The truth of the matter is complicated. Such things always are. Such things can be traced to the parents. (I'm a psychiatrist! Of course I will say this!) And, if all must be told, my mother is a picky eater too. She has lots of food allergies, and we never had the most normal meals when I was a kid. She didn't eat dairy, spicy foods, and a lot of vegetables ll those restrictions on her diet made cooking not a whole lot of fun for her, and combine that with picky kids - it's a wonder my mother ever sets foot in the kitchen. When I was  little, I liked whatever my older sister did not. I liked raw carrots only, she only liked cooked- you get the picture. Except spinach, of course, we both liked spinach, because no one else did.

 

The eating habits were my own weird thing. I never knew it was such a weird thing until my college roommates made relentless fun of me. What habits, you ask? Well, it's the culinary equivalent of filling a paper with one doodling line that curves all around and never crosses itself. Example: lasagna one layer at a time. Kit kats chocolate first from the outside, then each crisp wafer. Lucky charms all the cereal part first, then the marshmallows in rainbow order (you remember roy g. biv...). Salad with no dressing, each component eaten separately. No gravy, ever - it might mix flavors! No butter or cheese sauce, though tomato sauce was okay. Obsessive much, doctor? Guilty as charged. I can control myself. I don't do it in mixed company anymore... you can see that counting calories and restricting food categories is just a natural extension of my personality. Could be a good thing. Could be I should just drink a glass of wine and sit in the sun and breathe. (with SPF 15 on at least).

 

And now the second piece, which is beyond me and my lucky charms, but extends out to swallow up society and the slinky models who devour the ultra chocolatey brownies on TV.

 

First anorexia - spent 2 months working in a children's psych unit, and those girls (and  boys). Alien-thin, moving all the time. Shaking their legs at every meeting to burn calories. Standing whenever they could. Eating yogurt with the spoon circling around the edge, a milimeter of nutrition building in a rim on the end of the spoon, touch with the tongue, savor the bit of yogurt, then put the spoon back in the yogurt, around again. They wore sweatshirts and shivered at room temperature. They didn't consume enough protein and their hair fell out. They grew hair on their faces (lanugo hair - a sign of anorexia - happens to some stars - look at pictures of Jennifer Aniston at her skinniest). The worst smell of nail polish remover because of the metabolic byproducts of starvation

A good telltale sign is the skin over the hollow at the sides of the elbows. It

becomes paper thin in anorexia. Look around at a mall, at a movie theatre, at the oscars and on the runways. It's there. Go check out ana diaries at diaryland. 

 

Then there is the other side.  Much larger than the anorexia.  The binging Doritos. coca cola, trans fats, school lunches.  Fat.  Medical school makes doctors fat phobic.  This is a terrible thing, but true.  It starts with surgery, and  being the schmuck who has to lift the fat layers out of the way while the appendix  is removed.  Try holding up a pannus for 3 hours and not feeling a little bitter in the end. Then there's the post-op smell, and the yeast infections under the rolls of fat, and the diabetes and arthritis.  The fournier's gangrene and dressing changes that take four people to lift someone over.  Fat that keeps the lungs from expanding and leaves patients on a ventilator.  Patients have to be helicoptered to other hospitals because the CT scanners aren't big enough. Look around at the grocery store, at movies, at restaurants.  Watch for ankles that spill over the sides of shoes and arms that stick out like a kid who is wearing too much winter clothing.  Look over the

feederism pages you can find on google.

 

These websites are like basement cobwebs - push them aside and there's a dark  hole without bottom.  And recovery is a scaffolding of metal and plywood and boring and solid and no surprises.  No wonder it's easier to look at ana than at AA.

 

Behind all this is dopamine and endorphins.  Addiction tracts in the brain running from the limbic system to the cortex and midbrain.  Reptile signals of starvation and love and sex and rock and roll ruling our intellectualized and  meritocratous society.

 

That's my rant for today.