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Christy's Story


Though she narrowly missed making the U.S. Olympic gymnastics squad, Christy Henrich's successes were many during her highly profiled career that tragically eneded with her death from anorexia and bulimia in July of 1994. Perhaps the saddest story and most tragic member of The Examiner's Top 50 all-time greatest athletes is Fort Osage graduate Christy Henrich. Although she never swung a bat, stepped on a track or dribbled a basketball for the Indians, she is one of the most honored and respected athletes in the school's and area's history. Henrich was a world class gymnast, who was a member of the United States National Gymnastics team from 1986-1990. She represented the United States in international competitions in Germany, China, Switzerland and elsewhere starting in 1986 at the age of 14. She finished ninth at the U.S. Olympic trials in 1988 and missed making the Olympic team by .188 of a point. That was a devastating blow to the dazzling pixie, who bounced back from a serious injury ­ a broken vertebrae in her neck suffered in a fall ­ for her greatest season in 1989. She finished second at the U.S. National Championships that year and placed fourth on the uneven parallel bars at the 1989 World Championships in Stuttgart, West Germany. She suffered a variety of injuries in 1990 and fell to 10th at the national championships, then retired from the sport in 1991. Christy never really overcame missing out on her life-long dream of making the Olympics and developed two deadly eating disorders ­ anorexia and bulimia. And with her organs severely damaged by the effects of the her eating disorders, she died in July of 1994. "My life is a horrifying nightmare," she said to The Examiner before her death. "It feels like there is a beast inside of me, a monster." Her family and fiancee did everything they could to help Christy overcome her eating disorders. She was the first U.S. gymnast to die of an eating disorder, although Cathy Rigby, Christy Phillips, Cathy Johnson and Nadia Comaneci successfully fought the disease. Henrich was a mirror image of her idol, Mary Lou Retton, at the peak of her career. Henrich weighed 93 pounds when a judge at an international competition told her she needed to watch her weight. "That was perceived by Christy as 'You're too fat to be an Olympic gymnast,' " said Al Fong, her former coach at Great American Gymnastic Express. "She was an extremely strong person. She was a bull, a tank." When Fong approached Henrich to talk about her eating disorder, the two individuals parted ways. "I said to her, 'You're going to kill yourself.' She needed to eat. But she just couldn't." "I said to her, 'You're going to kill yourself.' She needed to eat. But she just couldn't."

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Karen's Story

S he was a great musician. A teenager turned accordion player turned flutist turned drummer turned singer. Karen Anne Carpenter was one of the all time great musical sensations of the 70s. On the stage she was glamorous and loved by the crowd. Thousands of people cheered her on as she performed classic song after song. She guest starred on TV shows, was on the front cover of many national magazines, and even toured the world. But amidst all this fame and fortune, she was dying. Karen Carpenter was suffering from an eating disorder not uncommon among the American population. Though disorder was not rare, it was rarely talked about. Most people at that time had never heard of the term Anorexia Nervosa. Sad but true, the death of Karen Carpenter in 1983 opened the eyes of the world to this life threatening disease. Karen Carpenter was well known in the 70s and 80s for her dazzling music. She was one half of the sibling music group, The Carpenters. Born in 1950, she grew up listening to the Beatles and performing with her older brother Richard, and in her lifetime captured 3 Grammy's, 8 Gold Albums, 10 Gold Singles, and 5 Platinum Albums. The music she made was so great that she held the record for the most Top 5 hits in the first year of business. You could say that she lead her life in the spotlight. Young girls looked up to her. She was a role-model and a symbol of American culture. At least, this is what she was trying to be. As it turns out, it was these social pressures that ultimately lead to her downfall. Richard Carpenter recalls that Karen was "a chubby teenager". Genetically, she wasn't meant to be super thin. Unfortunately for this singer, the only body that she would stand to have was a thin one. The dieting began in 1967 when Karen's doctor put her on a water diet, bringing her weight down from 140 lbs to 120. When she had made it down to 115 lbs, people told her she looked good, but she could only reply that this was just the beginning of the weight loss, and that she wanted to lose still more. By the fall of 1975, Karen was down to 80 lbs. She was taking dozens of thyroid pills a day, and throwing up the little food that she ate. Karen's body was so weak that she was forced to lay down between shows, and the audience was gasping at her body as she walked on stage. It was this year in Las Vegas that Karen collapsed on stage while singing "Top of the World". It was a big scare to the audience and her family. After being rushed to the hospital, it was reported that Karen was 35 lbs underweight. It was this final collapse that made Karen Carpenter realize that she had a serious problem. She went to doctors and therapists, and eventually began to believe that she was well. However, in reality, her body was still suffering from the lack of food, the over dosages of laxatives, the lack of sleep, and the anxiety of being on the road. When she died in 1983, it was a shock to many people who believed that she had been cured. The emergency call came at 8:51 am on February 4, 1983. Karen Carpenter's mother found her naked and unconscious on the floor of a walk-in wardrobe closet in their home in Downey, California. She was rushed to the hospital where attempts were made to save her life, but within an hour, Karen Carpenter was dead. She died of a cardiac arrest caused by the strain that the anorexia had put on her heart. At the age of 32, she was 5'4", but weighed only 108 lbs. Karen Carpenter was vibrant and energetic, they said. As Gil Friesen, the president of A&M Records described her, she was "...the girl next door, always up even when she was down". She had the common signs of anorexia. She was sweet, but kept her emotions inside. She was the kind of person who would take care of other people, but not herself. They called her a living skull, and a tormented and unhappy woman. She was psychotic about her weight, and self-conscious about her natural pear-shaped chubbiness. Karen Carpenter was a talented, ambitious young white female from a middle class home. She was the prime example of a victim of anorexia nervosa. Anorexia Nervosa is often referred to as the stars or starlets disease. Sometimes also called the slimmers' disease, or the rich women's disease. Anorexia is especially common among young white girls and those who need to have more control over their lives. Among anorexics, you will find female hyper-achievers, fashion models, dancers, gymnasts, and ballet troupes. It is the good girls disease. Ever since Karen Carpenter died in 1983, doctors, scientists, and therapists, among many others, have been investigating the cause of this fatal eating disorder. One common cause, as everyone agrees, is American culture and the media. For the past few decades, there has been an American philosophy of "trim and slim". This is a nation where it is sexy to be skinny and where fitness centers and more recently, dieting supplements, are being advertised more than anything else. The film and television industries are only perpetuating the image conscious nature of people within the American society. Studies have shown that since the beginning of Playboy magazine, the centerfold models have become thinner and thinner, leading to the ideal that thin is good. Super skinny magazine models act as role models, and girls find themselves dieting so that they can look like Twiggy the Shrimp, or whoever the supermodel of the decade may be. Still, many find themselves striving for the gymnast ideal, or thinning down to look like all of the other girls in the ballet class. It is a wide spread problem that is only getting worse as time goes on. Many sources report that there may be a correlation between a certain style of parenting and anorexia. Scientists are saying that anorexia can develop when parents set excessively high standards of achievement or exert too much control over their children. Children of authoritative parents don't rebel. Instead, they find areas in their lives where they do have control. One of them being their eating habits. Eventually, girls begin to develop a distorted view of themselves. Psychological disturbances cause them to stop seeing themselves realistically, which in turn causes them to have a low self-image. Often, other peoples' references to chubbiness, pudginess, or baby fat sends the signal that weight must be lost. Bright and successful people see themselves as disgustingly fat. They feel that they have to measure up, but that they can't unless they change their body weight. Anorexia is about control. For some, dealing with pressure means taking control of food. In 1983, it was predicted that one in every 300 women between the ages of 14 and 25 suffer from anorexia. All together, one in 200 women of all ages are victims of the disease. Studies have also found that one tenth of all female college students have at one time or another suffered from an eating disorder. 15 years ago, there were half a million young women with anorexia, and today, that number has risen to more than 2 million . Writers call it an "underestimated phenomenon", a great epidemic. To some people, dieting means cutting down on the sweets, and taking an apple for a snack instead of a candy bar. But to others, dieting has an entirely different meaning. Like Karen Carpenter, many people decide to go on water diets, where they hydrate themselves to the extent that their bodies are filled up with water and nothing else. Some are bullimic and force themselves to throw up after they've eaten. Many people take laxatives, or just stop eating all together. One author wrote about a woman who would eat half a raisin at a time so that she wouldn't consume as much food, a girl who would swallow cords to get herself to throw up, and a college student who would rummage through garbage cans late at night to collect food so that she could eat and then throw up everything that she had found. Though anorexia nervosa has a surprisingly high mortality rate, it still has serious consequences. As in the case of Karen Carpenter, it can lead to serious cardiac problems, which have proven to be fatal. Anorexia can cause a decrease in blood pressure and body temperature, hair loss, loss of menstrual cycle, and a decrease of protein in the blood. Bulimia can cause ulcers, hernias, a dependence on laxatives, and the loss of tooth enamel. When the body is deprived of food, it must look elsewhere for nutrients, and eventually begins feeding on muscle protein. The heart muscle weakens, and this leads to irregular heart rhythms and congestive heart failure. Additionally, anorexia causes an imbalance of electrolytes which causes cardiac abnormalities. In some cases, the bodies of anorexics have digested their own nervous systems. In the end, five to ten percent of the victims of anorexia die within 5 to 10 years of suicide or from depression caused by the illness, malnutrition, and heart problems. Before Karen Carpenter died, no one spoke of any of this. Girls starved themselves, but they didn't know that there were thousands of other girls that did the same things. They surely didn't know that their eating habits would kill them. No one was aware of anorexia and it's devastating consequences. Up until 1983, eating disorders were not taken seriously. They were treated like any other bad habits that no one ever mentioned. Many thought that there was a quick fix to the problem, and that the solution to an eating disorder was simply to start eating again. Girls believed that they were cured, when in fact, they weren't. This problem would have continued unnoticed had it not been for the death of Karen Carpenter. Immediately following Karen's death, there was a massive surge in the media regarding the great singer and her battle against anorexia. Eating disorders all of a sudden became highly publicized. Magazines and journals began publishing articles, and the news had top stories about anorexia and it's devastating effects. All of the media coverage on Karen's death encouraged other celebrities to go public with their stories. The death raised the profile of eating disorders in the entertainment community. Jane Fonda and Cherry Boon O'Neill, daughter of singer Pat Boone, admitted to their eating disorders and committed themselves to getting help. Also coming forward with their problems were Kathy Rigby, gymnast and actress, and actresses Jeannine Turner and Lynn Redgrave. Karen Carpenter's death gave people quite a scare. In the days and months to follow the tragic incident, there were a flurry of frightened phone calls to medical centers from people who had been jolted by the singer's death and wanted help. Psychologically-oriented groups had a doubling in attendance following Karen's death. In addition, many people began to launch voluntary support groups for victims of eating disorders. Karen Carpenter spurred public interest in anorexia. Soon their were clinics specializing in eating disorders. Richard Carpenter developed a fund dedicated to his sister for researching anorexia. This death awakened the public and lead to a focus on the problem at hand. It has been said that Karen Carpenter is responsible for making America aware of the problems of eating disorders. She brought it out of the closet and made it famous. As one person said, "...she's a name, and that's going to bring more attention." When I walk around school, I see people who feel the need to be thinner, who look at themselves in the mirror and see fat and ugliness. People often comment on the fact that I'm thin, and say, "You're really skinny". Being a female, a dancer, an over-achiever, vibrant and energetic, many would think that I suffer from the same disease that killed Karen Carpenter. But since 1983, much has been discovered about eating disorders. If someone was to suggest to me that I had an eating disorder, I would hand them this paper and educate them on what it really means to suffer from anorexia. The fact is, eating disorders are a big problem, no matter where you go. They effect me just as they effect everyone else. You don't have to have an eating disorder feel its consequences. Today, 8 million people suffer from eating disorders. For some reason or another, 7 million women and one million men are intentionally depriving their bodies of food. As time goes on, models are becoming thinner and thinner, as are American girls. 15 years after the death of Karen Carpenter, we are still suffering from this devastating disease, maybe more so than we were in 1983. However, the problem is no longer our ignorance to the fact that eating disorders exist and are killing thousands. Though the media perpetuates the problem, we are still better off than we were during Karen Carpenter's lifetime. We now have knowledge, which will eventually destroy the wrath of all eating disorders. Karen Carpenter can be seen as the great surge of awareness to the millions of people who suffer from this serious disease. Her struggle with anorexia has opened our eyes to the danger of eating disorders, and begun the race to finding the cure.

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Ipecac and Karen Carpenter

May 13, 1985 When Karen Carpenter collapsed at 32 from heart failure in a wardrobe closet of her parents' Downey, California home two years ago, the acting Los Angeles coroner, Dr. Ronald N. Kornbum, said she died of complications from anorexia nervosa, specifically "cardiotoxicity" brought on by the chemical emetine. What he did not specify was how the emetine got there. Experts now agree there was only one way possible: She had misused a common, over-the-counter drug called ipecac. A foul-smelling, amber-colored drug, syrup of ipecac has been sold in drugstores for years to induce vomiting in poison victims. General practitioners have long recommended having a bottle in the medicine chest as a cheap antidote; a one-ounce bottle costs only about $2. But the fact is that ipecac, in large dose, may cause irreversible damage to the heart, and if taken repeatedly, is a lethal poison. One month after Carpenter's death, Deborah Mae Mellon, 32, a mother of two, died of emetine poisoning. Two Philadelphia lawyers, Thomas E. Mellon Jr., Mrs. Mellon's brother-in-law, and Michael B.L. Hepps, have filed a lawsuit charging the numerous manufactures of ipecac with failure to warn the public about the drug's toxic dangers. The suit, initiated on behalf of Mrs. Mellon's estate, seeks $5 million in ompensatory damages and $10 million in punitive damages. "No one can know from looking at this poison antidote that it is a poison itself," says Mellon. "Like Karen Carpenter, Debbie thought ipecac was harmless. She was a happy, healthy woman who simply was desperate to lose weight." Mellon says if the cause of Karen's death had been revealed immediately, it might have saved Debbie's life. "And it would have stopped other women from taking ipecac, too. They would have said to themselves, 'This is what killed Karen Carpenter. I'm not going to take it.'" Now some doctors fear an epidemic of ipecac misuse among an estimated 150,000 anorectics and two million patients who suffer from bulimia, binge eating and purging. A group of psychotherapists who specialize in treating the two illnesses has decided to publicize the true cause of Karen's death. Chief among them is Steven Levenkron, a psychotherapist and author. It was Levenkron who treated Carpenter for anorexia-- successfully, he thought--for almost a year before her death. "Just as Karen slipped through our fingers, so are many other women," he says now. At a hearing later this spring in Washington, D.C., Levenkron and his colleagues will ask the FDA to declare ipecac a prescription drug. "Ipecac should not be readily available," he says. "It should be controlled immediately." When she died, Karen had been suffering from anorexia for eight years--apparently since reading a passing reference to her chubbiness in a review. After seeing several therapists in California, she moved to Manhattan to begin working with Levenkron. He eventually put her in the hospital, where she raised her weight from a skeletal 83 to 108 and overcame her addiction to laxatives. In November 1982 Karen decided that she was able to go home. Soon after, according to Levenkron's reconstruction of her final months, she must have begun swallowing several teaspoons of ipecac every night after dinner and eventually increased her intake to a bottle or two. The drug, which causes sharp cramps followed by violent vomiting, gradually weakened her and led, on February 4, to her sudden death. Levenkron says he was shocked to learn that his patient had died from ipecac poisoning. "I thought I knew everything about her." During phone conversations, he recalls, he had asked her, "Are you losing weight? Are you taking laxatives?" and she had always answered, "No." "Ipecac was something that never occurred to me to ask her about," he says. "I assume Karen thought this was a harmless thing to do," to eat regularly yet maintain her weight at 108. In a press release for his autopsy report on Karen, the L.A. coroner failed to mention ipecac. The release in fact stated that "laboratory tests had rued out drug or medication overdose as a cause of death." Says Dr. Kornblum now, "It never occurred to me to mention ipecac. In my mind, emetine and ipecac are the same thing." Since Karen died, Deborah Mellon's has been the only reported death from ipecac poisoning. But some observers suspect tat many diet-obsessed girls may have died from overusing the drug. "We think that many anorectics and bulimics who've died of mysterious heart failures may have actually died of ipecac abuse," says Levenkron. Dr. Alan Adlier, a Philadelphia physician who in 1980 treated the first reported victim of ipecac, most physicians aren't aware that it's cardiotoxic, and to my knowledge only one lab in the country tests for emetine poisoning." Ipecac comes from the root of the ipecacuanha plant, a shrub that grows in South America. It is the only non-prescription drug known to contain emetine. Until the late '70s, when studies of ipecac poisoning started showing up in medical journals, many doctors never considered that ipecac might be misused. "None of us had taken the trouble to investigate this drug," says Levenkron, "because who would abuse a drug that produces horrible pains, nausea and vomiting?" Dr. John Adams Atchley, a Manhattan psychiatrist who is president of American Anorexia/Bulimia Association Inc., answers the question: "If you heard [bulimics] talk about the great joy they get in cleaning themselves out, you'd understand why they're willing to take ipecac. They'll put up with all kinds of things to get the almost spiritual high. Anorexia is self-starvation resulting from a disturbed sense of one's own eating, followed by self-induced vomiting or purging by laxatives and diuretics. Bulimics are perfectionists and obsessive-compulsives, with high standards and low self-esteem; they are fleshier than anorectics, whose wasted look marks them as victims of a bizarre disease, and their numbers is growing. "In eight years I saw meetings in Jew Jersey change from groups of emaciated young women to groups of field hockey types who were bingeing their heads off, taking laxatives and throwing it up," says Dr. Atchley. But on closer look there are telltale signs: puffiness around the eyes and a swelling of the glands on the sides of the jaws. Chronic vomiters sometimes have facial rashes, damaged teeth and premature cheek wrinkles--like rows of parentheses on the sides of their faces. Although bulimics seem sturdier that anorectics, they are often actually less robust. Bingeing itself can be fatal. Recently a 23-year-old model, who had starved herself down to 84 pounds, died in London after gaining 19 pounds during one binge. According to a letter in the British medical journal, Lancet, the woman's fatal intake consisted of liver, kidneys, steaks, eggs, cheese, bread, mushrooms, carrots, a whole cauliflower, 10 peaches, four pears, two apples, four bananas, two pounds of grapes and two glasses of milk. Some vomiters end their binges with several bottles of diet soda. This makes the food float to the top of their stomachs and sparks the gag reflex. Some simply will themselves to throw up. Others--300,000 by some estimates--take ipecac. Despite the tragedy of Karen Carpenter, not everyone agrees that ipecac should be made a prescription drug. Dr. John Schiegel, president of the American Pharmaceutical Association, suggests that instead, "We endorse labeling changes on the product that will more adequately warn consumers about the potential dangers of using ipecac incorrectly." Says Ron Williams, APha's director of professional affairs, "Every year ipecac saves 150,000 lives. Everyone should have a bottle in the medicine chest in case of accidental poisonings." to counteract certain poisons, ipecac must be taken within a half hour. Dr. Atchley argues that requiring a prescription won't jeopardize poison victims. "A mother could ask her pediatrician for a prescription and keep a bottle in the medicine chest," he says. His position is seconded by former users of the drug. One of Levenkron's patients, a 14-year-old girl, said she bought ipecac at a drugstore after reading about it in a book about bulimia. She took it several times even though it made her vomit blood and bile. "Would you have used it even if it had a skull and crossbones on the label?" Levenkron asked the girl. "Yes," she said, she would have. "Karen wouldn't knowingly have done something that would kill her," says her therapist. Her grave is in Forest Lawn.

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Kate Moss' Story

Just 5ft 7in tall – a pygmy in catwalk terms – and with a lazy eye, Kate Moss may not at first seem obvious supermodel fodder. But in the course of her 13-year career the waif-like girl from Croydon has revolutionised the international modelling scene. Born on January 16, 1974, she was first spotted by model agency boss Sarah Doukas as a 14-year-old at JFK airport, and started her modelling career doing unremarkable shoots for teenage magazines. Photographer Corinne Day, one of the key players of the early Nineties "grunge" period, spotted her potential and snapped the adolescent topless and wearing a native American headdress. The picture was published on the front cover of style bible The Face, and a Generation X icon was born. More than a decade on, Kate's career has never gone through a fallow period. Unlike many of her contemporaries who lost their hipness through over-exposure or as a result of the fashion industry's constant need to reinvent itself, Kate has always been at the cutting edge of style. Today she is Britain's wealthiest model, with an estimated fortune of nearly 15 million. And a selection of hip boyfriends – including Mario Sorrenti, who shot her in the nude for the Calvin Klein campaign, Johnny Depp, millionaire model and photographer Dan Macmillan and Lemonhead Evan Dando – and even hipper friends including Noel Gallagher, Jude Law, Donatella Versace and Stella McCartney, has ensured the supermodel has continued to top hip party guestlists. In 1998 Kate made headlines when it was revealed she had checked into celeb-friendly rehab centre The Priory, in London, after suffering what was termed "exhaustion". Although she gave up modelling briefly, saying: "I quit because I thought, 'I hate it'. It's mind-numbing, repeating yourself like Groundhog Day", she was persuaded back onto the catwalks a couple of months later. As the millennium began, she cut off her trademark long hair – something she claimed she would never do – and emerged with a peroxide blonde wedge. Suddenly all the top designers were clamouring to use her in their ad campaigns. In the end, designer-of-the-moment Tom Ford landed her for the Gucci label. Since splitting with Johnny Depp in May 1998, Kate has been in a number of relationships, but none for a lengthy period of time. She is currently with Jefferson Hack, the former editor of style magazine Dazed & Confused, and in September 2002 the happy couple announced the birth of their baby daughter, Lila Grace. With the superwaif look nudged aside in recent years by bronzed beauties from Brazil, who in turn have given way to an army of androgynous Flemish femmes fatales with choppy haircuts and tattoos, these days Kate is concentrating on breaking into movies. Although Kate's career has been multi-faceted to say the least, not all has been rosy in the story of Kate Moss. Mostly known for her unhealthy image (her thin figure is what started the waif look and she is known as a heavy smoker), Kate checked into the Priory Clinic, in order to kick her heavy drug and alcohol habit. Having been romantically linked to fellow partier Johnny Depp for four years, Kate also dated Calvin Klein photographer Mario Sorrenti. Recipient of the VH1 award for model of the year in 1996, Kate Moss is unquestionably one of the most successful and controversial models of the 90's, having earned an income of approximately $10,000 per day.

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Kate Moss, too thin?

People Magazine, 09-20-1993, pp 74. BRITISH MODEL KATE MOSS seems almost too slight to bear the burden of controversy settling uncomfortably on her frail-looking shoulders. At 5 ft.7 in. and an estimated 100 lbs. (''I never weigh myself,'' she says), Moss looks as if a strong blast from a blow dryer would waft her away, let alone the winds of discord now whipping around her. When British Vogue published an eight-page layout in June of the lank- haired, blank-eyed Moss -- clad in scanty tank tops and tacky bikini panties as she posed in her very own unmade bed -- the magazine drew bags of angry mail accusing it of encouraging everything from pedophilia to anorexia nervosa. Colin McDowell, a writer for The Independent, a British daily paper, called the pictures of Moss, looking more vulnerable than her 19 years, ''extremely close to perversion in their appeal.'' Shocked by Moss' emaciated frame, Marcelle d'Argy Smith, editor of British Cosmopolitan, said, ''The pictures are hideous and tragic. If I had a daughter who looked like that, I would take her to see a doctor.'' When that same month American magazine readers saw Moss kneeling astride rapper Marky Mark in an ad for Calvin Klein jeans, her tiny naked bosom pressed firmly into his equally naked chest, a few outraged mothers actually mailed their daughters' jeans back in protest. ''It's just because I look 12,'' said Kate. But it's also because she looks anorexic and has become the unofficial poster girl of the au courant ''waif'' look. This fall, Moss wannabes -- and the mothers who love them -- will see her paper-thin figure virtually everywhere they look. Calvin Klein's new print and television ads for his Obsession fragrance feature a topless Moss filmed by her photographer beau, Mario Sorrenti, 21, on the Caribbean island of Jost Van Dyke. Moss also stars in a less steamy spot for Yves Saint Laurent's Opium, airing in Europe. Moss and the other hot ultrathin models in the waif wave -- among them Amber Valletta, Cecilia Chancellor, Emma Balfour and Shalom Harlow -- are having an effect on already weight-wary teens. ''My friends and I were looking at pictures of Kate,'' says Andrea Tebay, 16, of Weston, Mass. ''Gosh, we thought we had to look like Cindy Crawford, and now we have to look like this!'' Though Tebay's former school, private Greenwich Academy in Greenwich, Conn., ''was always bringing in people to lecture us about anorexia and bulimia,'' she says, ''we knew there were girls who were going to starve themselves anyway. Girls have pictures of these models up on their walls. They know all about their love lives.'' Adds Suzanne Henrick, a registered dietitian and counselor at Wilkins Center for Eating Disorders in Greenwich: ''I wouldn't say Kate Moss causes anorexia, but I had an anorectic in here just yesterday who said she wanted to look like Kate Moss. A lot of them bring in her picture as an ideal. I haven' t seen that with any other particular model before.'' Even without the deadly specter of anorexia, the skin-and-bones look, critics say, underlines the idea that thinness is a principal yardstick of a woman's worth. Jane Pratt, editor of Sassy, a magazine for teenage girls, which defiantly does not print diets, says she has ''definitely noticed that since this look has become big, girls have wanted to diet more. We get letters all the time from girls who are 5 ft.3 in. and weigh 100 lbs. who want help getting down to 95.'' (The average 14-year-old girl of 5 ft.3 in. weighs 110. By the age of 18 she has grown to 5 ft.4 1/2 in. and weighs 125.) ''A woman becomes anorexic because her soul has been battered by the unreasonable expectation that you can never be too thin and that fat -- any fat -- equals failure,'' says Dr. Michael Strober, director of the eating disorder center at UCLA's Neuropsychiatric Institute. Strober estimates that only three to seven out of 1,000 young women are anorexic. But many of the other 997 often feel fat and inadequate. The U.S. Department of Health and Human Services says that 70 percent of normal-weight women want to be thinner, while 23 percent of women who are already underweight want to be thinner still. Figures from the National Institute for Compulsive Eaters indicate that 80 percent of 10-year-old girls claim they're on a diet. Some philosophers on the female condition see more danger in the fragility of the image than its possible pathology. Backlash author Susan Faludi calls the waif phenomenon ''so counter to what is really going on in women's lives. Most women, if they're embracing any kind of body type, it's a bigger, stronger one. The most popular thing now is weight training.'' At waifdom's source, reckons Faludi, is ''a man's fantasy of shrinking women down to a manageable size. The look is about being very weak and passive. It is a very Victorian portrait of a woman where you are so weak you can barely get off your chaise lounge and on to the retirement home.'' In the fashion world, defenders of Moss' waif look find it more darling than deadly. ''She has this childlike, womanlike thing. It' s a kind of sexiness that I think is very exciting,'' says Calvin Klein. ''And it's very real and modern when a woman's hair looks a little dirty, when it sticks together a little,'' he said. Stephanie Richardson, fashion editor of Harper's Bazaar Italia, says the waif phenomenon is a reaction against the superwoman of the '80s, who was ''high-heeled, with big shoulder pads, lots of makeup, teased hair. Your Ivana Trump -- powerful, rich and glamorous. But it got out of hand because that wasn't a real woman.'' Waifdom's detractors, says Corinne Day, 28, the photographer who shot the controversial underwear layout in British Vogue, are ''older middle-aged people who have just lost touch with their youth and don't like it.'' As for the charge that the waif look panders to pedophiles, Sheryl Garratt, editor of The Face, a trendy British fashion magazine, says, ''I don't think you can mistake a 19-year- old girl for a 12-year-old. ((Day's photographs of Moss)) are not going to make people want to go out and sleep with children. They are just quite real documentary shots of what Kate is like.'' Moss herself is calm at the eye of the storm, happy with the more than $2 million she has made so far. Born in the London suburb of Croydon, Moss is the daughter of Peter, a travel consultant, and Linda, now divorced. Her brother, Nick, 16 and also a model, has tattled that ''at 14, she started hanging out with a crowd of older kids and going to pubs. She's never been very ambitious. She likes shopping.'' She was only 14, in fact, when she was discovered by British model agent Sarah Doukas while stopping over at New York's John F. Kennedy International Airport on the way home from the Bahamas with her father. ''She had a kind of ethereal look about her, a translucency, and such phenomenal bone structure,'' says Doukas. ''She was young and absolutely beautiful.'' Says Moss: ''People had told me that I ought to try it, but I would never have gone to a modeling agency and said, 'I want to model.' Never.'' Moss modeled for The Face magazine part-time until she graduated from high school at 16, then got her big break when Fabien Baron, creative director for Harper's Bazaar, spotted pictures of Kate at a photographer's showcase in Barcelona. He recommended her both for the magazine and the Klein ads, which he was designing. They were shot by hot photographer Patrick Demarchelier. ''I really like working with Patrick,'' says Kate in her tiny voice. ''It's really cool with him and Fabien.'' Soon she made the covers of Allure, Italian Vogue, Cosmopolitan and dozens more, and hit the runway for Anna Sui, Perry Ellis and Chanel, among others, in New York, Paris and Milan. At her busiest, she works five to seven days a week, pulling in as much as $10,000 a day. Moss, who left home at 17, shares a London house with boyfriend Sorrenti, a former model, and another photographer and his wife. But she works mostly in New York City, where she often camps in the apartment of Sorrenti's mother. ''His mother is a real mother,'' says Kate. ''I mean, she cooks dinner and everything.'' In her few off hours, says Moss, she just vegges out or goes to clubs. ''I like old music,'' she says. ''Jimi Hendrix, Lou Reed, Janis Joplin and people like that. If I had a wish, I would love to be able to sing and scream like those girls do. I can't, though.'' On the town, sometimes with fellow supermodels, who seem not to begrudge her her success, Kate says she finds it ''so weird that everyone knows who you are. You don't know them, but they all know you.'' And they all know her naked too. She shrugs. ''It's just work,'' she says. Staying thin is less work. She smokes, as many models do, and has never worked out. She doesn't diet either. ''I try to eat so I won' t be so waif- like,'' she says, ''but even if I do, I'm not going to become this voluptuous thing. I do have a sweet tooth, but I don't eat loads. I'll eat anything.'' Harper's Bazaar beauty and health editor Tina Gaudoin must be glad to hear it. She was so fed up with ''stacks and stacks of angry letters, newspaper articles and phone calls'' from the antiwaif movement that she wrote a defensive editorial in the July issue proclaiming that ''these girls eat like horses. Thin is their natural body type.'' Waifish model Valletta agrees: ''A lot of the girls who are thin can't help being thin. I mean, my best friend, ((fellow waif)) Shalom, she's thin, and she can't help it, and there are plenty of girls like that. I wouldn't diet. I'm going to eat the chocolate cake if I want to. '' Lesley ''Twiggy'' Lawson, now 43, who created the waif look in the '60s, says, ''I happened to be born like that. I got blamed for anorexia and all, but I always ate well -- anything, absolute rubbish.'' But all such disclaimers are usually relative. As a rule, models are unfamiliar with what the word eating means to most people. At a New York City club recently, Moss was reportedly sighted chowing down with model buddies Christy Turlington, Cindy Crawford and Gail Elliot on a single hamburger, cut in quarters. ''Maybe on a given day they eat anything they want, but it's not an everyday thing,'' says veteran model Beverly Johnson, 38. Notes model Beverly Peele, 18 and not a waif: ''You don't really have time to eat. You're so busy working and traveling and trying to get the few hours of sleep you can. You smoke a lot, and that keeps your weight down.'' Fortunately, most eating-disorder experts agree that merely admiring waif models is not enough to bring on anorexia or bulimia. ''There has to be a predisposing vulnerability,'' says Strober of UCLA. A real anorectic ''suffers from extreme self-doubt, inadequacy concerns and self-esteem anxieties that are far more extreme than other people's. The average person will not be induced into anorexia because they see Kate Moss.'' Adds Dr. John Mead, director of the eating disorders clinic at Chicago's Rush Presbyterian-St. Luke's Medical Center: ''Girls who have a healthy self- image and come out of a good parent-child relationship do not fall victim to eating disorders, yet they all want to be thin.'' But this is the world of fashion, and all in fashion passes. Nina Blanchard, head of her own Los Angeles model agency for 32 years, calls waifdom ''a bump in the business.'' Though she has been inundated with calls from short skinny girls of late, she ascribes Moss' success more to her face than her body. ''It would be better if people would stop saying this is the downfall of Western civilization,'' says Blanchard. Instead, she says, they should ''worry about the mental health of ((their)) children and look into their problems in terms of self-esteem, instead of worrying that they're not eating because they want to look like Kate Moss.

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Calista Flockhart's Story

Calista Flockhart was born on November 11th, 1964 in Freeport, Illinois. She was named after her grandmother, Calista, whose name meant most beautiful. After finishing high school, she studied at Rutgers University in New Jersey. She only majored in Fine Arts because she didn't want to list her major as undeclared. After graduating in 1987, she moved to New York to concentrate on acting. While appearing in smaller plays, Flockhart taught aerobics classes to pay the bills. She made her television debut in 1989 playing Elise in an episode of The Guiding Light. Soon after, she began winning praise for her performances in Off-Broadway productions of Sophistry and All For One. Flockhart made her movie debut in Darrow (1991), a bio-pic that starred Kevin Spacey as the famed Attorney Clarence Darrow. A year later, she had her first starring role in the made-for-TV movie The Secret Life of Mary-Margaret: Portrait of a Bulimic (1992). This was part of HBO's Family in Crisis Series. Afterwards, she won more praise for her regional theatre production of Chekhov's Three Sisters. However, this was the beginning of a downward trend in her career. Calista Flockhart worked for eight weeks off-off-Broadway for $400. During this time, she lived off of a case of Ravioli that her brother sent her. Her career picked up again with her Broadway appearance in Tennessee Williams' The Glass Menagerie. For her performance, she won a Theatre World Award and a Clarence Derwent Award. That year, Flockhart began appearing in more movies with small roles in Quiz Show, Getting In, and Naked in New York. In 1995, she had her first major supporting role in Drunks. The movie showed an Alcoholics Anonymous meeting, with different characters telling their stories. Richard Lewis, Spalding Grey, Parker Posey, and Faye Dunaway also starred. Flockhart appeared in two movies in 1996. One of them, the indie pic Pictures of Baby Jane Doe, was shelved until recently. In the other, The Birdcage, she played Barbara Keeley, the daughter of the arch-conservative Senator Kevin Keeley (Gene Hackman). Things were complicated because she wanted to marry Val Goldman (Dan Futterman), the son a gay nightclub owner (Robin Williams). The movie was a critical and commercial success. Calista Flockhart next appeared in Telling Lies in America, which was a quasi-autobiography by scriptwriter Joe Eszterhas (Basic Instinct, Showgirls). In it, a young Hungarian, Karchy (Brad Renfro), moved to Cleveland in the early 60's and had trouble adjusting until he met a payola-taking disc jockey (Kevin Bacon). He began telling lies to make himself seem cooler but soon suffered the consequences. Flockhart played the girl who continued to date Karchy even after he tried to give her Spanish Fly. Despite several good reviews, the movie bombed at the box office. Apart from her brief role on The Guiding Light, Flockhart had refused to do television up until this point. She finally took the plunge with Ally McBeal (1997). She starred as the title character, a lawyer. She had become a lawyer because she wanted to be with her boyfriend, who was going to law school. However, they broke up. In the show, things were complicated when they Alley and her ex, who was now married, started working at the same law firm. The show was a hit, and in 1998 Flockhart won a Golden Globe for Best Performance by an Actress in a TV-Series - Comedy/Musical. However, her success was often in danger of being overshadowed by rumours that she was anorexic, which she has strenuously denied. Flockhart will next appear playing Helena in Shakespeare's A Midsummer Nights Dream. Kevin Kline will play Bottom and Michelle Pfeiffer will play Titania. The movie will be released on May 7th, 1999. Later in the year, she will appear in Like a Hole In the Head, which is based on a Jen Banbury novel.

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Thin Theory

Is anorexia all in its sufferers' heads? One psychologist theorizes that it may be an ancient survival instinct gone awry in our modern culture of plenty. By Maia Szalavitz
For years we've been fed psychological theories about anorexia: It's a hunger strike against controlling parents; it's the ultimate capitulation to cultural commandments to be thin; it's a disease of perfectionism abetted by unattainable images of whippet-thin models. But a new theory about the disorder suggests it may be biological, a remnant of evolutionary history that helped some women flee famine.Shan Guisinger, PhD, a Montana psychologist, recently published this hypothesis in the journal Psychological Review after noticing that many anorexics—90 percent of whom are female—desperately wanted to recover, despite the clinical definition of the disorder as a “refusal” to maintain a healthy body weight. “It felt biological to me,” she says. Guisinger, who has a master's degree in zoology from Colorado State University, considered whether there could be an environment in which it made sense for a starving animal not to eat. She found that many animals stop eating to focus on a more important task—be it incubating, migrating, or defending a harem—despite extreme weight loss. Also, research shows that if rats are forced to lose 30 percent of their normal weight, they will run frantically on an exercise wheel and ignore food. Intriguingly, this phenomenon develops faster in female animals.Unlike involuntary starvation, anorexia leads to periods of hyperactivity, Guisinger says, accompanied by a feeling of being on a mission: “There is this sense of superiority, of virtue—a humorless quality.” In her paper, she describes how such a mechanism could enable women to escape death, giving them the energy and tenacity to travel beyond the famine-stricken region. When a woman reached a food-rich region, she would become hungry, settle, and eat.As for why today's anorexics don't recommence eating, Guisinger says that while they do tend to lose their appetite for much of their illness, they often experience a period of great hunger, typically late in recovery. But because our culture has made them so frightened of becoming fat, rather than yield they often redouble their dieting and exercise. She also accounts for why women would suffer from the disorder disproportionately: Men wouldn't benefit as much from a famine-flight strategy. In nature, males who try to enter the territories of others are attacked, while females are usually welcomed.Guisinger's theory is bolstered by other research. Studies now find that anorexia is, at least in part, genetic, with identical twins much more likely to share the condition than fraternals. There is also evidence that anorexics have conflicting levels of appetite-regulating substances in their brains and stomachs. Their brains' levels of the neurotransmitters serotonin, dopamine, and norepinephrine are the opposite of what they should be to signal a craving for food. At the same time, their stomachs send out mixed messages, telling the brain they are full and hungry simultaneously. Essentially, “this means that the person with anorexia is tormented by desire for food she cannot bring herself to eat,” Guisinger says. This odd chemical imbalance could be the biological signature of a need to seek food but not eat it.In industrialized nations, only compulsively driven perfectionists and those with wasting illnesses would be able to starve enough to activate this mechanism in the first place. And indeed, anorexia sometimes starts when another disease causes dramatic weight loss, Guisinger says.Her theory suggests that current treatments focused on perfectionism or family dysfunction are misguided. Perfectionism may start the disease process, but then biology takes over. Research shows that one new therapy that's been proven effective teaches those closest to the anorexic to help her to eat—even in adult anorexics, this is usually the mother—and it's easier to engage mothers in therapy that doesn't blame them. “Theories on schizophrenia once blamed the 'schizophrenogenic' mother.… With anorexia, controlling mothers are still the culprit,” says Guisinger, who hopes her ideas will end this view.But the eating disorder-treatment community—many of whom have spent years working on the assumptions of the perfectionism theory—has responded coolly. William Davis, PhD, the vice president of research and program development of the respected Renfrew Center for eating-disorder treatment, agrees that anorexia is not caused by intrusive parents but thinks that Guisinger's theory is “irrelevant to clinical practice—it has nothing to do with an anorexic's experience of herself.”Research academics in the field, however, are more supportive. “It's a plausible hypothesis,” says Janet Treasure, PhD, the director of the Eating Disorders Unit at London's Maudsley Hospital. Evolutionary psychologist Debra Lieberman, PhD, of the University of Hawaii is skeptical but says, “It's wonderful we're starting to think about these disorders in an evolutionary light.”

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Diary of an Anorexic

At the end of the year, it is only natural to reminisce. New millenium hype notwithstanding, most people think of where they have been and where they are going, of friends and family, present and past. Perhaps that is why I recently reviewed old passages of my mother's diary. A long-term anorexic, she kept a meticulous account of her daily life throughout the 1970's. It was written in shorthand, and I did not have it decoded until 1990, when I began researching the disorder. My experiences with this document began inauspiciously. A needless and bitter argument with the translator ended in my paying her three times what I had initially offered. To my surprise, much of the record was boring: endless details about chores, groceries and household items. At the time, I did not know that anorexics are notorious list-makers and that such entries were symptomatic of the illness. On the other hand, the insightful portions were exquisitely painful.Some may believe my decision to unearth the diary amounts to an invasion of privacy. In my opinion, any such violation is outweighed by the passage of time and the potential benefit to readers offered by this rare glimpse into the deepest recesses of a self-starver's mind. At the request of her attending physician, my mother used her diary to keep detailed records of her medical condition (such as weight, blood pressure, and body temperature) during her last illness. Shortly after the original transcription was completed, I delivered the entire manuscript to the doctor's office. However, before doing so, I had copied the older and more interesting entries reproduced below. Because this material can be depressing, I strongly suggest you read it when you are in a relatively good mood. At first glance, it may seem uniformly negative. However, closer inspection reveals the humanity of a spirited woman struggling against overwhelming forces. I shall have to seek further support in diaries as I am very weak. I allow the bad part of me to take over. Do you think there is a chance for me which I feel, as I have failed most? Please stay with me. Perhaps with your kindness I can...I hope my new psychologist can be of some help. I need all the support I can get. Today is one of my hungry days. Once I stay in one place or sit down, I am completely exhausted. I must take my life day by day. I hope I can control myself. Please, please God help me. Did you have everything you have so far? Can this go on much longer? I must have a stronger will and overcome. 62 ½ pounds. I told dad that I was not going to live very much more, and then I began to cry. Sorry I spoke to him like that, and I told him that I would try and get better...must find this evil in me more strongly. Forgive me God, nothing or anyone can help me now. It is strongly up to me. Amen. 11/18/72- I can't sleep. I won't sleep. [Later entries report chronic sleep disturbances and the ineffectiveness of sleeping pills.] 11/19/72- I'm completely out of hand now. 11/22/72- [There are recurring references to physical weakness and being on the verge of collapse. My mother notes that she was hospitalized on this date. 60 pounds. I must get me a tie for my son. Tomorrow I will do a wish. I wish my legs didn't ache, but I can talk it away. I think I will exist now by habit for my son only.[My mother had not lived with my father and I since 1969.] I was irritable with my son today. I must try to be more tolerant of him. I felt more beaten than I have in a long time. Have grapefruit juice during night, and dolite, and tranquilizer. - 70 pounds. Thank God for getting me through this day. 12/9/72- I am fighting a lost cause. Don't help me. I am getting weaker every day. Trying to fight. 12/12/72- Tried to know my child but no, no. Thank you, God, for keeping me alive even though I am worthless. 12/15/72- God, I am not worth your forgiveness. I have two hostile roommates. [She notes that her belly and ankles are very swollen.] 12/16/72- I want to live. Today I blew up at my son and my husband. [My parents were not officially divorced until 1974]. My rudeness, my behavior was unbearable, but I could forgive me.- The doctors made an appointment for me to go into the hospital, but I put it off until next week. I have a lot to do before I go in. My mother died on February 2, 1978. She had been suffering from anorexia nervosa for over 10 years.

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Anorexia Nervosa: 11 Areas of Advancement

Although the origin, treatment, course, and outlook of anorexia nervosa (AN) have remained a puzzle, advances in at least 11 areas have helped us better understand this disease.

Genetic Links
Important multicenter studies on the genetics of anorexia nervosa are underway to compare vulnerable patients with their siblings and parents, and to sort out clusters of genes that increase vulnerability to anorexia nervosa. Unlike Huntington's disease, for example, the genetics of AN do not determine whether one gets the disease. However, genetics probably do provide a crucial predisposition to AN through abnormalities of serotonin and metabolism and their effects on personality, reactivity, perseverance, and perhaps weight control, hunger, and satiety.

The Brain as a Mirror
The brain is clearly affected structurally and functionally as a consequence of AN. Several studies have confirmed the significant effects of self-starvation on the brain. With starvation, the ventricles of the brain increase in size and the cortical mass decreases. One matter of concern is the fact that there is improvement, but not complete normalization, of gray and white matter as long as 6 to 12 months after weight restoration. The very powerful imaging tools of functional MRI and PET scans are demonstrating a change in the interaction between the prefrontal cortex and components of the limbic system in regard to the sensing and perpetuation of emotional distress in active AN. These tools will not only demonstrate the effects of eating disorders but will also document the relative benefits of a variety of treatments.

Critical Diagnostic Criteria
In another development, diagnostic criteria for anorexia are being reviewed with a goal of sorting out the critical features and introducing more flexibility for traditional but perhaps out-of-date criteria. Including amenorrhea as a criterion for AN is less useful than noting abnormalities of reproductive hormone function in general. Broader recognition of medical consequences of starvation not limited to levels of reproductive hormones is even more useful. The key concept here is that AN involves self-starvation to a substantial degree below the individual's usual or healthy weight. Some people may be semi-starved even if their hormone levels are normal and they are at their normal weight. This means that amenorrhea is not as important as are general measures of self-starvation, and that a final lowest weight of 85% of normal healthy weight is not as crucial as is a significant decline in weight from an initial healthy weight.

Men Develop EDs, Too
A recent large epidemiologic study has substantiated that males are probably underrepresented in both epidemiologic and clinical studies. While earlier studies reported ratios of as many as 10 females to 1 male, a ratio of one male to three or four females may be more accurate. This raises concerns that males are underrepresented in clinical programs, and calls for better understanding of the factors that may be keeping them from seeking treatment.

Axis I Comorbidities
The recognition that AN usually has associated comorbidities on Axis I or II has been confirmed with awareness that AN seldom presents by itself but there is a high probability of Axis I diagnoses, including comorbid depression, anxiety, and substance use disorders. On Axis II, there is an overrepresentation of cluster C for restricting AN and a mixture of clusters B and C for AN binge-purge subtype. Recent studies from Denmark have highlighted the especially deadly combination of AN with insulin-dependent diabetes mellitus in young individuals. These studies spell out an approximately tenfold increase in mortality with this combination, compared to having either of these disorders alone.

The Rise of Neuroleptics
A number of trials are underway using atypical neuroleptics such as risperidone and olanzapine. The hope is that they will have an effect on the core psychopathology of AN rather than merely stimulating weight gain, as was the case with chlorpromazine in the 1960s.

An Excellent Outcome May Be Possible for Many
Although AN is often considered a chronic disorder with a poor prognosis, in fact the duration of AN is quite variable, and more than 75% of patients will have an excellent outcome. This is especially true for adolescent anorexics who are treated comprehensively to full weight restoration with associated cognitive behavioral psychotherapy, and then followed up carefully. A 10-year follow-up study at UCLA documented complete improvement with absence of any diagnostic features for any eating disorder in 76% of patients.

Insurance Limitations
Despite improvements in outcome with modern treatment modalities, many patients cannot get access to treatment because of irrational insurance limitations. Decreasing length of hospital stays, an increasingly common occurrence with restrictive and irrational insurance limitations, is leading to more frequent relapse and less sustained improvement. Groups such as the Eating Disorders Coalition have been working to change this.

Arguments Over Effectiveness of Prevention Efforts
Controversy exists between clinicians, between treatment centers, and between countries on the possible effectiveness of preventive efforts in AN. Several studies are now suggesting there is a decrease in the prevalence or severity of AN in vulnerable individuals when pressure to lose and maintain an abnormal body weight is removed. For example, there is evidence that the number of cases of eating disorders declines when a strict ballet school refuses to let a dancer participate below a certain weight or when a collegiate wrestler is barred from participating below a certain percent body fat or absolute weight. The more adventurous approach toward empowering young people with media skepticism, with assertiveness, and with improved body image has not yet been tried on a broad-enough population to comment on its effectiveness. But the approach to "inoculating" the vulnerable subgroup of young people with techniques to make their way through a society obsessed with thinness merits continued work.

A Disease That Stands on its Own
There has been some attempt to subsume AN into other diagnostic categories, such as obsessive-compulsive disorder (OCD), major depression, or psychosis. In fact, AN "breeds true," with evidence that the core syndrome has not changed in hundreds of years. There is ongoing discussion about the presentation in different cultures in regard to the content of the core psychopathology. There is support for the concept that overvalued beliefs are part of the core psychopathology of AN, and that the overvalued beliefs vary from culture to culture. For example, in the West, we overvalue thinness. To further clarify this, overvalued beliefs are defined as culturally normative beliefs that have been assigned disproproportionate values in a particular individual and that demonstrate that individual's thinking, emotional life, and behavior. Nor are they the type of ego dystonic thoughts or behaviors required for obsessive-compulsive disorders. Although overvalued beliefs are not abnormal themselves, what is abnormal is the excessive value assigned to them. This diagnostic criterion is less frequently used than it should be and helps to differentiate the AN psychopathology from OCD or psychosis and also explains some of the chronicity of the disease. It also offers hope for change through stopping the abnormal behavior and challenging the core overvalued belief with cognitive behavioral techniques.

Family Therapy
There's exciting evidence that the families of young anorexics may be able to be empowered through teaching techniques to keep the patient from ever being hospitalized, even when very starved, when parents practice a stepwise approach toward changing the self-starvation with caring but firm techniques.

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Facing the plate

My heart began to pound, shaking my protruding collarbone and rattling my jutting wrists. Blood turned to lead in my trembling arms, anchoring them to my lap. Voluntary movement was not possible. I'm not ready for this, I thought. I faced the pile of spaghetti, alone. A hill of stretched, pale worms wound around each other. Dark scabs of meat infested the blob of red goo that sank the mound's middle. It looked like it could writhe at any moment. The smell conjured up a meal at "Mom's Italian Restaurant" on Route 27 rather than the institutional cuisine I'd expected. That didn't matter. To me, sustenance meant guilt and revulsion. I could sooner have swallowed a piece of homemade ravioli as chewed a giant beetle that crunched and then squirted. Anorexia nervosa literally means nervous loss of appetite, but that's not accurate. Like the bodies of other anorexics, mine yearned for food. Conventional wisdom holds that taming hunger instills a sense of control and mastery that a person lacks elsewhere in her life. The late 1970s, when I was sick, marked the beginning of what turned out to be a boom in eating disorder awareness in the general population. Girls of my generation, however, didn't invent these illnesses. Ancient Egyptian hieroglyphics depict conditions that resemble what we now call anorexia nervosa so it's probably been around for at least several thousand years. The first formal account lies in a medical paper from 1689, in which a patient was described as "a skeleton clad only with skin." For a long time, anorexia nervosa was thought to be a form of tuberculosis or a manifestation of some other physical disease. It wasn't until the 1930s that researchers began to think that this type of self-starvation might stem from psychological roots. Today, symptoms of eating disorders -- inappropriate dieting, maladaptive preoccupation with shape and weight, and overvaluing the role these characteristics play in a person's life -- are extremely common, although the full syndrome of anorexia nervosa strikes rarely. Experts estimate that about one-half to 1 percent of young women suffer from the disease. Many factors probably contribute, and researchers are investigating the roles of personality traits, family structure, social patterns, biology and cultural influences. Several recent studies, including one that involved 2,000 twins published earlier this year, have suggested that predisposition to anorexia is inherited. This result implies that certain forms of genes put people at risk for the disorder, thereby focusing attention on genetic as well as environmental factors. In many ways, I was a typical anorexic -- female, adolescent, conscientious with a perfectionistic streak, and seemingly happy and successful, yet haunted by feelings of defectiveness and loneliness. In contrast to the textbook cases, however, I was acutely aware of what I was doing, and why. I had gone to a lot of trouble to land myself in the hospital. At 15, I had embarked on a diet and had shed 50 pounds in six months. My body had started out slightly padded, clad in baggy painter's pants to conceal my thighs. As I shrank, I wore tighter pants to flaunt my success, until those too began to hang on my diminishing frame. By summer, my pelvic bones looked as if they could cut my bathing suit. I snuck downward glances as I walked briskly to the edge of the pool, admiring how they rose sharply to define the valley that used to be my belly. Now a vast chasm of air separated my thighs when I stood with my feet together. The contours of my ribs resembled a row of black piano keys, and bald cords of sinew had replaced my neck. When I unzipped my jeans, they dropped to the floor. To accomplish this dwindling feat, I memorized the USDA's book of nutrition and dug out my mother's scale for weighing food. I slid the shiny knobs back and forth to measure exactly 100 grams of cherries. After I'd lost 20 pounds, my mother wanted me to put it away and stop tallying calories. "You've reached your goal," she said, "You're thin enough." The times I failed to shove it all the way into the corner on the top shelf, she knew I'd been sneaking it out. "You're trying to cause trouble," she'd accuse, yanking open the cutlery drawer. So I left the scale in the cabinet and honed my ability to weigh with my eyes. I dished noodles into a measuring cup in my mind and multiplied the calories in one grape by the number in the cluster on my plate. My chest clenched when I had to estimate the calories in a bowl of soup or a heap of casserole. It relaxed when I encountered a single-serving Rice Krispies box or a pre-packaged frozen bag of broccoli in cheese sauce. I could just read the nutritional information label. If I added about one and a half times as much water as the package of instant oatmeal called for, I didn't dilute the flavor too much, but felt as if I was eating a heartier breakfast. For variety, I might try half an English muffin (dry) with a slice of cantaloupe. That gave me a good 100-calorie start on the day. Lunch was more of the same, though sometimes I'd substitute the fruit. No blueberries, though -- too many calories per feeling of fullness. For dinner I might eat a bowl of iceberg lettuce (dressed in a few drops of water), a drumstick of skinned chicken and maybe a small baked potato. Under this regimen, I biked, swam, ran and played tennis every day that summer, except when I was vacationing with my parents in Switzerland. There I woke early to stuff the croissants meant for breakfast into my knapsack before my mother and father appeared in the dining room. I ate my lunch high in the Alps, amid snow-capped mountains and green lawns dotted with wildflowers, perched on the other side of the rock so Mom and Dad wouldn't see how small I pared the cheese, and so they wouldn't witness the surgical procedure with which I removed the soft part of my rolls. I screened my activities with hunched shoulders, my body taut with deception. I had never liked egg yolks so at least I could eat only the whites (which carry most of the protein, but few of the calories) in the open. I scrutinized every decision about what I would eat and do. Did it contribute to my program of maximizing the ratio of expended to consumed calories? I refused to go on trips that would confine me to a vehicle for hours at a time. I could burn only so many calories jiggling my legs. I avoided situations where dinner was served after 7 p.m. Too close to bedtime -- not enough hours to walk off my so-called meal. For a treat, I might go to a movie. But once inside the theater, I couldn't concentrate on the screen. I was too busy thinking about what not to eat the next day. Nothing was really funny, anyway. Even as I starved myself, I took pains to avoid permanent damage. I always drank enough so my electrolytes wouldn't get out of whack and provoke a heart attack. And although I knew I could stick my finger down my throat, I succumbed to the urge only once. I could imagine bingeing and throwing up forever, without being noticed, and that was not what I was after.

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Anorexic sues college

By: Martin Finucane
An anorexic student sued her college Wednesday, seeking readmission after school officials turned her away because of her condition. Keri Krissik, 20, suffered cardiac arrest while at home in Milford, Conn., in April. She completed her spring semester coursework, but administrators at Stonehill College, a Catholic institution, refused to let her register last fall. The Rev. Mark Cregan, the university president, said "we don't have the ability to support her in the way she needs to be supported." "The last time Ms. Krissik was on campus she almost died," said Elise Busny, a lawyer representing the college located in Easton. "There's the risk that she would drop dead on campus." Krissik, 5-foot-6 and between 97 and 100 pounds, has been anorexic since she was 8. She now has a defibrillator implanted in her heart. She said she is protected by the federal Americans with Disabilities Act. "I'm feeling good and I feel like I can handle the challenges," she said outside federal court. Krissik's lawyer, Abbe Ross, said her condition had improved and that the school was "only keeping her out because of her disability." Anorexia nervosa is marked by obsessive fasting. Its effects can range from weight loss to delayed sexual development, heart problems, depression and death. U.S. District Judge Rya Zobel said she would rule quickly. update! Krissik decided to go to another college and the court ruled that Stonehill was ADA compliant. The case was settled in undisclosed terms.

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Fat like mommy

I wanted it to be my mother's problem. She was the one obsessed with weight. She was the one who hated her thighs. She cooked our meals, making nothing but salad for herself, then hovered over the kitchen sink sucking shreds of chicken meat off the bones we left behind because she was so hungry. Not me, I always declared. I have a positive sense of self. My body is my home. Then my body became somebody else's home. Within 10 weeks after my pea-size fetus moved in, that home gained 15 pounds. "Your mother only gained 15 pounds throughout her entire pregnancy with you," said my dad. "Well, she also smoked throughout her entire pregnancy with me," I answered, in a weak attempt to hide how fat and inadequate I felt. After I hung up the phone, I went to my kitchen and made a pot of macaroni and cheese. It was July. I was so hot and so nauseated that all I could do was lie on the sofa in front of the air conditioner or eat pasta. Sometimes, when I did both at the same time, I counted it as exercise. "You're gaining too much weight," my first obstetrician declared from behind his enormous desk. He was looking at my chart, not at me. He held the manila file with the records of my pregnancy thus far. His fingers were thick and stained with the unnatural caramel color that comes from regular sessions at a tanning salon. "What do you think I should do about it?" I asked him, prepared to hear about nutritionists, prenatal exercise programs and salad. He tapped his fingers on the desk. I couldn't imagine this man reaching inside me to help pull out my child. "Eat less," he said, still looking at my chart. At that moment, I knew I was leaving his practice. What if I hadn't read all those books about pregnancy and I had interpreted "eat less" to mean "diet"? I could seriously harm my baby by following his idiotic advice. He droned on, spewing some incomprehensible crap about pregnant pioneers in covered wagons bouncing merrily over the prairies and how modern women worry too much. ("Although you're a Jew, right?" he asked. When I answered yes, he said, "Me too. Our ancestors didn't know from covered wagons.") To my recollection, lots of those carefree pioneers died en route to the West. I asked the receptionist to make copies of that chart of mine before I left. But the doctor's words had left an indelible impression. I was gaining too much weight. Suddenly, all my self-assurance went right out the window. Every pregnancy-related pound I added made me sweat in fear of a lifetime of fat.

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Don't hate me because I am beautiful

by Ann Abel
My first week this year at Rice, a new acquaintance told me she'd like to have just a little bit of what I have. That scared me. What I have is anorexia. I came to Rice as a freshman last fall and decided to take the spring semester off to concentrate on my recovery. With much hard work, I managed to regain my health and return to Rice this semester. My recovery is going well, but when I heard a girl lightly tell me she was jealous of my disease, I remembered an essay I wrote six months ago. Writing this piece was cathartic, and I hope my words help others who battle or know someone who battles with an eating disorder. As I walked past an overweight co-worker yesterday, she grabbed my thin arm. "...And then there are lucky little things like her..." she said to her also-dieting friend. I have no idea as to the rest of that conversation, but I'd guess they were discussing, like many women, their desire to lose weight. I laughed along with them, but desperately wanted to shake this woman and scream about how wrong she was. I am not lucky. I am anorexic. Unfortunately, she is not alone. Despite its progress, our society still equates "thin" with "beautiful" and is often blind to the problems my excessive thinness cause me. Few seem to realize that being 30 pounds underweight is more dangerous than 30 pounds overweight. Certainly as unattractive. But after all the articles I've seen comparing the risks of "apples" and "pears," I have yet to read about the hazards of "string beans." When meeting someone a little larger than average, or even -- dare I say -- fat, who would dream of rudely asking, "How did you get so heavy?" "When are you going to take some meat off your bones?" "You could stand to lose a few pounds, couldn't you?" Ridiculous ... right? Yet people seem to ask me similar questions, or even tease me, without giving it a second thought. An actual conversation with a friend's brother went something like this: "Hi. I'm Ann. Nice to meet you." "I'm Eric. Do you ever eat?" I could have replied that he wasn't exactly built like Arnold Schwarzenegger, but I'm more polite than that. So I don't want to hear how "lucky" I am or how "jealous" anyone thinks she is. Dropping a few pounds can improve self-esteem as well as health, but if a little is good, a lot is not always better. I should know. For me, it began three years ago when I was 16; a little "successful" diet that ballooned into a devastating anorexic illness. While the symptoms and effects of anorexia are well known among the medical community, the causes of the disease are much harder to understand. What is known is that most victims are attractive, high-achieving members of upper-middle class families. I certainly fit this "anorexic" mold. High achiever in high school. Pretty. Graduated seventh in my class of 400. National Merit Scholar. Well-liked. Involved. But while I came off as "completely together," I was falling apart inside. During my high school sophomore My year, the scale hit 135, and I took some teasing about being "voluptuous" and winning wet T-shirt contests. best friend tried to console me. "Yeah, but you carry it well." I thought I'd be happier if I just lost five pounds. Soon I had my chance. The summer before my junior year, I had my wisdom teeth out. I lost that weight during the week when I couldn't eat anything solid. I felt better about myself. People complimented me. I decided I'd lose a few more for "insurance." I lost it all the "right way" -- a little less fat, a little more exercise -- like all the experts said. I dropped a reasonable pound a week -- for about a year. I wish I knew when my diet became an obsession, but I have no idea. Four months after my wisdom teeth came out, my family and friends began to worry. I denied my problems and continued to cut out more fat. Although I never stopped eating, at one point, my 5-5 frame held little more than 70 pounds. And even then some people still complimented me! Last fall, I realized my dream of going to Rice, only to discover how serious my anorexia is. I loved that semester, but knew I couldn't survive another until I got my health back together. After the worst week of my life, I made the hard but necessary decision to take the spring semester off, come home and concentrate on my recovery. There were many "extras" that accompanied my recovery. The joy of spending hundreds of hours and thousands of dollars on doctors, therapists, dieticians, tests and Prozac. The pleasure of wading through the bureaucracy of my insurance company (although I shouldn't complain. At least my insurance covers mental health). The privilege of putting my education on hold for a semester. The good fortune of destroying my self-esteem. The fun of my skinny life in general -- I can't wear sleek sexy stylish clothes. I can't go ice skating because I get too cold. I can't go swimming because I'd really rather not wear a bathing suit in public. I can't sit on bleachers because I don't have enough padding. I can't concentrate because I'm usually obsessing about food. Does this sound "lucky?" I would gladly trade cellulite for all the "luck" I've had. All sarcasm aside, I have been lucky in two important respects. My health is extraordinarily good, much to the amazement of my doctor. I don't suffer from low electrolytes or anemia. The damage I've done to my reproductive system may still be reversible. Less tangible, but equally important, is the vast amount of encouragement my friends and family give me. Along with their support, I'm lucky to have access to such good doctors and therapists. I've been in therapy for over a year now, and my progress is good, but slow. My greatest blessing is in living in a city large enough to have a group therapy outpatient program at one of the hospitals. Six women meet with a therapist one evening a week, and I find myself looking forward to Wednesdays. At group sessions, I can complain about "having to eat Hagen-Dazs ice cream," and find sympathy instead of sarcasm. My recovery is going well. I'm gaining my prescribed pound a week, I've returned to Rice and I'm optimistic about my future, yet I'm constantly faced with the unpleasant reality of having gone far beyond that American ideal of "thinness." I don't understand how classmates, acquaintances, even virtual strangers tell me how wonderful it would be to have my thin frame. I think I look like I've just emigrated from Somalia. Some tell me I don't need to try to gain weight. That perplexes me even more than the idea that gaining would be fun and easy. "You can eat whatever you want!" they claim. I beg to differ. I really want to eat fruit for dessert, but it doesn't have enough fat. I wish I had the luxury of occasionally skipping lunch during hectic or stressful days. Store clerks compliment me on my "slight delicate physique" and tell me I can wear anything. True, I've had no problems getting things to zip, but I'm tired of hiding out in baggy styles -- almost anything else reveals too many bones. I hardly consider "thin" a compliment anymore, but anorexia has made it so hard for me to eat anything fattening. I wish I had a pound for every time a woman has told me she wished she had my problem. Or that she'd have no trouble gaining weight. As anyone who has ever dieted knows, changing one's weight is difficult. It involves willpower and not eating what one desires. The same holds true for gaining. My eating premium ice cream when I'd prefer sorbet is no different than the woman who craves the cream and settles for the sorbet. It isn't easy. It's hard to unlearn the behaviors I developed while losing weight. My intuition tells me not to eat those greasy fries -- and social expectations make it even harder. Our culture accepts, even expects, women to be trying to cut back and lose weight. In high school and college, my friends often dieted together -- a female-bonding rite-of-passage which excluded me. Hallmark prints weight-loss motivation cards. Oprah's viewers cheered when she "victoriously" slid into those size-10 Calvins. I constantly hear about a co-worker's progress with Weight Watchers. Why is it that when she announces she's lost three pounds and is closer to her goal of attractiveness, people congratulate her? If I mention the three pounds I've put toward my goal of health, I find as much sarcasm, eye-rolling and misunderstanding from them as admiration and support from my true friends. I have few chances to forget how unusual what I am doing is. Women's magazines and television commercials overflow with articles on celebrity weight-loss tips, diet plans and features on dressing thinner. Even the comics are a painful reminder of my anorexia. The creator of Luann seems to find the disease suitable material for laughing at over Corn Flakes. I saw a postcard today that joked, "Finish your vegetables, kids. There are people in Beverly Hills with eating disorders." Ouch! Twice a week, after I've been coping with my emotional problems with my psychologist, her receptionist's mug reminds me of the emphasis on thinness and dieting. "If God had wanted me to be thin," it reads, "He would have given me willpower." I like to believe God has more important things on His mind. I guess I do sound rather cynical. My emotional problems are frustrating and I'm sick of being the butt of jokes as well. Jokes about AIDS, cancer, even fat people are considered to be in bad taste, but it's still open season on skinny people. As if a subsequent "you know I'm just jealous" justifies hurtful words. My slenderness can also be inconvenient. Just once I'd like the window seat in a car trip. But no one else fits quite as well in the middle. I'd like to be greeted at work with something other than "Oh, you've got skinny hands. Can you reach in this box for me?" I'd like to be thought of as more than skinny. I see people I meet as much more than their measurements, whether they're above, below or exactly average. If people had more of an idea about the impact my physique has had on my life, I doubt they'd be so cavalier about my "luck." I wonder how anyone can be jealous of all the insensitivity and misunderstanding I live with. I'd gladly take those 20 pounds people tell me they'd like to give me, but I don't know if they really want to part with them. They're some physical and emotional padding in a rather sharp world ... They're just a little more to love ... Sounds pretty lucky to me.

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Anorexia does not increase death rate

Anorexia does not decrease survival rate Susan Aldridge, PhD A long-running survey suggests that people with anorexia do not have a higher death rate than expected for their age or sex. Many people with the eating disorder anorexia nervosa end up in intensive care, which has created the impression that the disease is often fatal. In fact, this is not so - according to a new study. Doctors at the Mayo Clinic now report upon a long running study - the Rochester Epidemiology Project. They looked at those participants who met the diagnostic criteria for anorexia between 1935 and 1989, who were monitored for up to 63 years (the exact time depending on when they joined in the study). During this time, 208 patients died - 193 women and 15 men. One woman died of complications of anorexia, two women committed suicide and six patients - five women, one man - died of complications of alcoholism. On the whole, the death rate is not different from that expected for a similar group without anorexia. But the potential links between anorexia, suicide and alcoholism should be further investigated, the researchers say. Source Mayo Clinic Proceedings March 2003

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AnorexTM pill causes fury

New diet pill's tacky name tough to swallow April 3, 2003 BY RICHARD ROEPER SUN-TIMES COLUMNIST The breathtakingly tasteless name, the box, the advertising pitch, the product itself--all of it sounds like something straight out of a "Saturday Night Live" commercial parody. But it's for real. There really is a diet pill called AnorexTM. "When is a Diet Pill worth $153 a bottle?" is the question posed on the Web site for the product. The answer: "When you're more than 20 lbs. overweight and tired of wasting money on one ordinary diet pill . . . after another." The Web site shows a woman standing on a scale and holding up a pair of baggy jeans that are now far too big for her. She beams and tells us, "It's working! Finally a diet pill strong enough for me!" According to the ad copy, the casual or slightly overweight dieter should not try AnorexTM. "To begin, if you are one of those people who constantly worry about 5 or 6 simple 'vanity' pounds, Anorex is not for you. But if you're one of the millions of Americans who are significantly overweight (more than 20 lbs. of excess body weight and/or have a BMI [body mass index] greater than 30), there is no longer any way to deny that ordinary diet pills and so-called 'fat-burners' (if they work at all) so often fail to help the significantly overweight.... "But now there's Anorex--the first weight-control compound designed to mitigate the profound effect that variations in the human genetic code have on the storage, use and disposition of body fat. Anorex is an extremely powerful anorectic agent and is not intended for use by the casual dieter. . . . However, if substantial, excess body fat is adversely affecting your health and self-esteem, then it's time for you to discover Anorex--the first comprehensive weight-loss compound designed specifically to overcome your genetic predisposition." Great! And if that doesn't work, maybe somebody can manufacture a product called Bulimi-Ahhhhh, the first pill specifically designed to help you feel better after a binge-and-purge! Of course, there isn't really a product called Bulimi-Ahhhhh, because that would be tacky and grotesque. You know, sort of like calling a diet pill AnorexTM. According to Webster's, to be "anorectic" literally means "having no appetite." It can also mean one is "affected with anorexia nervosa," which as we all know is "an eating disorder characterized by a fear of becoming fat, a distorted body image and excessive dieting leading to emaciation." There is no such word as "Anorex"--but is there anyone who wouldn't hear that name and immediately think of the widespread eating disorder that plagues thousands? Why in the world would Klein-Becker usa, the manufacturers of the diet pill, take out a trademark on "Anorex" if they didn't want to draw that connection? Even with the disclaimers about the pill being only for the "significantly overweight," isn't it likely that some anorexics will seek out the product for all the wrong reasons? My calls to Klein-Becker usa over the last couple of weeks were not returned. Funny, you'd think they'd be proud of the product and would want to talk about it. In any case, the ingredients in AnorexTM include calcium; Vitamin B6; Anorex itself, aka Leptoprin, which consists of Acetylsalicylic acid, caffeine, L-Tyrosine, Green Tea (leaf) Extract, Kelp, Cayenne and Ephedrine alkaloids (extract from Whole Plant Ma Huang). You're supposed to take two capsules three times a day, with or without food. "Jitters, anxiety, dry mouth or insomnia may occur during the first week of use," warns the box label. Here's another possible side effect. I didn't take even one Anorex TM, but the name itself made me feel nauseated.

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Reckless perfection

Reckless Perfectionism Issue of 2003-03-17 // Posted 2003-03-10
This week in the magazine, Judith Thurman profiles Vanessa Beecroft, the Italian artist whose tableaux vivants have made her a controversial star of the performance-art world. Beecroft's provocative work, which combines elements of fashion and performance art, is tied to her obsession with her eating disorder, exercise bulimia. Here Thurman discusses the complex relationships between food, illness, and art, as well as fashion and design, with The New Yorker's Matt Dellinger. MATT DELLINGER: Your Profile of Vanessa Beecroft deals as much with her eating disorder, exercise bulimia, as with her art. How are they related? JUDITH THURMAN: I wanted to write something on art and bulimia, and I had heard about Beecroft's book. I wanted to write about the motives behind it, and about eating disorders—a neglected and fascinating subject that ought to be addressed by more artists but, for mysterious reasons (having to do with courage, I suspect), isn't. So that is the reason bulimia has such a prominent place in the piece. My initial interviews with Beecroft were all about food and eating. And she very much wanted to talk about this subject, which obsesses her almost exclusively. Beecroft seems completely unashamed of her eating disorder—she talks very frankly about it. Is her bulimia somehow a source of pride? I don't think Beecroft is unashamed of her obsession. On the contrary: I think her art is about shame, about facing the shame, about enlisting others to feel it, about imposing it on others—she is a "shame" artist as much as a "hunger" artist. And I don't think she is in any way proud of herself. There is a pride, yes—a perverse pride, a sense of amazement that she has made her shame so glamorous and interesting—and, at the same time, a desire to have her power curbed. What about having herself treated? Isn't bulimia a medical problem, not a cultural one? Her bulimia—exercise bulimia—isn't life-threatening. It isn't like anorexia, which can lead to death. It isn't even like the more conventional kind of bulimia, which involves vomiting, and which can lead to unpleasant physical conditions, such as gum disease, tooth decay, ulcers, etc. Her obsession does, of course, "eat up" a tremendous portion of her life, daily and psychic. But it also apparently feeds her art. And she does see a therapist. As she says herself, she didn't (and I think doesn't) want to "waste herself" completely. But she's an unusual, and unusually strong, person. Does her work glamorize eating disorders—or, at least, an obsession with weight—for an audience that might be more vulnerable, like teen-age girls? It is always hard to know how teen-age girls will react to anything. By their standards, Beecroft is old—almost thirty-four! She also has a quite wonderfully healthy-looking figure—she's not skinny. Her "girls"—the women who appear in her performance pieces—are another story. I don't find them glamorous, and I tend, personally, to overvalue thinness. They are rather frightening. There is something robotic, gruelling, and, of course, punitive about bulimia that Beecroft captures in the performances. Beecroft has said that the whole purpose of starting her "Book of Food," which is, in essence, a bulimic's diary, was to show it to a doctor, and to get professional help for and perspective on her obsession. It dramatizes, without glamorizing in the slightest, the devastating grip of bulimia on a teen-age body and soul. I also think that her extraordinary (and, in a way, courageous) candor on the subject is a discouragement to present or potential young bulimics. At least, I hope it is. I think she hopes it is. You describe Beecroft's almost adolescent lack of foresight or sense of mortality. And yet she's obsessed with perfection. How does she reconcile these two contradicting aspects of her personality? The perfectionism and the recklessness—that's a hard one. They are contradictory. But artists, I think, are people who tend to be blind to their self-contradictions, or who have a tremendous tolerance for them. Extreme perfectionism can coincide with extreme recklessness in the same way that criminality and refinement can coincide. Or, in the character of a great writer, penetrating insight into human nature can exist in the same personality with monstrous narcissism and egotism and blindness to the crudest of one's own behavior. Take our old friend Count Tolstoy. Or my idol Flaubert. People criticize fashion magazines for not representing a full spectrum of beauty. Is Beecroft's work, and her personal life, susceptible to the same criticism? I personally find the earlier Beecroft pieces, in which the girls aren't so perfect, and in which there is a much greater variety of bodies, much more eloquent and moving, because of their vulnerability. But her own vulnerability seems to require armor—and thinness is armor. It was interesting to hear about Beecroft's young friends in Italy who were anorexic. I think that many people think of eating disorders, as well as obesity, as a very American phenomenon. Is this not the case? Anorexia and bulimia have taken over Western culture, and are spreading elsewhere. The only community that seems relatively immune is the African-American one. A friend told me about a Central American girl she knows who decided to live on an apple and a piece of hard candy a day, and has been hospitalized. There are stories of anorexia in the Third World. Eating disorders are as contagious and addictive and are becoming as ubiquitous as drugs. In your article, you write that Beecroft was once put in handcuffs to stop her from beating her husband. She idolizes her absent father, and describes herself as the male of her family. Can you talk about the gendered, sexual dimension of her work? I think that of course there is something extremely sexual about Beecroft's work, but I also think there is obviously something sexual about eating disorders. My own theory is that anorexia stems, in part, from an identification with the father. It certainly strips a woman of her female characteristics. It gives her the body of a pubescent boy. My eighty-pound, five-foot-four-inch, thirteen-year-old son probably has a body any anorexic would admire. He, of course, is desperate to gain weight and bulk up. Her work is certainly sexually provocative, or it uses sexual imagery as a provocation. I'm not sure there is that much sexual content to it. It is, as anorexia and bulimia are, about resisting desire, about lashing oneself to the mast so one can't be swept away. Has Beecroft ever used men in her work, or is it exclusively concerned with the female gender? She has done a series of pieces with sailors and men in uniform, including a performance on the deck of the Intrepid. She is very interested in uniformity and fitness, and she has certain martial (Spartan, ferocious, violent, authoritarian) inclinations, and, in that sense, I suppose one could also say, a virile temperament. But I also don't want to put it that way. Gender is a bell curve. There is no such thing, really, as pure femininity or masculinity. Both sexes experience all aspects of desire, passive and aggressive. You suggest that viewers could get something very different from a Beecroft piece if they stayed for the entire duration. How long do the pieces last? I sat through a long video of her last piece: about two and a half hours. I have never seen one of her performances in a museum or a gallery, but they also last about two or three hours. I have seen other long performance pieces—Marina Abramovic's, for example. The time element is very important. It changes one's experience of the performance and its meaning. One gets a very distorted impression of Beecroft's work from the photographs, which is how most people encounter it. She is right to say that they leech her work of its emotion and ambiguity. They are too glamorous and fashion-y. There is a kind of contemplative or meditative aspect to a long performance in which nothing happens—although things happen, very slowly, internally to the viewer and to the performer. You are wrestling with your own impatience, your own hunger for stimulation, your own frustration—and those emotions become part of the piece. Let's talk about how Beecroft's work blurs the line between art and fashion. You have written essays and criticism on both. Are they kindred enterprises? Fashion and art have an incestuous relationship. Designers give large donations to museums who then host their retrospectives, as with Armani at the Guggenheim, and museums profit from blockbuster fashion shows where the work is treated uncritically, as in the case of Versace at the Victoria and Albert Museum. Artists like Beecroft showcase the products of designers like Prada and Tom Ford. Tara Subkoff, who figures in the Profile of Beecroft, and who designs the supremely trendy—and, actually, quite interesting—label Imitation of Christ, likes to think of her business, as she put it to me, as a "project." This is art-world jargon for something too cutting-edge to be called simply a "piece," a "work," or a "performance," much less "a line of tweaked vintage dresses you sell at Barney's." Designers refer to their boutiques as "spaces," and they hire famous architects to "conceptualize" them. God forbid they should just sell stuff in a store. On the other hand, the best designers, like artists, are canaries in the mine who pick up the scent of the Zeitgeist, for lack of a better word, before it reaches the rest of us. Art, at least since 1863 and the Salon des Refusés, where artists rejected by the Emperor's gallery showed their work to adoring crowds, isn't supposed to be beholden to academic or bourgeois values, or idées reçues. It's supposed to be esoteric, impious, defiant, and subversive. But you can be only so esoteric and subversive in the fashion business. The stuff has to sell—or else, as Miguel Adrover discovered with his Middle Eastern collection of 2001, adios. At the same time, it's snobbish and provincial to dismiss fashion as mere frivolity. It occupies too great a place in the culture. It's a language, a drama, an arena. Clothes speak. About power, beauty, pleasure, sex, money, class, desire, gender, age—the aspirations and desperations of millions of people. So it's a subject worthy of serious thought. I also happen to love clothes. And I was delighted to read in an essay by Roberto Calasso that Stéphane Mallarmé edited a fashion magazine.

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Obesity caused by single gene

By Alison McCook
A small percentage of people who are severely obese may have developed their condition as a result of a genetic change that affects the process by which the brain tells the body to stop eating, researchers said Wednesday. The vast majority of people have bulging waistlines as the result of a number of factors, including their eating behavior and genetics. However, two new studies in The New England Journal of Medicine (news - web sites) suggest that approximately five or six percent of severely obese people may carry a particular genetic change that causes them to gain unhealthy amounts of weight. These particular cases of obesity also appear to be characterized by binge eating, during which people uncontrollably consume abnormal amounts of food, the researchers note. For overly obese people, learning that their condition results from genetics, which is beyond their control, could be somewhat comforting, Dr. Joel F. Habener of Massachusetts General Hospital told Reuters Health. Habener co-authored an editorial that accompanies the current research. For this small group of people, who have likely struggled unsuccessfully with their obesity, the extra weight "is not their fault," Habener said. "They actually have an inherited disease," he added. In the future, as researchers learn more about the human genome (news - web sites), these findings may prove useful in devising treatments that target the effects of this particular mutation, Habener said. But any such development is likely a long ways away, he noted. And no person who is obese currently has the option of a pill that will melt the pounds away, Habener added. "There are not magic bullet drugs that will make people stop gaining weight, stop eating." The mutation featured in the current research is a change in a gene called MC4R, which is short for melanocortin-4 receptor. A number of findings suggest that MC4R plays a role in appetite regulation. MC4R receptors are abundant in the hypothalamus, a part of the brain that helps control appetite. Previous research has found that mice that are missing MC4R receptors overeat and are obese. In one of the current studies, Dr. Ruth Branson of the Klinik Hirslanden in Switzerland and colleagues found that, among 469 severely obese white people, approximately five percent carried the MC4R mutation. All of the obese carriers of this mutation said they were binge eaters, the authors note; in contrast, only 14 percent of obese people without the mutation reported binge eating. Although knowing their uncontrollable binge eating may be linked to genetics cannot stop the behavior, understanding why they can't stop may provide patients with the MC4R mutation with some relief, Habener said in an interview. For this reason, it may be worthwhile for some obese patients who binge eat to consider seeing a genetic counselor to determine if they carry the MC4R mutation, the researcher said. In another report, Dr. I. Sadaf Farooqi of the Addenbrooke's Hospital in the UK and colleagues examined the bodies and genetic makeup of 500 people who had developed severe obesity before the age of 10. The authors found that almost six percent of the participants carried the MC4R mutation; most carried only one copy of the defective gene. People with two copies typically had a more severe form of obesity, the authors note. Extending their research into the mutation carriers' families, Farooqi and colleagues discovered that all family members that carried two copies of the mutated MC4R gene were also obese. However, around one-third of relatives with one copy of the mutated gene did not develop obesity. These findings suggest that not all MC4R mutation carriers are doomed to obesity, and some other genes may play a role, perhaps blocking the effects of the mutated MC4R, Habener said. Habener cautioned that the proportion of obesity due to MC4R may differ in the general population from what is reported in the current research, since certain groups of people may be more or less likely to carry the genetic change. Another report in the journal Nature adds indirect support to the current research by suggesting that obesity is a result of a number of different conditions. The researchers found that obese mice tended to show two distinct genetic patterns, suggesting that different genetic changes can lead to the same disease. The findings also add hope that researchers may one day fight obesity using treatments tailored to each person's type of disease.

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Pounds with weight watchers

By Alison McCook
Although following Weight Watchers appears to help people shed more pounds than they would on their own, people who followed the program for two years lost an average of only six pounds, researchers said Tuesday. But especially diligent participants -- who attended at least 78 percent of the weekly meetings -- lost an average of 11 pounds after two years of the program, the authors note. The average weight loss among Weight Watchers participants "is not very much in comparison to what people hope they will lose, or what people need to lose in order to reach the desired, svelte self," study author Dr. Stanley Heshka told Reuters Health. These findings suggest that people who need to lose a significant amount of weight fairly quickly for medical reasons may want to opt out of Weight Watchers and similarly structured programs, said Heshka, who is based at the New York Obesity Research Center, St. Luke's/Roosevelt Hospital in New York City. In the program, participants attend weekly meetings and receive guidelines for exercise and how to pick the healthy foods and portions. But these findings, published in the Journal of the American Medical Association (news - web sites), do not suggest that Weight Watchers holds no benefit for people struggling with their weight, he added. People enrolled in Weight Watchers shed more pounds than did people who were simply provided with information about smart eating and exercising, who lost, on average, less than one-half of one pound after two years. Furthermore, while, on average, participants lost only small amounts of weight while enrolled in the structured program, some lost much more, with the maximum amount of weight loss reaching around 50 pounds. The structured program "seems to hold advantages over trying to lose the weight by yourself," Heshka said. For people who are not yet obese but are experiencing an increase in weight, or have a family history of problems that can be aggravated by excess weight -- such as heart disease or diabetes -- a structured program like Weight Watchers may have a significant impact on health, he said. In some instances, "even small amounts of weight loss, weight maintenance -- preventing yourself from gaining more weight -- might be medically important," Heshka noted. "Whatever amount you can lose and keep off represents a victory," he added. Indeed, Dr. Catherine DeAngelis, editor in chief of JAMA, agreed that losing weight via any method is extremely difficult. "Food intake is a habit," DeAngelis told Reuters Health. "And it's very hard to change those habits." She added that while Weight Watchers and similar programs may work for some people, they clearly don't work for everyone. Programs have the best chances of working if they feel natural to the people following them, she noted, otherwise the weight loss is too difficult to maintain. "It works as long as you stay with it," she said. During the study, 423 men and women between the ages of 18 and 65 were either given a number to call to find the nearest Weight Watchers meeting and vouchers to attend, or provided with two brief counseling sessions with a nutritionist, then left to lose weight on their own. In an interview, Heshka explained that Weight Watchers funded the current study, and he hoped that other weight loss programs will do the same. "I wish that more commercial weight loss providers would do studies like this with their programs so the consumer could have some idea of what it is they're getting for their money," he said. In a related study, published in the same issue of the journal, Dr. Deborah F. Tate of Brown University and Miriam Hospital in Providence, Rhode Island and her colleagues found that among people who followed a structured, online weight loss program, email counseling helps. As part of counseling, a trained therapist would send participants frequent emails, answer their questions, and track their dieting progress. When 92 overweight people followed the program for one year, those who received counseling lost an average of 10 pounds, relative to an average of only 4 1/2 pounds lost by those who did not receive counseling. These findings suggest that people who need a structured program that is more convenient than regular group meetings -- which provide similar services to email counseling -- might benefit from an online program that includes counseling, Tate told Reuters Health. "If convenience is one of the advantages of the Internet, perhaps this type of approach might be something we could use in the long-term in a convenient way for participants," she said.

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Manorexia

Manorexia "An eating disorder traditionally associated with self-conscious teenage girls is leaving some men famished." By Peter Davis They breezed down the runway at the European shows this winter, wisps with swizzle-stick arms and sunken chests. Yes, waifs are nothing new in the underfed fashion world, but there's a difference: These were the men. It makes one wonder: Aside from the scrawny Larry Clark-style models for Hedi Slimane, the Christian Dior designer, could any fully grown man fit into these clothes? Well, Karl Lagerfeld can. Last year he whittled himself down by 93 pounds with a strict diet of fish, vegetables, horse meat (really) and Diet Coke. As Karl likes to proclaim, "Muscles are out. Bones are in. " Skinny-chic may be as foreign to the average man as Dior's razor-cut sleeveless top, but lately some guys who live far from the catwalk have been pursuing their own version of radical dieting. Even Howard Stern obsesses about his waistline. Look around: Men's Health cover boys have zero percent body fat surrounding those six-pack abs, and every rock band from the Strokes to Coldplay appears slightly malnourished. (And they still land the hot girlfriend!) No wonder men who once