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“In the truest sense, freedom cannot be bestowed; it must be achieved.”

—Franklin D. Roosevelt

Before you picked up this book, you probably looked for ways to recover many times. Maybe some of your methods were questionable: You tried diets to lose weight; you chewed sugarless gum until your jaw ached; you may have tried drugs to squelch your appetite or control your feelings. Maybe you surrendered to your eating disorder and isolated yourself with TV and binge food as your main companions. In public, you may have hidden your too-thin or too-fat or just plain unacceptable body in layers of clothing, smiled a smile you didn't mean, and kept yourself so busy you didn't have time to know what you were feeling. You may have distracted eyes from your rotund or skeletal body by wearing expensive or flamboyant jewelry.

When these tricks succeeded, you felt safe as eyes bounced off you and moved on, or if you beguiled those eyes with accessories. At the same time, you were not happy being treated as if you were invisible or when someone focused on your embellishments. You created a barrier between yourself and other people so that having a genuine relationship was an unlikely possibility. This “success” caused you much loneliness.

Now, book in hand, you are ready to explore a path that might be new for you—and it might work. You want to be free. You share this desire with all men and women who are dependent on an eating disorder.

Most of the people I work with are women, so I use the feminine pronoun in this book. I'm reporting the details of the successful treatment of women in my practice over the years, plus my own recovery story. When you, man or woman, focus on the personal details of your life and understand how you act out your eating disorder, you have the potential to move toward your recovery and heal. Are you ready to begin?

Research about eating disorders continues at all levels of psychology and medicine, dispelling myths and gathering new information. (See Appendix C for findings and summaries.) Yet many of the ideas and information about eating disorders, even when based on credible ongoing research, are still controversial.

Eating disorders have the highest mortality rate of any mental disorder. Bingeing and purging plays havoc with teeth and gums and can harm the esophagus, and over extended periods of time it disrupts electrolytes in the body, which can result in a heart attack. Anorexia leads to heart problems, infertility, and osteoporosis.

Some people might suffer from bulimia and anorexia without having complicating medical problems. Some live long lives. I've known anorexic women in their eighties, bent over with osteoporosis and suffering from mild to moderate dementia. I remember Bella, frail and thin at eighty-five. Her osteoporosis created a “hump” in her back that pushed her upper torso forward. I watched her buttoning her cardigan sweater. Because of the angle of her body, the buttons and button holes didn't connect. In a harsh staccato voice she said, “I'm so fat. Damn it. I'm not eating today.” My breath stopped. My chest ached as I stood witness to the ravaged leavings of a lifetime of anorexia. Bella no longer had a choice, but you do.

This book lays out essential guidelines for creating and supporting your ongoing recovery. As you move through the chapters, you will learn how to choose or create the exercises and activities that are right for you. You and I are collaborators in this process. Each chapter lays the groundwork for exploring your emotions and experiences at tolerable levels of intensity. As you develop the emotional capacity to be present, you will grow beyond your suffering. You can be known and understood.

The following list of experiences may not seem, on the surface, to relate to eating disorders. Most of them are not specifically about food or eating. But they can reveal how you use your eating disorder to live behind a façade. In responding to the list below, please use the words never, rarely, sometimes, often, or always.

1 I hide from people.

2 I've thought about suicide.

3 I find it difficult or impossible to make long range commitments.

4 I have emotional meltdowns where I am terrified and feel lost.

5 I have a disappointing—and somewhat shameful and secret—sex life.

6 I feel a low, continuous anger and resentment towards people in my life.

7 My short-term memory doesn't function well.

8 I say to myself “This is the last time I will ______” about certain behaviors but invariably repeat them.

9 I describe my suffering to someone and ask for help, yet reject suggestions offered.

10 I perform relentless exercise routines to ward off caloric consequences.

11 I eat mindlessly when I'm not hungry.

12 I tell lies at the grocery store checkout stand when buying my binge foods.

13 I weigh myself every day or several times a day.

Please breathe and know that you have just completed a powerful task. You might feel anxious or relieved. You may think you are overwhelmed, but you are not. You may be surprised or dismayed to discover how many of these descriptions apply to you and how much time they take up in your life. You may begin to criticize yourself or feel terribly deficient. But please put aside self-punishing thoughts. You are simply beginning to take a first look at the reality of your life, especially those aspects dominated by your eating disorder.

If you have had any of the experiences in this list, you have to live this way. Let's acknowledge that strength right now. Fortitude, creativity, determination, and strategic thinking are required to maintain an eating disorder and all of its demands. If you have the strength and ability to sustain an eating disorder, then you have the strength and ability to move beyond it. Together, we have a chance to find a way out of your torment and into a much healthier and happier way of living.

Your honest response to the questions in the list will alert you to areas in your life that need support, love, care, healing, and encouragement. When you finish going over the list, create a recovery journal with a separate page for each item that applies to you. These pages will provide topics of your choosing for journal entries, free writing, and explorations. Instead of eating or starving, or relying on food or excessive exercise to give you safety and emotional numbing, your journaling on these topics will help you heal your way through your troubling experiences, ultimately making your eating disorder unnecessary.

Sometimes your feelings will come up so fast you seem to have no choice except to act out your eating disorder. Often, you don't know you are feeling anything. You follow an irresistible urge to eat, or you discover yourself eating without being aware of when you started. You might, for example, find yourself eating your child's unfinished lunch in the kitchen before you wash the plate. You might notice that the one cookie you ate from the dish on the coffee table led to your eating all the cookies. You may or may not have noticed the surprise on the faces of people who saw you.

If you have the strength and ability to sustain an eating disorder, then you have the strength and ability to move beyond it.

When you are in the grip of your urges, you have emotional tunnel vision. It's difficult or impossible for you to imagine options. You are not aware of the consequences of your behavior to your health, your use of time, and your relationships.

At the close of each chapter, you'll find exercises based on the healing benefits of mindful breathing, affirmations, and writing that will help you expand your mind and develop your ability to move beyond the dictates of your eating disorder. They will become more involved as you progress on your recovery path. To start, here's a description of what to expect and what to try first.