September 3, 2011

Guest Post: Eating Disorders in YA

Today Laura from All of Everything is stopping by with a guest post on YA books about eating disorders!

Hello everyone! I'm Laura, the girl behind All of Everything. For my Psychtember post I'm going to talk about Eating Disorders in YA fiction, specifically Anorexia Nervosa and Bulimia Nervosa. I'm currently in my third year of university majoring in Psychology, a subject I've been intrigued by for a long time. I've also taken a course about eating disorders and found it especially interesting, hence my topic today! First here are some facts about each:

Anorexia Nervosa
  • People with anorexia are obsessed with controlling their eating. Basically, they feel that if they can control what they eat, they can control their lives and any stress or problems they have to deal with.
  • They will have a weight that is below what's normal for their age and height and have an intense fear of becoming 'fat', but can't see themselves for what they really are. An anorexic looks in the mirror and sees 'huge' while the reality is they're dangerously thin.
  • Anorexics tend to come from families that emphasize looks, or like to keep up appearances. The stress of the pressure at home or at school can be the trigger for the disorder.
  • The reality is anorexics starve themselves, which leads to many complications, some dangerous: loss of hair, dry skin, slow heart rate (bradycardia), low blood pressure (hypotension), amenorrhea (periods stop), osteoporosis, anemia, electrolyte imbalance and irregular heart beat (arrhythmia). Organs become starved due to lack of nutrients and can start shutting down. Heart disease is usually the cause of death in anorexics
  • Dealing with someone with anorexia can be very frustrating, for doctors and friends/family. They don't see themselves as sick, quite the opposite. They're intensely proud of their weight loss and can become very defensive and reluctant to accept treatment or help. They could deal with the illness their whole lives, and sadly about 10% of anorexics die within 10 years, making it the most deadly psychiatric illness.

Bulimia Nervosa
  • People with bulimia go through cycles of bingeing and purging. The out of control bingeing can be a way to numb feelings of anger or sadness, but afterwards it creates feelings of anxiety about weight gain so the person purges to get rid of the food, usually by vomiting, or with laxatives or diet pills.
  • Whereas anorexics are proud of their control over food, bulimics tend to be ashamed and embarrassed by their relationship with food, and keep it a secret, making it difficult for them to seek treatment.
  • Purging isn't actually an effective way of losing the calories in the food, and bulimics usually can be seen as having a normal weight, so it's harder to diagnose just by looking at someone.
  • Purging, and especially vomiting, can cause a number of physical symptoms that could worsen and be fatal if continued: tooth erosion, gum problems, electrolyte imbalance (could lead to kidney failure), or rupturing of the esophagus.
  • Bulimia also tends to coexist with other disorders, like mood or anxiety disorders. Treating these problems can be the start of uncovering why bulimics feel the need to binge and purge and eventually get them to stop these destructive behaviours.
Now onto the books! I've read three books that I thought really captured these eating disorders in a way that realistically portrayed their seriousness. If you'd like to get a better picture of anorexia or bulimia I'd recommend reading any or all of these.

Wintergirls by Laurie Halse Anderson
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This is probably a very well known book and for excellent reason. Reading this after I'd learned about eating disorders, I was hit hard by how realistic this book is.
It portrays a character with anorexia, but not struggling with it. Like most anorexics, Lia wasn't ashamed of her illness, she was proud. She didnt even think she was sick.

Who wants to recover? It took me years to get that tiny. I wasn't sick; I was strong.

To read this book is to go inside the mind of an anorexic, someone who doesn't want to be treated. Absent parents in the midst of divorce let Lia keep her illness hidden until she blacked out while driving, and she was found out. She's sent to a treatment centre, not once, but twice, and becomes what she's expected to be until she can be let out and start all over.

I knew how much it hurt to be the daughter of people who can't see you, not even if you are standing in front of them stomping your feet.

At one point Lia is ecstatic about reaching a specific weight. she wants to go lower. Such becomes the problem, which Lia admits. No number will ever be low enough. She wants to keep losing weight until she disappears into nothingness and is finally able to escape her life and all she has to deal with.

If I got down to 070.00, I'd want to be 065.00. If I weight 010.00, I wouldn't be happy until I got down to 005.00. The only number that would ever be enough is 0. Zero pounds, zero life, size zero, double-zero, zero point. Zero in tennis is love. I finally get it.

Lia also had a friend, Cassie, with bulimia and they each shared a deep desire to be thin, actually competing over it. Cassie eventually died from complications due to bulimia, sending Lia into a dark spiral of self destruction, while her loved ones struggle to help her.

The light beyond my eyes flashflashflashes with a hundred futures for me. Doctor. Ship's captain. Forest ranger. Librarian. Beloved of that man or that women or those children or those people who voted for me or who painted my picture. Poet. Acrobat. Engineer. Friend. Guardian. Avenging whirlwind. A million futures--not all pretty, not all long, but all of them mine. I do have a choice.

Hunger by Jackie Morse Kessler
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If you want to ease into learning about anorexia, Hunger is the book for you. Lisa is anorexic and has been chosen as the Hoseman of Famine, bringer of starvation. The paranormal elements somewhat soften the harshness of the disorder but the basic issues still remain.

Lisa's absent mother and loving but clueless father lets her keep her anorexia secret from all but her worried now-ex-best friend. The 'Thin Voice' is always in her head, telling her how fat she is, or does she really want that french fry? you're disgusting, you're weak, over and over on replay.

Along with starving herself, Lisa also suffered from what's called 'anorexia athletica', a compulsive desire to exercise. Most nights she'd sneak downstairs and jump on the exercise bike for hours, anxious to burn off any calories she may have consumed, which was usually very few to begin with! Because of this, she was almost always very weak to the point of collapsing.

Similar to Wintergirls, Lisa also had a friend with bulimia, with whom she shared a desire to be thin. Obviously not the best person to associate with, she praised Lisa for her control, all while she binged on junk food and excused herself to the bathroom to throw it up, suffering the entire time.

When Lisa becomes Famine, she becomes witness to real starvation around the world and hates what she sees. Her compassion is what drives her to use her new powers for good and find the strength courage and, most importantly, the balance within herself to overcome her struggles with food and seek help.

Living means constantly growing closer to death. Satisfaction only temporarily relieves hunger. Find the balance, and plant your feet.

Purge by Sarah Darer Littman
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I recently finished Purge and it's the first book I've read that focuses on a MC with bulimia. It was able to portray bulimia, as well as anorexia, in a less harsh way than Wintergirls, and with a bit more humor too.

Janie is admitted to Golden Slopes after she broke down and purged at her step sister's wedding. She's a great character to follow, as she really wants to recover, but getting there involves opening up to the psychiatrist about the darkness she feels inside her, and how purging is able to, temporarily, make her feel light and beautiful.

As soon as I finish eating, itís like this tape starts playing in my head: ìYou are SO FAT! What the hell did you eat that for?îÖDid I used to be able to eat a bar of chocolate without hearing that critical voice in my head?

Golden Slopes, along with the 'Barfers', is home to the 'Starvers', the anorexics, and they are constantly at odds with each other. It was entertaining to witness meal times with the two groups, as they were completely different. The bulimics would eat quickly, savouring every bite before they were monitored to prevent purging,  while the anorexics would be at the table for far longer, struggling with every mouthful.

There is a dynamic group of people in recovery, guys and girls, and it gives a good idea of how eating disorders can affect wide ranges of people, not just teenage girls as many assume. It was wonderful to then see all these different people come together and share their fears and feelings, giving each other strength and support to commit to recovery.

Iím afraid that without [bulimia], Iíll crumple into a heap of nothingness on the floor. But on the other hand, what if letting go is like being unshackled from leg irons that have been weighing you down? What if doing it makes you so light and free that you can fly?
All three of these books deal with a serious mental disorder, but they also all give the reader a resounding feeling of hope. I'd recommend them all to you, and I sincerely hope you take that message and maybe pass it on to someone who could use it. Make someone's day; tell them you love them, they're beautiful, you care. And if you think someone might be dealing with an eating disorder, don't hesitate to ask for help. It could get worse before it gets better, but you could be saving a life.

Huge thanks to Danya for letting me be a part of Psychtember! Psychology and books, my two huge interests, together. I really hope you're all enjoying it and get a clearer picture of the complexities of the mind.

The information I've provided and more can be found from the sites below:

National Eating Disorder Information Centre: definitions, stats, research, treatment, how to help, tons of articles
National Institute of Mental HealthA detailed booklet that describes the symptoms, causes, and treatments of eating disorders.
The Something Fishy Website on Eating Disorders: Contains information and resources pertaining to anorexia, bulimia and compulsive overeating. Definitions, signs and symptoms, physical dangers, treatment finder, online support and much more.
Eating Disorder on Wikipedia: Might not be the most credible site but there is lots of information here to get you started, and seems to be accurate.

Thanks, Laura, for a very informative post! 

Thoughts on the books Laura mentioned, or generally, YA books about eating disorders?


  1. First, thanks for wishing me a happy 2-year blogoversary! :)

    And this is a GREAT guest post. More awareness about eating disorders is always needed, and I definitely support WINTERGIRLS. LOVED that book and the insight it provided. I actually have had Hunger sitting on my shelf for... what? A year already? but never got around to reading it. I'll definitely have to try it sometime since Laura recommends it.

  2. Great post - very informative. I haven't read any of the books listed, but I feel like I should, now. Also can't think of any to add (I'm sure I've read YA with anorexic characters, but I can't remember right now). Thanks for sharing!

  3. Interesting post! I still remember the first book I read that it had a MC with an eating disorder. It was called Second Star to the Right and it was the story of a 14 yo girl who struggles with Anorexia at a time when the term was just being coined.

    I love that book, and I loved that it show that complex as our relationship is with food, eating disorders and never really all about the food, but about everything else in your life too.

    It was a wonderful book.

  4. When I first read Hunger, I thought it was a great portrayal of bulimia-her friend's case, that is. Honestly, I thought it was a CRAPPY showcase of anorexia. Having suffered from it myself, and subsequently knowing many, many anorexic patients, I know that none of us were like Lisa. Her temptation to food was ridiculous-more like those girls who purposely starve themselves to lose weight, not starve themselves because they literally can not help it. They're two very different things.

  5. I have read all but Hunger and just added it to my TBR list. Thank you so much for posting!

  6. This was a really informative post and I think it's going to be very helpful for those who don't know much about anorexia or bulimia. I didn't even know about Purge so I'll be adding it to my wishlist.

  7. What an informative post! Of these books, I have only read Hunger. I've heard that Wintergirls is an excellent portrayal. I hadn't heard of Purge before, thanks!

  8. You picked some great books to use as examples. I haven't read PURGE, but I read the other two. I especially liked HUNGER because of the fantastic element.

  9. Great post! I really want to read Purge. Wintergirls was amazing, and the quote about zero in tennis equaling love was my favorite in the whole book. Such an incredible insight.

    I didn't love Hunger, even though I thought she did a great job with the eating disorders, because I thought the paranormal aspect was... gimmicky and I actually felt that it detracted a lot from the seriousness of the story. I understand that this might serve as a draw for some readers, but I was pretty disappointed in it.

    But overall, great job! Great post!


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