Now here's one I hadn't heard before. Researchers recently discovered that anorexics have extra fat -- in their bone marrow. The results came from radiologists at Children's Hospital Boston, who used MRI to image the knees of 20 girls with anorexia and 20 healthy girls of the same age.

MRI of a control patient's knee

MRI of an anorexic patient's knees

It's only a number. A number on a bathroom scale. But when the number ventures into new territory, higher territory, than the number to a recovering anorexic isn't just a number. It's source of panic.

Panic is a form of anxiety. It's fast. It's rush-like. It's awful. Some components are mental: an apprehensive mood. Others physical: drumbeat racing from the heart. Panic is also emotional; something is really wrong and that fear is escalating. Panic prompts behaviors such as starving oneself for a day to try and avoid experiencing the same discomfort at the offending number.

And therein lays the connection to an eating disorder.

About a year ago, I gave a talk to a group of patients with eating disorders at Sheppard Pratt. Apart from obvious signs of eating disorders (e.g., low weight), the group couldn't have been more different, given the age range was 11 to 55 years. What could I say to a preteen to which a mid-lifer could also relate?

The answer was simple: the eating disorder itself. I described what happened when my eating disorder was active. I spoke about a voice in my head, harsh sometimes, seductive others.  It cajoles me into old behaviors. I saw the nods and the tears and I knew I hit my mark.

And then one young girl raised her hand. "What do you do when you start to recover and you go back out into the world, and you start slipping back?

Here's an exercise. Take a raisin and spend some time eating it. Feel free to imagine the grape it once was swinging on a branch in vineyards bathed in sunlight. Plop it on your tongue and hold there. Take bite and experience the burst of sweetness.  Chew many times before swallowing.

Now you've performed mindful eating. Could you envision it for every meal you eat, every morsel of food?

That's the goal in a wonderful nugget of eating disorders research based on mindfulness. The practice stems from Buddhism and described as a calm awareness of one's body functions, feelings and consciousness. Some say its knowing consciousness itself. Whatever the definition, in recent years mindfulness has become part of many new therapeutic approaches, such as dialectical behavior therapy, cognitive therapy and acceptance and commitment therapy.

 

The winter holidays approaching, I thought I'd deviate from the usual "tips" and resolutions. For those in recovery from an eating disorder, here's a game of 20 questions. See if you can answer, honestly.

So I was reading a story about Grammy-winner Alanis Morissette, when a line jumped out at me.  In LimeLife, Meieli Sawyer Detoni writes about Morisette's metamorphic vegan diet and weight loss after a bout of self-indulgence and weight gain in the wake of a break up with ex Ryan Reynolds. As Detoni describes the nuts and beans, kale and collards, she writes, "the nutrient-rich diet also gave Morissette the fuel to train for and complete a marathon this year, to raise awareness about eating disorders."

Come again?

The other day, I witnessed a diet-binge in action. My colleagues had decided to celebrate November's employee birthdays with a dozen pies, set out for the taking in our lunchroom. As I walked in, I saw a co-worker digging ferociously into one of four pie wedges, piled on her paper plate. Without looking up, mouth full of chocolate mousse, she announced that she had just finished her "diet" and could now eat "whatever and whenever (she) wanted."

I thought about all those pies of birthdays past, all the treats of holidays present and all the diets of New Year's future. These food schemes will be broken by February, lamented in March and resumed by spring - just after the parade of swimsuit advertisements.

Coincidentally, I stumbled across a recent study that explains the diet-binge cycle. It's about brain chemistry and stress -- not behavior and lack of willpower.

Pietro Cottone and colleagues at Scripps Research Institute recreated a diet-binge-diet cycle in rats. The researchers fed one group of rodents alternating cycles of regular chow (5 days) and sweetened, chocolaty chow (2 days). A second group of rats ate only regular-tasting food throughout the entire experiment.

 My 13-year daughter came home from health class with a troubling assignment.

   "List everything you eat and do for the next three days," her teacher told her. "Then calculate calories taken in versus calories burned off. We'll share our logs in class."

 

 

At a recent conference at Harvard, I heard a series of talks that left me cold - and hungry. The "Aging and Healthy Lifespan Conference," focused on the latest molecular and dietary techniques to achieve life extension.
 
The presenters were an impressive team. Cynthia Kenyon, PhD, spoke about magical worms that live at least twice as long as their normal counterparts -- because of a gene mutation. Harvard's David Sinclair, PhD, talked about his work in discovering that a compound from red wine grape skins increases the lifespan of yeast, roundworms, flies and mice on high fat diets. (Sinclair co-founded a company called Sirtris that is developing synthetic drugs, based on the compound, called resveratrol, to prevent or treat diseases of aging.)
 
What left me frowning was the fact that resveratrol's fame stems from studies of caloric restriction.

At a talk I gave last fall, one audience member, a psychiatrist, asked me what I thought helps people recover from an eating disorder. My answer, in a word, is self-expression. Among the nearly four dozen women I had interviewed for Lying in Weight those who had reached bottom and then somehow found their way back had all embraced some kind of creative endeavor.

 

These women wrote, painted, danced, advocated, designed, blogged, and social networked (in a good way) their path to wholeness. And as they journeyed forward, unpeeling layer after layer of calcified hurt and pain, their projects expressed their odysseys.