article

04.16.09

Was I Born Anorexic?

A new study suggests that some are genetically predisposed to anorexia. This might explain why my bout with self-starvation started when I was a small child.

Just the other morning, my therapist and I agreed that pretty much everything wrong with me can be traced, in one way or another, back to my parents. This revelation, which has cost my insurance company thousands of dollars, is hardly groundbreaking. Long before the first neurotic was chained to an asylum’s basement wall, we have known that our parents ruin our lives. It has taken the miracle of modern genetic science, however, to discover that this is not totally their fault.

As a small child, I remember telling my mother that when I grew up I wanted to weigh 110 pounds.

According to a new and seemingly conclusive neuropsychological study, anorexia is the latest on the list of the various genetic maladies we can inherit from our parents. The researchers conducted neuropsychological testing on over 200 girls and young women being treated in hospitals for anorexia in the U.S., the U.K., and Norway. The results showed that 70 percent of the patients had suffered damage to their neurotransmitters, had undergone subtle changes in the structures of their brains, or both. They also found that these conditions occurred in the womb and were not due to external or environmental factors.

This news is of special interest to me. For a period of roughly three years, between the ages of 18 and 21, I suffered from a relatively serious case of anorexia. I know this revelation may be difficult to believe if you’ve ever seen me in a buffet situation (or if you have eyes), but I assure you the period is well documented in my medical and psychiatric records.

I say my case was “relatively serious” because I was thankfully spared many of the incredibly devastating and debilitating effects of this terrible disease in its gravest incarnation. My condition never required a feeding tube. I never developed premature osteoporosis or heart arrhythmia or suffered neurological damage. I did, however, lose hair in some places and grow it in others. The skin on my face and arms took on a mottled, yellowish appearance, like an old newspaper left out in the sun. I ceased to menstruate for about a year, which my doctor has said could have a lasting impact on my fertility. And at one point my blood pressure dipped so low that I was told I was in immediate danger of major cardiac arrest. All in all, my anorexia undoubtedly caused far more long-term damage to my body than any other of my youthful follies, such as habitual drug-taking, casual sex-having, or the time I dyed my hair the color of Tang.

Today, looking back, the period of my illness seems remote. To think of it now feels like hearing a traumatic experience recounted by a loved one—I can certainly sympathize, but it does not feel as though it happened to me. Still, the results of this study are, frankly, a relief. I have often wondered about the root causes of my bout with this most mysterious of disorders, and whether I was born with “an underlying vulnerability” to it, as the study’s researchers put it. What pushed me over the edge? Why did it happen to me?

Now, as then, I feel certain that my illness was not caused by the things I have been told it was by well-meaning social workers, feminists, or sensationalist media outfits. For example, I am absolutely positive that the physiques of Kate Moss, Posh Spice, or any other convenient scapegoat had no more than a kernel’s worth of influence over my decision to live on raw broccoli and Swedish crispbread for most of my college years. This is what we’ve always been taught—Barbie makes us hate our bodies as girls, and some unholy alliance between the worlds of fashion, Hollywood, and advertising keep feeding the furnace well into womanhood, until we’re supposedly too old to care. “But what we are learning more and more from research in this area,” says Susan Ringwood, the director of Beat, a leading U.K. eating-disorders charity, “is that some people are very vulnerable to anorexia, and that [it] is down to genetic factors and brain chemistry, and not them trying to look like celebrity models or suffering a major traumatic event early in their lives.”

I have often asserted that my illness took me by surprise, that what had started out as a perfectly innocent effort to eat more healthily had somehow metastasized out of control. But the truth is that the warning signs were always there. I cannot remember a time in my life when the idea of losing weight was not in the back of my mind, a nagging, constant goal. As a small child, I remember telling my mother that when I grew up I wanted to weigh 110 pounds, which was what the National Enquirer said Princess Diana weighed at her thinnest. By the time I was nine or ten, I was spending hours in front of the mirror in my underwear, poking at any place that looked round with disgust. I was an extremely picky eater, which was something I cultivated, making rules for myself about what I could and could not eat. Many days I skipped meals altogether. In my late teens, when circumstance, ability, and willpower coalesced into a full-blown disorder, I felt a palpable sense of freedom that the inevitable had finally come to pass. I remember a friend around the same time sharing with me his relief at finally coming out to his conservative parents, that something he had always known was there was finally out in the open, for all to see. While there is obviously no comparison between the two (his being healthy, mine the antithesis to health), somehow I knew exactly how he felt.

Naturally, my parents, like any decent human beings, blamed themselves for my illness. My mother was not above expressing dissatisfaction with her body, but in my family, contrary to stereotype, the major food issues came from my father. Between graduating from high school and marrying my mother—the exact same time period at which my own anorexia presented—my father, who had been an overweight adolescent, lost more than a third of his body weight and has kept it off, and then some, for nearly 40 years. Nor has time cooled his commitment. He remains fanatical about exercise, and while he takes in the minimum amount of calories he needs for sustenance, he is highly finicky about the particulars—no meat, very little fat, and I have never in my entire life seen him order, let alone finish, a dessert. That he has remained breathtakingly thin while his contemporaries have gradually developed the comfortable paunches and stumbling waddles of balding Teletubbies is a point of great pride for him.

Many people are quick to blame anorexia on upbringing, and I have no doubt that many years of observing my father’s habits and absorbing his casual disdain for people unable to control their weight had something to do with my troubles. But there is a control group in this case: My younger sister, who grew up in exactly the same atmosphere, hearing exactly the same things, was utterly unaffected by them. I have to infer that something about her brain is different than mine, just as she is blond and I brunette, she is short and I am tall.

From my father, I inherited my full lips, my allergy to mollusks, the large space between my first and second toes. It has never occurred to me to question that any of these similarities were genetic; the links are simply too evident to be ignored. So I am perfectly prepared to believe that my vulnerability to anorexia was a direct physiological legacy from him, as I believe are many of our shared characteristics: tenacity, discipline, determination, drive (all of which are directly related to the anorectic personality).

Why my vulnerability flowered into a grievous health hazard while his remained an endearing eccentricity to be alternately mocked and admired is difficult to say. My best guess is that it has something to do with another biological factor: Like 90% of all anorexia sufferers, I am female. But I can hardly blame my mother and father for that, any more than I can blame them for the host of other physical and genetic misfortunes that are sure to plague me as they have the rest of my family: high blood pressure, loss of hearing, breasts that will eventually require structural engineering to stay above my waist.

Beyond that, I am very happy to hear the results of this study. Putting a scientific face to the causes of anorexia will help demystify what can be a frighteningly enigmatic disease. The sooner we as a society begin to treat anorexia as a symptomatic manifestation of a physiological cause, the better off the sufferers—and their families—will be. After all, as my therapist told me, apportioning blame doesn’t help anyone. But identifying the cause—that’s when the real work can begin.

I just hope my insurance company agrees.

Rachel Shukert is the author of Have You No Shame? And Other Regrettable Stories, and is at work on her second book, The Grand Tour. She lives in New York City.