I come from generations of women with eating disorders. The women in my family range in size from morbidly obese to zipper-thin. Zipper thin in my family has nothing to do with genetics. Family get-togethers can be bizarre events on a certain level because nobody addresses the elephant in the dining room. And it most certainly is all about the food. My mother prepares lavish and elaborate meals, ensures everyone is getting enough (more than they need) to eat. I don't think I've ever seen my mother eat.

Recently I watched another TV show featuring women with eating disorders; in this case, anorexics and bulimics. Pictures of bony bodies and distraught family members are peppered throughout the show. The audience is tearful, the host is very grave and making his best effort to get through, and the guest is saying exactly what the audience and the host want to hear. (Of course, I'll do whatever it takes and I'll get help...) Do these people realize that literally, some women would rather die than be fat?

I think you'll see these women have lost perspective. Now it's about sheer control; it's about intake and output, and it's about numbers. It's about numbers of calories in and calories burned on the digital display of the elliptical trainer, numbers on the scale, numbers on my clothing size labels... And on and on. This disease is truly an obsessive numbers game. Combine that with the competition factor of friends, co-workers, and family members; i.e., who will be a size 0 first? and we have the recipe for disaster. Some of us have been kicked out of health clubs because of spending too much time in there. Some of us have maintained several gym memberships simultaneously to run from one to the next to the next, visiting 2 or 3 daily, spending hours in each one.

This disease goes 'way beyond looking good in your new outfit. Ultimately a six-pack could be considered unappealing when the object is a concave belly with prominent hip bones and well-delineated ribs. A bony face with a stark profile is an object of beauty. I've known several women that have wanted "elegantly" bony arms and hands, or the little row of vertebrae seen through the trendy blouse. How thin must we be to not have fat showing over our bra straps? So just when do we lose our perspective on what's healthy and what's not?

With some it begins as a child; yep, on the playground, when the other kids call you fat. Maybe it's high school when the thin girls are the ones who get asked to the prom. Perhaps it's later on, when the thin girl gets the promotion at work. Or maybe it happens after having kids, when you feel you've lost all control of your body and want so desperately to get it back. Maybe you've just observed the women in your family long enough to know how it works and you just follow suit. Whenever this skewed perception happens to a person, it can change your life forever. Once you begin the race, it's very difficult to drop out (reaching the finish line can ultimately mean only one thing.)

Eating disorders can take a toll on every aspect of your life; financially, health-wise, and relationships. It's hard to maintain a healthy relationship when you're running to the bathroom to purge on a dinner date and later on, after every meal with your partner. It's hard to focus on work and life when what you really want to do is go weigh yourself for the 25th time that day (weight really does fluctuate throughout the day.) Do you have any idea what hell it is to go out to eat with family and friends when you have an eating disorder? You're not listening to the conversation; you're busy calculating how many sit-ups you'll have to do when you get home or how many hours on the elliptical it will take to eliminate the calories you just consumed in your salad (without dressing, of course.) So finally you just start avoiding friends and social situations. Before you know it you're all alone with your best friend and enemy; your eating disorder. And what about the money and the perplexed look on the face of the cashier at the drug stores and grocery stores, when they ring up all those tools of the trade-in bulk, might I add? These items aren't cheap. Having worked several years as a cashier myself and being able to spot a person with a problem a mile away, I know they know what I'm up to when they're ringing up my order.

At first you're complimented on your "healthy" new thinner look. Eventually concerned friends and family members plead with you to gain weight, not realizing it ain't gonna happen. (Interestingly, when your pendulum swings the other way and you put on the pounds, nobody says ANYTHING at all to you.) People that have never had an eating disorder don't seem to understand the complexity of the disease and the control of it. They think you can just stop damaging yourself one day and start eating normally again. I've had family members that plan on being hospitalized a couple of times a year for nutrition therapy, just to sustain them through another several months of binging and purging. I've had friends go through gastric bypass surgery, just to regain all the weight within a very short time; again, control, control, control. Just watch me-I can stretch my stomach out again like before-showed you! Very self-defeating. And because we're on our little power trip, we are convinced we can stop the self-inflicted damage whenever we want.

This disease isn't at all glamorous, although it's very difficult convincing others in the beginning stages of the disease. There's nothing glamorous about your teeth becoming discolored due to enamel erosion; nothing pretty about rotting teeth, your hair falling out, the erosion in your throat and constant heartburn. There's nothing glamorous about being cold all the time, tired all the time, and just plain feeling sick and hungry all the time. There's nothing glamorous about having organ failure. You can fool people for a while, yes you can, thinking you're pretty smart, but sooner or later they figure out what's going on and are pretty disgusted by it. This disease affects everyone around you in a very negative way.

Intellectually we know what we're doing. We know it's bad and we know it can kill us. But like I said, perspective is totally gone. The only person who can effect change, I believe, in a person with an eating disorder is the person experiencing it. Scare tactics might work, they might not. Bullying doesn't work. Deprivation doesn't work-we're the masters of depriving ourselves! Right now I'm in the obesity phase of my eating disorder and I know that once I decide, really decide, to lose weight, it's probably not going to be the healthy way. But this is the only way I know.