They do it because they’re desperate. People are engaging in secret, shameful behaviors all for the sake of getting or staying thin.
Shortly after giving birth, Lauren, 35, would tell her husband that she was going to the grocery store late at night. There, she would buy bags of junk food, gorge in her car, and then make herself throw up in the parking lot. Her goal was to reach her pre-pregnancy weight. At all costs. The “cost” to Lauren was her relationship with her new baby, which she says she lost during the two years that her bulimia raged untreated.
"How tragic,” we say. But her story just scratches the surface.
For the past seven years, Kaitlin has engaged in “chewing and spitting.” She puts food her mouth, tastes, chews and then spits out the masticated glob without swallowing. She thought she was operating on the sly, getting some enjoyment out of food, without suffering the weight-gain consequences. But Kaitlin suffers other consequences. The corrosive acid, from letting the chewed food sit in her mouth, then the spitting, has deteriorated her teeth below the gum line, a condition that is virtually impossible to repair. At the ripe age of 23, Kaitlin wears dentures.
Had enough? It gets worse. Arguably,diabulimia is the most dangerous "stealth" anti-caloric practice anyone can do. It’s performed by individuals with type 1 diabetes, who don’t make enough insulin. As they have to take the hormone daily, some diabetics have figured out that by skipping doses, their bodies can shed pounds. Medically speaking, without insulin, cells cannot metabolize sugar. Instead, they flush it out through nearly constant urination. The practice is akin to bulimia, except that it is sugar, not food, that's being purged from the cells -- and body.
While “sugar out” means “calories out,” diabulimia can also lead to “lights out.” A recent study reported that when anorexia or a related eating disorder was present alongside diabetes, the 10-year mortality rate rises from 2 percent of diabetics without anorexia and 7 percent of anorexics without diabetes to 35 percent for those with both diseases.
Not surprisingly, eating disorder experts are alarmed. According to Brenda Woods, M.D., director of medical services at Remuda East, an eating disorders treatment center in Milford, VA., most of Remuda’s diabetic patients “underdose” their insulin in a misguided attempt to slim down.
We can argue that these behaviors, however tragic, are rare. But let’s move onto the anything goes realm of college campuses. There, students skip meals in order to save their “calorie quote” for binge drinking. While the practice is not new, its moniker, “drunkorexia,” is. No one has firm statistics about how many drunkorexics are frequenting frat parties and university pubs. But studies do show that at least a third of alcoholics also have eating problems. For my book, “Lying in Weight: the Hidden Epidemic of Eating Disorders in Adult Women," I interviewed Tracy, 43, who for decades vacillated between alcoholism and bulimia, recently settling on a mild version of the latter. And Janet, 56, who started in her late teens, still both drinks and binge eats, simultaneously. Followed by purging.
Finally, there is the simple craving to be really thin. “Wannarexia” has popularized itself into Wikipedia, defined as “a label applied to someone who claims to have anorexia nervosa, or wishes they did.”
Do we click our tongues at desperate people who do desperate acts for thinness? Do we dismiss them, saying they should pay the price for their own demise? Or do we turn our appetites for the sensational into an honest bit of soul searching. Desperation for thinness is a spectrum, with life-threatening diabulimia on the severe end and simple longings to be skinny at the opposite pole.
How far are you willing to go? And why is thinner important to you? Is being skinny, to you, the means to feel attractive, á la fashion model Kate Moss? Is “fabulously thin” a Fountain of Youth, to place you in the market after a midlife divorce? Is getting thinner the way you try to hang onto an errant spouse?
Desperate people, wanting basic love and admiration, do desperate acts. While the concept is age old, the stakes today are higher as cosmetic technology flirts with genomics, promising yet newer ways to sculpt our bodies -- at the molecular level.