Tuesday, August 30, 2016

Almost Anorexic... another book review

When I was younger, I went through some pretty disordered eating rituals.  I was obsessed with my weight and how it looked on me.  You'd never know it to look at me then or now, but I engaged in some behaviors consistent with eating disorders.  I was not really a binge eater or a purger, but I did sometimes stop eating.  There were a few times when I was younger that I'd actually stop eating for several days.  My weight would go up and down, along with my moods.  I could be funny, goofy, and almost manic, or very depressed and angry.  Some people thought I was so moody that more than one person asked me if I was bipolar.

It took many years, but I finally quit obsessing so much about my weight.  Sure, I'd love to be a lot thinner than I am now; but I no longer obsess about my weight.  I don't starve myself or force myself to exercise more than I want to.  I do engage in some behaviors that might be considered disordered to some people, though, and that's one reason why I decided to read Almost Anorexic: Is My (or My Loved One's) Relationship with Food a Problem? (The Almost Effect).  This book, published in 2013, was written by Dr. Jennifer J. Thomas, who is (or was) an assistant professor of psychology at Harvard University in the Department of Psychiatry, and Jenni Schaefer, a singer, songwriter, speaker, and author who suffered from eating disorders and managed to recover.  I also read this book because I myself have studied public health and social work and this book might be considered professionally relevant to me if I actually practiced.  This book is the fourth in Harvard Medical School's "Almost Effect" series.    

Dr. Thomas goes by the name Jenny, so in order to make things less confusing for readers, she is referred to as Dr. Thomas in this book.  Jenni Schaefer is referred to as Jenni.  My name is also Jenny, so I felt like I was part of the club!  In any case, Dr. Thomas and Jenni keep their writing conversational and personal as they explain why they wrote about a condition called "almost anorexia".  Basically, what they mean is that there are many people out there who are eating disordered, but don't quite qualify for a formal diagnosis of a specific eating disorder.  The book is called Almost Anorexic, but it's actually about a spectrum of eating disorders-- everything from orthorexia (an obsession with clean, healthy eating) to binge eating disorder (binging on food, but not purging).  My guess is that they chose to call the book Almost Anorexic because anorexia is probably the most dramatic, the most recognizable, and is certainly the most lethal of recognized eating disorders.  I think it also has more of a fascination factor and less of an ick factor than, say, bulimia does.  

This book is for anyone who "flirts" with eating disorders.  The authors offer insight into what eating disordered behavior is.  Eventually, toward the end of the book, there are some strategies offered to help combat the behaviors that can lead to full blown eating disorders.  I got the sense that preventing full blown eating disorders was what the authors were really after, though they did recognize that many people suffer for years engaging in behaviors that make them miserable and can ruin their health.  

One thing that I appreciated was that the authors point out how eating disordered behaviors, even if they aren't bad enough to qualify for a diagnosis of anorexia nervosa or bulimia, can do a lot of damage to a person, physically, emotionally, and mentally.  Aside from that, life is short and obsessing about calories, food, exercising, what others look like and what you look like to others is a serious waste of precious time.  It truly doesn't lead to anything but self-destruction and makes life much more difficult than it needs to be.  The authors recognize that their readers who might be struggling with disordered eating should strive for moving beyond those "almost anorexic" behaviors, but they also know that actually doing that is very difficult for most.  So they offer some good strategies and encouragement, along with anecdotes that make the reading more interesting.

I have read a lot of books about eating disorders over the years.  It started when I was a teenager and got to a fever pitch when I was a young adult.  Lately, I don't read as much about eating disorders as I used to.  The topic just doesn't interest me as much.  However, I did notice that the authors, particularly Dr. Thomas, whose voice seems to be the principal in this book, mention a lot of books that I've read.  I was really impressed when she mentioned Fasting Girls, which is a really great book about the history of eating disorders that I remember reading when I was a college freshman in 1990. She also mentions Cherry Boone O'Neill's classic anorexia memoir, Starving For Attention, which I read for the first time in 1986.  

So, not only has Dr. Thomas got a lot of professional experience and training, she's also read some of the best books.  But she also includes a lot of the latest research in a way that will speak to younger readers... the ones who are addicted to pro-ana or pro-mia Web sites or refer to their eating disorders as "Ed" or some other name.  "Ed" is the little voice in your head telling you you're too fat or that you look awful in your favorite jeans.  "Ed" is the voice that tells you to engage in unhealthy and obsessive behaviors.  Dr. Thomas and Jenni explain strategies as to how to get "Ed" to shut up and go away, even as they acknowledge how difficult and scary it is to do that.

A lot of people struggle with "eating disorder not otherwise specified" or EDNOS.  That is essentially what "almost anorexic" refers to-- having subclinical signs of an eating disorder that don't quite qualify for a diagnosis.  Not being full blown anorexic or bulimic doesn't mean you aren't suffering or doing damage to your health.  That's really what this book is about, as well as encouraging readers to take care of themselves and get healthy.  I think it's an excellent read for a lot of people... many of whom never talk about "Ed", but hear from "Ed" every day.  I give it five stars and a hearty recommendation, especially for those actually suffering.  I think it's slightly less helpful for family members and friends, though it's probably worth a read by them, too.


  1. Another book I'll need to read; the list is getting longer, though I did just finish Nadia Comaneci's book.

    my mom said once that it's probably a good thing in many ways that i'm naturally thinner than a sane person would want to be because I have many of the extreme personality traits of someone with an eating disorder. I don't know if it's true or not, as one should not practice on one's family members. I really hope I don't turn into the Good Year Blimp if I ever get pregnant, but if I do, I think I can deal with it rationally.

    1. I think the folks who have really severe anorexia have a lot more going on than just wanting to be thin. But a lot of people do mess up their health trying to be "anorexic" and a lot of people engage in self-destructive and pointless negative self talk that screws up their thinking.

      I'm mostly past that myself... to some extent. But one reason I hate visiting doctors is that I hate talking about my body.

  2. When my mom was in private practice she really didn't like dealing with eating disorder patients, or, in particular, with groups afflicted with the disorders. Where in many psychological group settings, most people genuinely want, to some degree at least, to get past the behavior for which they are there in the first place, my mom felt that in eating disorder groups, the secret agenda was often to swap tricks of the trade, which made monitoring what was shared in the group far much more difficult than it might be in a typical support group.

    I think my mom feels that I have many of the characteristics of an anorexic without the major physical manifestation typical of the condition. She thinks I supplant an obsession toward thinness with my tendency toward the need for academic perfectionism. I wonder if she now regrets restricting me from phone, TV, and computer privileges when I was a h.s. junior because I had a minus following one of my A's on a mid-quarter progress report (because I refused to take a quiz because the teacher had told us point-blank the day earlier that there would NOT be a quiz on the following day, and because I knew our lowest quiz score would ultimately be tossed out in his grading system). I'd say if I have an addiction to perfection, my mom fed right into it.

    Isn't it fun to blame one's parents for anything that is wrong? Seriously, nothing about that incident really affects me today because I don't think I have a problem with perfection.

    1. I could probably write a book about how my parents messed me up. :D And, in fact, probably have done so already on this blog. Maybe it's a blessing I am not a mother myself!

      I would think eating disorder patients would be very difficult to treat. They tend to be very manipulative and secretive. They don't usually want to be helped and often can't be, especially once they become adults. But I know that having an eating disorder is pretty hellish. I wouldn't wish it on anyone.


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