"So, I'm sitting there on Valentine's Day, right? And the doorbell rings. And it's a package for me. I get all excited." The group leans in, listening to Lindsay.
"And it was from my dad!"
"Ohhhhh!" The group erupts into laughter.
Lindsay continues, "So, it sucked, no secret admirer, but...it was a huge pretty, tin of chocolates." The group goes uneasily silent. "So I picked up the phone and called my dad and said, 'Are you trying to kill me? Who gives two pounds of chocolate to a bulimic?'"
The group is quiet for a minute, making eye contact all around. Suddenly, they burst into shrieks of laughter.
The eating disorders group at the University of Pennsylvania is small -- only five girls attend on a fairly regular basis, taking out time here and there for performances, assignments, the necessary rhythm of a busy student life. The group is led by two therapists, both of whom are sure that the small group size is in no way representative of the proliferation of eating disorders at Penn. The small group structure works well. Most girls have been with the group for over a year. Conversation is easy and familiar. Occasional awkward silences are laughed away and tough issues are confronted with a united front.
In this session we talk about the reasons we eat, or don't eat, and how we try to control the foods we allow ourselves to eat. The discussion fluctuates between humorous and sober. We talk about stress, sleep, school, family, our past eating habits and how things have gotten better. Never once is the issue of weight or appearance brought up. I can't decide whether it's because this is just assumed or is too touchy to talk about. It may be that it's irrelevant to the problems of the group.
Alex walks into the room late, obviously stressed out. She flings her backpack down and throws herself into her seat, her long hair framing her tired face. In a slightly out of breath voice, she apologizes for being late. She was downtown volunteering at a high school as part of the Urban Nutrition Initiative. This volunteer-based organization works to get healthier food into inner city schools. I can't help but think that her choice of philanthropy is more than a little ironic.
Alex is thin, painfully so. Seeing her on the street, you might think she was ill. Her hair is dull and her eyes rimmed with dark circles, a bruise-like tint. Her clothes hang on her bony frame and her cheekbones stand out in stark relief to the rest of her face. She takes a sympathetic swig of her Diet Coke as she sees Lindsay do the same. I wish I had one, too. Solidarity through Diet Coke.
Looking around the room, I notice the diversity of women here. While Alex is waif-like, a washed out watercolor of a girl, Lindsay is wholesome and fresh. Her skin reminds me of milk, her cheeks a fresh-scrubbed rosy clean. Though her clothes are baggy, you can tell that it's for the fashion statement, not necessity. In short, nothing about her indicates poor health or unhappiness. Maria is Mexican, short and compact, but full of energy. Her smile is quick and bright, her laugh a girly, silly giggle that belies the fact that she is actually a serious student with an active mind that leaves her prone to periods of deep self-analysis and thought.
Just now Maria is talking about when she was younger and lived in Mexico. She says that she used to have a problem with leaving food uneaten. She was afraid of wasting it, that it would go bad. Anything good in the house, she had to eat it, all of it, right away. She used to imagine the food talking to her. "Eat me, eat me, don't let me be wasted and thrown in the garbage!" Maria says this in a squeaky high-pitched voice. Maybe that's what chocolate pudding sounds like in Mexico.
In her senior year of high school, she began putting notes on all of the food in the cupboards and refrigerator. They said things like, "don't eat me," "don't worry, I won't go bad" or "save me for someone else to eat later." Again, she repeats these phrases in the voice she must imagine food to use. Sounding like a cartoon mouse, the flan begs not to be eaten. By now we're all cracking up. I'm trying not to laugh out loud, trying not to be the rude new member, but the laugh comes out through my nose and before I know it I'm snorting.
When everyone calms down though, the discussion takes a quick u-turn, courtesy of Dr. Fichter, who moderates the group. "So, is this how we control our eating? Do we begin to make up tricks and rules and things to avoid it?"
The floodgates have been opened and everyone wants to talk. After hearing the others, even I'm willing to jump in. The list of mechanisms to avoid calories, fat, overeating, begins to multiply.
Don't ever use real sugar. Use Sweet 'n' Low or Equal, but Splenda's the best. Buy sugar-free candy to suck on when you get hungry instead of eating. Give yourself one day a week to totally pig-out -- then the rest of the week deprivation will be easy. Eat only fruit and vegetables. Drink water constantly so you're always full. Don't eat after eight p.m. Always get your dressing on the side. Only eat in the kitchen, nowhere else in your house, especially not in front of your computer or the TV. Plan your meals. Count your calories. If this were Weight-Watchers this would be a pep talk, a great game plan.
Lindsay latches on to the rule about no eating at night. "It's so hard," she says. "Because you avoid eating all day and then at night you're starving so you end up eating. Then in the morning you're not hungry, so you're stuck in this bad eating cycle."
"But I'm hungry in the morning. I'm hungry at night, but I still wake up wanting breakfast." Alex seems confused.
"What do we think this means? Anyone in the group have any ideas?" Patricia throws the question out there. The result is the stultifying silence of a classroom in which the answer is obvious, everyone knows it, but no one will raise his or her hand. I finally inch my hand up.
"I think your body's telling you it needs food. You need to give it some fuel."
A sigh of relief goes around. I've said it. The new member has taken charge. I feel a part of the group, telling Alex subtly that something needs to change. Of course all of us realize that we need to change something, it just sometimes takes a group of peers to point it out.
The meeting ends and we all exit the building together, but immediately scatter, heading off in different directions, hurrying back into campus.
•
It turns out Carolyn isn't new, just a repeat offender. She was part of the group last year, but hasn't been back since. She has the look about her, different from Alex only in the sense that where Alex is tall and lanky, Carolyn is petite, almost fragile looking. The bones on the backs of her hands run in channels down to her long thin fingers. Her hands seem large for her small frame, but maybe it's just the fact that they're so thin that makes me think this. Her hair is pulled back in a tight ponytail, accentuating the fact that the bones in her face are strongly defined as well. Her eyes have a hollowness in them that we all recognize. It's the look of hunger self-imposed.
We all are making our introductions as Dr. Fichter and Patricia join us. The group can now officially begin. The talking trails off, as we all look to them for a beginning to the session. Just then, Katie comes bounding in, sweaty and red-faced. "Sorry I'm late," she says. Her short blond hair is pasted to her left cheek. "I'm coming from dance practice."
Katie's clothes attest to this, her orange sweatshirt thrown over a black leotard, tights peeking out of the tops of her sneakers. Her build is larger than the traditional dancer and she appears flushed and healthy. She's carrying with her a bag that looks like it's from dining hall takeout. All it contains are three Diet Cokes and two bananas. Lindsay again has a soda peeking out of her black backpack. I make a mental note that Diet Coke is the drink of choice. Katie and I are introduced, and Dr. Fichter begins the session by asking Carolyn to talk to the group about her experiences of the last year.
•
I can't say that any of us would have been friends. Maybe a smile passing in or out of a building, an "excuse me" ricocheted between us. A sympathetic glance as we hear someone ask if there's mayonnaise in the tuna at the salad bar. A recognition of the hollow look in another's eyes as they're trudging tiredly up the walk. But that's not all that we're about, or all that we share. We might have appreciated the sound of each other's silvery laughs down the hall, or admired the work that one of us had done in the community. Perhaps we would have seen the art or dance of another and found it achingly beautiful. Nevertheless, it would have been nothing more than that. A passing, a chance admiration, a moment of fleeting recognition. But for the group, we would not have known one another at all.
Our nationalities, backgrounds, families, and interests defy any search for a single common thread. From the sciences, to the arts, to civic activism - all is represented. Some of us are socially active, alive to the bustling campus scene around us, while others are quieter, preferring the independent channels of culture and curiosity that Philadelphia provides.
What we do share is a common attitude. We realize that this is a problem not to be dealt with alone. So we're here, every week, hashing it out, bouncing things off of each other, wrestling with ourselves to let go, to be free from this preoccupation with food, what should be the sustenance of our young lives, but instead is the enemy. But from under the yoke of this disease we can also laugh. We find it funny to discuss anti-depressants as if they were flavors of ice cream. For while it's not true that everyone on an anti-depressant has an eating disorder, the converse is pretty much a given. Lexapro, Effexor, Prozac, Wellbutrin, the merits of each are run through as easily as saying you don't like the Rocky Road because it has too many marshmallows. We also agree in our distrust of perpetually happy people. We want to know what they're on. How do they live? Where do they exist?
"I've known two genuinely happy people here at Penn," Lindsay says. "And they were both from Canada."
We can also joke about which restaurants will and will not serve you a pile of lettuce and then respond affirmatively when you ask, "Do you have mustard?" Mustard being a magic food -- no calories. Neither are any of us ashamed to call ahead for a buffet function to find out exactly what will be served. This way, we can plan ahead and won't have to be faced with a plethora of choices from which we'll inevitably either take everything or nothing. We can also share in each other's triumphs.
"I had a donut at work today, and everyone cheered." Carolyn tells us.
I admit, "Just before this, I splurged on an avocado and hummus sandwich."
"And I'll bet it was damn good."
It was. Damn good.
If you or someone you know would like more information about the eating disorders therapy groups call CAPS at (215) 898-7021. CAPS can provide resources both within and outside of the University.
