An Extreme Self: Harriet Brown

If you don’t have an eating disorder, you know someone who does: current estimates suggest that 25 million Americans suffer from anorexia, bulimia or binge eating disorder – and the number is likely much higher. Even if you aren’t a clinical case, there’s an 80 percent chance that you dislike your body, and a 22 percent chance that you’re a chronic dieter.

To Harriet Brown, statistics like these are unacceptable. Brown, a journalist and body image advocate, has been waging war on eating disorder-related issues for years – and with increased fervor since her own daughter, Kitty, developed anorexia in 2004. In January, Brown published Feed Me!, a collection of essays on food, fat and body image. She also posts frequently on her blog, dissecting the media’s sloppy, inaccurate and downright dangerous coverage of eating disorders.

Brown is one of a kind, and that’s too bad: as the disordered eating epidemic grows, we need more of her kind. But at least she’s not slowing down: right now, Brown is writing a family memoir, tentatively titled Brave Girl Eating, that she describes as a mix of recollection, research and her own uncensored opinion.

Your journalism career is an eclectic one – you’ve written a book about a day-care, articles on all-things science and are a published poet. What made you focus your energy and activism on eating disorders?

It really grew out of a number of things. Food and weight are issues that have been rampant in my family, and my daughter developed anorexia when she was 14. I’ve just become radicalized about the epidemic. You eat every, single, day. If you can’t come to terms with that, you’ll be living in a nightmare. And so many people do.

I’ve heard everything from the media to family to genetics in the blame game for eating disorders. Are some of us just hardwired to be sick, or is this largely cultural?

There’s the expression that genetics loads the gun, but the environment pulls the trigger. I’m sure we have some genes that predispose us – my family is testament to that. But my daughter also had the other characteristics that you could call “triggers”: she’s an athlete, a type-A personality and so on. Ninety-five percent of teen girls diet, but they don’t all develop eating disorders. That suggests a genetic role.

There are two dominant schools of thought: that someone can recover fully from an eating disorder, and that they’ll carry it with them for life. Where do you fall on that question?

I fully, truly believe you can recover completely, and I know many people who have. Research shows that eating disorders present themselves in a window of opportunity, from 8 to 25 years old. If you can get through those years, recover and be well, I think you can leave it behind.

But I also think relapse, in that window before 25, is somewhat inevitable. There’s something about the transition to adult independence that’s difficult, and that can trigger someone who might have struggled at 13 or 14, then been doing okay until they hit 18 or 20 and moved forward into adulthood.

Treatment is another question mark, because it runs the gamut. Only 10 percent of people ever get any formal treatment, but that 10 percent have a lot of options. What works?

I’ve seen it all, methods like touchy feely art therapy and horseback riding. That’s fine, if someone enjoys art and wants to do art. But there’s no evidence to suggest that it will treat an eating disorder. The Maudsley approach (a three-stage, intensive outpatient program with active involvement of parents) works. Not 100 percent, but 80 percent or 90. In the world of treatment, that’s huge. I wish something was foolproof, but this is what we have right now.

Eating disorders are often discussed as a teen phenomenon. Are older women and men succeptible?

I was commissioned to write an article on older women developing eating disorders, and I must have interviewed 500 women. What I found were simply people who had never been diagnosed in adolescence. Like, “oh, no, I was a healthy teenager, except those five years of making myself throw up.”

These things start early. But I do think most women eat in a disordered way, even if they don’t have “an eating disorder.” That’s the media, this culture of thin and our fat-phobia. We are so scared of fat, it truly is ridiculous to me.

So, some of us are predisposed to problems. Most of us are disordered in one way or another. And we’re terrified of fat and obsessed with our appearance. What’s an American trying to raise healthy kids – and be healthy themselves – to do?

Shut up about how fat you are. Stop talking about your butt getting big when you eat a cookie. Get over it. If we could collectively make a conscious effort to stop talking about appearance, that alone would do so much. Why does it matter? Have a cupcake!