I’m really excited to share a really special opportunity I had with you all, but before I can, I’d like to share a story. When I was a freshman in college, I was walking around campus when I saw a white flyer with the following words on it:
Andrea Smeltzer, age 19, died in her sleep from an electrolyte imbalance after 13 months of bulimic behavior. Join us for “Andrea’s Voice,” a presentation by her parents, Doris and Tom Smeltzer….
It was the first sentence that stuck out to me. 19. She was 19 when she died and I was reading this as a 19 year old. At first I wasn’t sure if I should go to the presentation or not. I mean, I didn’t have an eating disorder and sure I hated my body and had dieted off and on for 3 years by that point, but I didn’t deserve to be around other women at my school who were surely struggling. I never admitted this, but I had this really sick thought that having an eating disorder was like being part of this special club and I wasn’t “whatever” enough to get in. But I pushed that part of me aside and went to the presentation. On that night, I heard her mother, Doris talk about Andrea’s accomplishments; how she studied abroad at age 14 in Spain, how she was trained in opera, and loved to write poetry, and then how bulimia took her life.
Andrea’s father and Doris’ husband, Tom would speak during the presentation but only using Andrea’s own words, taken from the plethora of incredibly insightful and wise journals and poetry she wrote. It was a powerful presentation that literally moved to me to tears and after it was over I headed to my dorm room to think about what I had just heard. I didn’t know Andrea but I was stunned and astonished that someone could die so young from 13 months of bulimia. I was sad that she had died because what had she done to deserve that? She didn’t deserve that. I knew eating disorders were deadly, but I never heard about someone actually dying of one, at least not someone who wasn’t a celebrity.
I wrote an email to Doris that night, expressing my condolences for her loss and appreciation for her moving speech. She wrote back to me and thanked me for coming to listen and for the next few years I’d remember the speech and go onto their website to read more of Andrea’s poetry and her story. There was something about it that stuck with me and during the first semester of my senior year in college, four years later, I had to admit that I had a problem and I remembered Andrea’s story. Throughout the last two years I’ve remembered the picture of the girl with bright red hair who left the world far too early, and how both her and her family didn’t think she would die.
This is the most inspirational and tragic story I’ve ever heard and it’s beautifully written in Doris’ book (co-authored by Andrea, using her poetry and journal entries), Andrea’s Voice, Silenced By Bulimia, which she was kind enough to send me a copy of. I wish that I had read this three years ago. I wish that my friends who died of eating disorders would have read this. If you are struggling right now, I HIGHLY suggest that you purchase this book and also have your loved ones read it. It’s incredibly powerful and emotional, but its raw yet relatable content brings the severity of this disease to the forefront of our attention. With that, I hope that you will help me welcome Doris and will soak in each word she shares with us.
Thank you Doris for the honor of allowing me to interview and for sharing your story here on Raw Recovery. I’m grateful for your time and knowledge and know that you have so much wisdom to offer all of us. My first question is what was your knowledge of eating disorders prior to Andrea’s struggles and do you think that parents and society at large are undereducated when it comes to identifying warning signs and red flags?
Prior to Andrea’s struggles I knew very little. I knew what the words anorexia and bulimia meant but that was about all. Which is about what most parents and society at large know today. I do think it’s important for people to know the identifying warning signs and red flags, yet I also know how myopic our vision can be when a loved one is involved. I’d like to think that had I known the signs I would have recognized them early on in Andrea but there’s a part of me that thinks I may not have seen them for what they were. After all, some of those “signs” were evident in me and I certainly did not feel that I was sick. Our weight-obsessed culture promotes and normalizes many of the behaviors that are red flags in the ED world:
- black & white thinking
- body hatred
- poor self-esteem
- calorie counting
- owning a scale and checking weight often
- excessive exercising, especially for the sole purpose of weight loss, etc.
Andrea’s story is probably the most harrowing story of an eating disorder that I have ever heard and it’s heartbreaking that she passed so soon after her struggles began. What encouragement or advice would you give to a parent who has a child suffering from an eating disorder?
Advice: Seek skilled treatment ASAP and hang in there for the long haul. Healing from an eating disorder is a marathon, not a sprint. Encouragement: Never lose sight of the fact that healing is absolutely possible. Expect it and work only with a treatment team who expects it as well.
I know that in my own journey, I often felt ambivalent about recovery and felt certain that it would never kill me. Perhaps the most poignant memory I have is my younger sister trying to keep me from engaging in eating disorder behaviors and shouting at me, “I DON’T WANT TO LIVE WITHOUT A SISTER!!!” Eating disorders come in as an intruder and it can be difficult to distinguish the ED voice from one’s own the longer the disease takes hold. What words of wisdom would you give to someone struggling with an eating disorder and what do you think Andrea’s advice would be?
Before I respond to your ultimate question, I must comment on your statement about ambivalence. I think the “ambivalence about recovery” is one of the most difficult aspects of the illness. As parents we can sometimes feel that we want our child’s health restored far more than they do (which is often an accurate reality). We must keep in mind that starving, bingeing, and/or purging are behaviors that alter neurochemistry to the point that “rational” thought becomes challenged if not downright impossible. It is an illness through which the sufferer needs an advocate–someone who is able, with loving, non-judgmental calm, to insist on the very best treatment for the sufferer and have the strength to “meet” and stand up to the ED. Engaging in our own therapy so that we can be guided about how best to respond to our loved one’s pain, play a valuable role in the healing process, learn how to distinguish the ED voice from the sufferer’s voice, and how to avoid engaging with the ED voice are all important skills to develop.
Your question asked for my words of wisdom. That’s a hard one, especially since ambivalence about recovery and difficulty recognizing one’s own voice (versus the ED voice) are hallmarks of ED symptomatology. Therefore, I do not believe there are words I can say that could convince a sufferer of the realities of which I am now aware:
- EDs are REAL illnesses that require intensive, skilled treatment from which to heal.
- If left untreated (or treated by those inexperienced) they can be deadly.
- They can kill quickly…if they do not kill the body, they most certainly kill the soul.
- That it is important to trust the moments of awareness that things have gotten out of control, the voice that says that help is needed–for that is their voice, their soul, and it is telling the truth.
- Reaching out and asking for help, no matter how frightening or risky that feels, is the first step toward healing. And most importantly, that…
- Healing IS possible.
The more difficult question: What advice would Andrea give? I had to think about this for a while…and then it came. I believe she’d say something like, “Read my journals, my letters, my poetry.* Find yourself in my words and then remember that my intelligence and my intense will to live were not enough. Bulimia shocked even me…by killing me in my sleep.”
Thanks to your kind permission, Alex, I actually wrote a blog that expounds a bit further on this answer (http://bit.ly/KWJ4k5 )
A lot of times people do not understand how multi-faceted an eating disorder is and that there is no one, single cause. Can you speak to the complexity of eating disorders from your experience with Andrea and all the knowledge you have acquired since her death?
It is now understood that parents do not cause eating disorders. The development of these illnesses cannot be explained with one simple “cause”–they are as complex as the individuals who develop them. What puts one at greater risk for developing an ED? There appears to be a cluster of genetic/biological/psycho/social factors that contribute to their appearance. There must be an underlying genetic predisposition which allows many other risk factors to contribute to the rise of the illness:
- dieting: Ancel Keys’ study back in the late 40′s beautifully illustrated the effects of calorie deprivation when his healthy young men developed symptoms very like EDs (intense preoccupation with food, counting calories, weighing, body image disturbances, bingeing, purging, etc.)–so much so, that his experiment (which would be illegal today) had to be halted
- individual personality traits/characteristics/temperament (perfectionistic, driven, sensitive, anxious, obsessive/compulsive, etc)
- life experiences including trauma, and our responses to or interpretation of these experiences
- familial values/characteristics/traits (having a parent or sibling with an ED puts one at greater risk, parents with the same individual traits already mentioned and/or an on-going focus on fitness or weight, chaotic lifestyles, substance abuse, etc)
- media: exposure to one very “narrow” ideal body
- culture: rampant fear of fat, demonizing and devaluing fat bodies, no acceptance of a natural diversity in body sizes, etc.
And this is just a partial list of the potential contributing factors…”complex” may be an understatement!
The above is based on the “knowledge [I've] acquired since [Andrea's] death.” You also asked that I speak to this from my experience with Andrea. I think the following paragraph from our book, Andrea’s Voice, Silenced by Bulimia, sums it up well:
So here we have a child who at a tender young age was faced with the precariousness of life, who feared losing her parents, and who had a genetic predisposition to mental illness. We add to that Andrea’s tendency toward anxiety and some obsessive behaviors, her extreme sensitivity and vulnerability, her black and white, all-or-nothing thinking, and an inclination toward perfection. We combine this with her sometimes driven personality, her tendency to think of others before considering herself, her depressed, also driven and perfectionist parents (one of whom dieted throughout Andrea’s pre-teen years, modeled body hatred and exercised for the sole purpose of weight control). We plop this child into a media-driven culture that promotes dieting and a hatred of fat as well as unrealistic and unattainable body types, and voilà! We have a recipe for the development of an eating disorder.
The only missing ingredient? A weight-loss diet, which Andrea began in her college freshman year…dieting triggered Andrea’s treacherous slide into bulimia.
What are your thoughts on how women can create a more positive body image that isn’t based on a clothing size or number on a scale?
An important first step in this process is to recycle our bathroom scales. The number revealed by that ridiculous device does NOT determine our worth, the sort of day we’ll have, or the goals for our lives! Then, it is important for us to look carefully at the unnecessary pain caused by our focus on weight. Yes, we hear constantly how “fat will kill” yet we rarely question that assertion.
For me, the journey to loving my body began by looking at how yo-yo dieting had harmed not just my body (and my daughters’ feelings of self) but my body’s ability to serve me with its wisdom–I had become so dependent on external rules around what, when and how much to eat, that I could no longer even identify my own hunger and fullness cues. Relearning how to respect and love my body as well as trusting its wisdom has been a very long journey for me. It helped that during this journey I was educating myself by reading valuable books (Health At Every Size by Dr. Linda Baconhttp://www.haescommunity.org/, Intuitive Eating by Resch & Tribole http://intuitiveeating.org/, Big Fat Lies by Glenn Gaesser), blogs ( http://healthateverysizeblog.org/ ) and media literacy web sites (AboutFace http://www.about-face.org/ Many other valuable sites can be found on our web site: http://andreasvoice.org/fighting-eating-disorders/weblinks/10-information
I think it is also important that we surround ourselves with like-minded people. Studies* have shown that the more “fat talk” ** we engage in or are exposed to, the more we dislike our bodies AND the more problematic our eating becomes. It is difficult to find friends who do not engage in fat talk….so we need to either attempt to educate those we love and/or join groups where that is a priority…either by finding them or forming them ourselves (on campus, at work, etc), and by joining organizations & online communities that support a weight-neutral approach to well being: ASDAH (https://www.sizediversityandhealth.org/Index.asp), NAAFA (http://www.naafaonline.com/dev2/) The Body Positive (http://thebodypositive.org/), Body Positive (http://bodypositive.com/), Healthy Weight Network (http://www.healthyweightnetwork.com/index.htm).
* Ousley et al 2008
**fat talk examples: “Do these jeans make me look fat?” “I hate my thighs!” “Wow, she really should NOT be wearing that skirt!” “I need to lose 10 pounds!” etc.
If there is one thing you think everyone should know about eating disorders, what would that be?
I will answer this assuming that what I’ve already shared is understood (narrowing down to “one thing” is just too difficult). As important as all of the above is to comprehend, asking the question, “How can I, as an individual, become a part of the solution?” has just as much value. The answers to this query have been alluded to in many of my previous responses, yet one seemingly simple action has the potential for revolutionary benefits: change how we speak.
Instead of our common greetings of “You look great!” or “Have you lost weight?” simply say, “It’s good to see you.” Do not engage in fat talk about self or others. If those we are with begin to fat talk, change the subject. Ask a question that goes beyond appearances, or walk away. Slowly…very, very slowly…changing how we speak will begin to positively affect how we think and feel about ourselves and others, which will ultimately make the world a more positive place for all of us to live.
Again, a huge thank you to Doris for giving me the opportunity to interview her and for the wealth of wisdom she has shared with all of us, through her presentations, blog, and book. I’m so sorry that Andrea passed away but am grateful that Doris and Tom have turned their family’s tragedy into a movement that is helping so many others, including myself. If we can all turn our pain and struggles into something that can help others heal, even if it’s on the smallest scale like smiling at a stranger or just keeping conversations healthy and focused on who we are as people with something to offer the world, imagine what a difference that would make.