal with teens suffering from eating disorders.
For more information about eating disorders, visit the National Eating Disorders Association.
— Diane Colson, currently reading In Darkness by Nick Lake and listening to Heft by Liz Moore, narrated by Kirby Heyborne and Keith Szarabjka.