ALAN v25n3 - Eating Disorders: A Recollection and a Review of Some Relevant Young Adult Fiction

Eating Disorders:
A Recollection and a Review of Some Relevant Young Adult Fiction

Elizabeth M. Myers

The National Health Institute estimates 1 out of every 200 American females ages 12 to 18 will develop, to some extent, an eating disorder - anorexia nervosa, bulimia, or compulsive over-eating. While the exact causes of the disorders is difficult to identify, researchers indicate their development to be a combination of physiological, psychological, as well as environmental factors. As someone who experienced both anorexia nervosa and bulimia as a teenager, I recall how I was consumed by the vicious cycle, creating for me a lonely, closeted existence. In turn, my seeking help was hindered, for, although I felt helpless and scared, I feared being labeled a failure, or disgusting, or "crazy." More than anything, I felt unable to talk about my problem because I thought I was the only one experiencing such guilt and anxiety over food.

As a teacher of adolescents, I wanted to explore the possibility of using in the classroom young adult fiction with characters who had eating disorders. In this article I will describe my own experience with eating disorders as an adolescent, then review recent young adult books that use fictional characters to portray students such as I. My hope is to provide insight for those who may wish to understand more about the persons experiencing eating disorders, as well as provide recommendations for relevant young adult novels.

A personal recollection:

A shy, chubby fifth grader, I tended to linger at the back of line, allowing others to go first. But, today we were running the fifty yard dash - for time - and I didn't want the boys to watch me huffing and puffing as I charged towards them, trying earnestly to achieve the golden "85th percentile" on the physical fitness test and finish under 7.5 seconds. I was heavy; it was obvious I had started to develop, and my gymsuit fit snugly. I was mortified with the idea of the boys from Mrs. Arbeiter's fifth grade class being able to watch as my breasts jostled and bounced around on my body. I had a plan this time, and by going first, I would thwart the boyish comments. Earlier that day in cattle-like fashion, we had gone through the humiliating routine of being weighed, measured, and analyzed for percentage of body fat. One boy announced a most heedful warning before I stepped onto the scale. "Don't break it"! he shouted, causing the entire class to laugh hysterically. My face reddened; and, although a bit embarrassed, I was momentarily hopeful, for if the scale broke, then no one would know how much I really weighed.

Standing at over five feet tall and donning a pair of size ten shoes, there was no question that I was the biggest girl in the fifth grade. I wore the largest of the cheerleading uniforms, always served as the base for the pyramids, and played center half-back for the soccer team. Yet at that point in my life, I never once felt the need to be concerned with my weight.

Later that year, I began to notice the little giggles and snickering remarks made behind my back. In the locker room, I'd stand in my usual corner, facing the wall as I dressed, and no matter how hard I tried to conceal myself, I could feel the other girls stare. Even at lunch or after school, there was always one of the more "popular" girls asking me how much I weighed or what size jeans I wore.

The summer following fifth grade, I started my first diet. At the time it seemed harmless. (I'm sure my mom was relieved to see me eat something other than double cheeseburgers and fries.) I perused the various beauty and health magazines gathering "diet tips" and "celebrity health regimens." By the time I reached high school I had become a label-reader extraordinaire - counting calories and analyzing the fat content of every morsel that went into my mouth. With each day I adhered to my routine of diet and exercise, the girlish snickers and critical stares slowly disappeared. The first high-point of my dieting career came when, as a sophomore, I had my first real boyfriend - a senior on the swim team, who was "six foot two and eyes of blue." Ever since the latter half of fifth grade, I had longed to be someone's "sweetheart" and to be thought of as pretty. I wanted to attend homecoming dances and proms on the arm of a handsome popular boy, while everyone gazed with envy. I knew dating the senior on the swim team would have been out of the realm of possibility for "fat Elizabeth." When our relationship finally ended, I somehow became convinced there was something wrong with me. So, I intensified my mission to achieve perfection, thinking that, as I became increasingly thinner, I would become increasingly perfect and then no one could possibly resist me.

After months of running, dance classes, and strict dieting, I returned my junior year thinner than ever. At school, I was showered with compliments by my friends, asking "How'd you do it?" or "How can you be so disciplined?" My cross-country coach, especially, who in seeing me at 5'8" and a lean 115 lbs., praised me for my accomplishment. Keeping one's weight down, he explained, made it easier to run longer and faster. My determination was presented as an example to the rest of the team, noting how I would push myself to run farther each day. I was a fuel-efficient machine, eating minimally and running six to ten miles per day. At home, as long as my parents saw me eating, they didn't complain. I was maintaining an A+ average and studying harder than ever. Although they had never asked for it, I felt I had become their perfect child. I maintained the extraordinary physical and mental discipline, through what I perceived to be superior organization. I kept a record of everything: I wrote down how much I weighed, what I ate, how much I exercised, what I wore to school. I had lists and rules from how I would brush my teeth, to how many times I would chew my food, and in what order I would eat it. Deviating from these rules was forbidden, and I swore to myself that I would never lose control or be fat again.

The fall of my senior year came around and the behavior changed, but not for the better. During cross-country season, I developed shin-splints from excessive running. When the six-to-ten miles a day routine was disrupted my world began to crumble. I began to gain weight and hated myself for not being able to maintain my once perfect appearance. I knew others had noticed and I felt ashamed after all the compliments and praise I had received for being rail thin the year before. To avoid people, I'd constantly make up excuses not to go out in public, especially school. When I did attend, I made every effort to make myself invisible. When the last bell would ring I'd rush home so that I could be alone.

Once home, I'd head straight for the kitchen, stand in the refrigerator door, and furiously stuff my face with as much food as I could find. After gorging, with my stomach stretched to its limits and overwhelmed with a feeling of nausea and guilt over what I had just done, I'd feel a strange mix of depression and elation. Next, I would proceed up to my bathroom, dispel the contents of my stomach and then sleep for the remainder of the afternoon. The cycle became my daily ritual. If someone were home after school, I would take-off somewhere - a grocery store parking lot or the park - and devour the day's feast in my car. Gradually, I grew oblivious to the torture and abuse I imposed upon my body. Regularly, I'd perform the exhausting ritual, as if some other force had taken over my body and had left me completely powerless.

For the next five years I persisted in a cycle of bingeing and purging. Although it had ceased as a daily ritual, I'd undergo periodic phases triggered by school-related stress or loneliness. Gradually I began to emerge from the cycle when, in college, I met and talked with other young women who had similar experiences. Being able to share the stories of our experiences helped me realize I was not alone in my struggle as well as my feelings of powerlessness. Through the sharing of experiences and the growing friendships I learned new ways of coping.

The Treatment of Eating Disorders in Young Adult Literature

As a classroom teacher, I wanted to explore the possibility of using of young adult fiction containing characters with eating disorders. In my search I discovered there were few books on the market that featured characters with eating disorders - below I review six of the ones that I found. All of the six novels I reviewed seemed to give somewhat accurate portrayals of persons dealing with eating disorders, as each described characters with the symptomatic behaviors and personalities. Among the novels, their differences resided in their depiction of the intensity of the problem, family dynamics, physical settings of the protagonists, and the presence or absence of a therapist as a character. Four of the six novels (Levenkron's The Best Little Girl in the World , Ruckman's the Hunger Scream , Terris' Nell's Quilt , and Franks' I Am an Artichoke ) center on a conflict within the family, primarily a power struggle between the parent and child. In addition, The Best Little Girl in the World and The Hunger Scream also include therapists as characters.

Of the six, I preferred Leslea Newman's Fat Chance and Lucy Frank's I Am an Artichoke , based on their potential for adolescents to identify with the characters as well as the potential for them to still "enjoy" reading the novels despite their serious subject matter. Commonly throughout the six novels, there were intense scenes of the parents, therapists, and the children arguing extensively. These scenes were exhausting, and often the protagonist was voiceless in such interactions. In addition, with the adolescent reader in mind, I caution that a student reading about the characters' experiences may find "tips" in perfecting their behaviors rather than identifying the complex issues. The two novels I have recommended emphasize the need for relationships with the family and with friends as a means of coping.

Since novels involving eating disorders pose a limited appeal within the classroom, I suggest that a teacher incorporate them into a thematic unit on discovering the self. For those who may be interested in the use of these novels in the classroom, I have provided a brief summary and commentary on Newman's Fat Chance , portraying a character with bulimia, and Frank's I Am an Artichoke , entailing a young girl's struggle with anorexia nervosa. I close with an annotated bibliography of the four other novels I reviewed.

Recommended Young Adult Fiction

Leslea Newman's Fat Chance. Putnam and Grosset, 1994.

Summary:

"Fine," I said, and I shoved my entire supper into my mouth. Then later after I did all the dishes and made Mom her coffee I just went upstairs into my bathroom and threw up the whole thing. That'll show her. If she's going to make me eat like that, I just don't have a choice. I've simply got to get thin, and that's all there is to it. (pp. 98- 99)

Judi Liebowitz, as the narrator of Leslea Newman's Fat Chance , relates her experiences through her diary during the first semester of eighth grade. The diary, given to her at the beginning of the school year by her English teacher, Mrs. Roth, catalogues each day's events as she strives to attain her three goals for the year: to figure out what she wants to be when she grows up, to have a boyfriend (Richard Weiss), and to lose enough weight to be the thinnest girl in the entire eighth grade.

Judi commences her dieting with "operation fast," starving herself for a period of three days until her mother interferes. Judi tries to compensate for her mother's fattening dinners by skipping breakfast and lunch and performing exercises each night before she goes to bed. Then one day while at lunch, Judi discovers Nancy Pratt - the most beautiful, most popular girl in the entire eighth grade - forcing herself to throw-up in the bathroom. Judi reasons, "Even Nancy Pratt does it" and decides its the only way she will become thin. Judi, now able to thwart her mother's fattening dinners, delights at what she calls her new "secret weapon."

Judi chronicles her weight loss as it goes up and down; and, although she begins to lose weight, she is never really happy. Throughout the novel Judi feels unable to talk to her mother about her problems, her low self-esteem and eating disorder, and draws herself inside. She finally gathers enough courage and presents her journal to her mother as a Hanukkah present. Her mother writes her a letter conveying her love and support, and the novel closes with Judi and her mother visiting a therapist, easing her way to recovery.

My reaction:

Fat Chance , related through Judi's journal, allows the reader to enter her world, her thoughts, feelings, and perceptions, and to understand her experience. Adolescents struggling with eating disorders will relate to Judi's desire to be popular and to have a boyfriend and will understand her feeling of inadequateness when comparing herself to her peers. Despite its serious subject matter, Fat Chance is delightfully humorous, as the story is told through the voice of an eighth grader. With Judi as the narrator, young adults may relate to her like one of their friends.

Fat Chance was my favorite of the novels I reviewed, primarily for its use of humor and the relationship Judi has with her mother. Unlike the other novels, which often depict troublesome relationships at home, the relationship between Judi and her mother is loving and mutually respectful. Judi indicates that they talk often and her mother asks periodically if anything is bothering her. Even though her mother senses Judi may be struggling with something, she resists pressing the issue in respect of Judi's need for privacy and need to establish a sense of independence. Rather than a battle for control, Judi conveys embarrassment and shame for mishandling the trust her mother has bestowed upon her by allowing herself to be destroyed by eating disorders.

Lucy Frank's I Am an Artichoke . Bantam Doubleday Dell. 1995.

Summary:

"You can be fat or skinny or anything and I won't care. You're my riend, Emily. We're friends." She clutched the teddy bear closer, and I thought I heard a little noise - a sigh, or it might have been a sob. Then she turned toward the wall. "But Emily," I said, "I'm worried about you. Don't get any skinnier, Emily. Please." (p. 74)

Lucy Frank's I Am an Artichoke details the experience of fifteen-year-old Sarah during her summer job as a mother's helper to Florence Friedman - freelance writer, recently divorced, and mother of twelve-year-old Emily. Thinking her position was merely to baby sit a little rich kid, Sarah discovers an entirely different reason for her presence in the Friedman household. One day while out for breakfast, Emily reveals to Sarah that her purpose as "mother's helper" is to try to get Emily to eat. Emily's parents' had hoped that if Emily were around a "normal" person then maybe she would begin to eat normally again. Following the Friedman's divorce, Emily had assumed control of family matters by refusing to eat. Her parents' argue daily over the phone about how to respond to Emily's refusal to eat. Emily's father threatens her with hospitalization and criticizes her mother for her inability to make Emily eat. Emily's mother, in her effort to maintain custody of Emily, convinces herself Emily is improving, denying the seriousness of her daughter's condition.

On the night of her mother's big birthday bash, Emily finds her journal out of place and accuses her mother of invading her privacy. An intense argument follows and Emily runs away. Sarah finds her later that night in the park; and, after Emily pleads with Sarah not to return to her mother's apartment, they go back to Sarah's family's house. The next day Emily's parents arrive, relieved she is safe. A long discussion transpires in which Sarah provides valuable insight into the issue of control among the members of the family and explains how Emily's illness is an attempt to keep everyone together. With hope of better communication and a new friendship, the novel ends promisingly for Emily's recovery.

My reaction:

I Am an Artichoke , emphasizes the need for friendships and family communication. Sarah's friendship with Emily helps her to realize that true, loving relationships are not based on physical appearance. Gradually, with Sarah's help, Emily learns to trust Sarah as she accompanies her on various outings. While I identified with Emily's experience, I appreciated Sarah's position as the outsider in learning to deal with the person undergoing the eating disorder. Sarah, although somewhat uncomfortable with the situation, handles Emily with ample consideration.

Narrated through Sarah, her point of view allows others who may not have an eating disorder understand the experience of trying to help someone in that situation. As the observer, Sarah discovers aspects surrounding the individual with an eating disorder such as Emily's daily routine as well as her interactions with her mother. In addition, with the story told through Sarah, it creates a necessary distance from the familial conflict and allows for moments of humor, bringing a smile to the face and relieving the reader from the intense moments.

Annotated Bibliography of Four Other Young Adult Novels Portraying Characters with Eating Disorders

Levenkron, Steve. The Best Little Girl in the World. Warner Books, 1978.

Francesca Dietrich develops anorexia nervosa as a result of feeling deprived of attention from her parents. After several battles with her parents on her refusal to eat, she is finally hospitalized. The therapist Sandy Sherman helps in convincing Francesca to help herself and have the desire to get better. The novel ends with Francesca leaving the hospital with the prospect of recovery. An intense novel, The Best Little Girl in the World provides a chilling view into the mind of an anorexic.

Ruckman, Ivy. The Hunger Scream. Walker and Company, 1983.

Lily starves herself in order to achieve a seemingly perfect appearance, both to gain the attention and admiration of her parents and Daniel, the neighbor boy across the street. Lily starves herself to the point in which she must be hospitalized. With the help of her therapist through making "contracts," she begins her recovery. In addition, through their conferences, the therapist reveals Lily's disorder to be in part a result of her problematic relationship with her parents. The story concludes with Lily having recently left the hospital, happy and hopeful, and on the road to recovery.

Terris, Susan. Nell's Quilt. Sunburst, 1987.

Set in the late 1800s Susan Terris' Nell's Quilt presents a complex, fascinating story of Nell in her struggle to comply with her parents and the conditions of the arranged marriage they have set for her. In defiance, she refuses to eat; and, to deal with her frustration as well as the hunger, Nell sews an elaborate quilt with each square symbolic of people and events contributing to her strife. Nell's Quilt, although difficult for some adolescents in relation to its time period and understanding of an arranged marriage, is highly recommended for its artistic qualities.

Woodsen, Jacqueline. Between Madison and Palmetto. Delacorte, 1993.

Margaret and Maizon are two friends who encounter various changes as they enter their teenage years. They encounter new schools, new friends, and "new" bodies. Margaret, having trouble accepting her changing body, develops bulimic behavior. The eating disorder, however, is not the central focus of this novel and her problem is solved rather simply with a trip to the family physician and recommendation to engage in daily, moderate exercise to handle the new weight associated with her growing body. Other issues in this novel involved friendships, race relations, and estranged fathers.

Works Cited

Frank, Lucy. I Am an Artichoke. Bantam Doubleday Dell, 1995.

National Health Institute. http://www.kidsource.com/kidsource/content/disorder

Newman, Leslea. Fat Chance. Putnam and Grosset, 1994.

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Elizabeth Myers teaches seventh grade Language Arts at Southwest Middle School in Orlando, Florida.

by TG