Moderate Drinking for the Former Anorexic
Problems with regulating consumption don't stop after eating is a non-issue.
Posted Feb 08, 2014
Years ago, while researching my book How to Disappear Completely, I spent some time flipping through a photography book on eating disorders. I ended up discussing my opinion of this book at length in my work (spoiler alert: I am not a big fan) so I won’t write about that here. What I’ll focus on, instead, is something surprising I noticed in one interviewee’s daily intake of food. The item on the menu that struck me was a glass of wine to be consumed at 6:09 PM (or some other ridiculously specific time.) I thought, then, that this seemed very atypical for anorexics, usually so hesitant to cloud their disciplined mind. A glass of wine seemed like it would fall too easily into the category of “indulgent”––empty calories that would lead, particularly to someone who hadn’t consumed much else, to a heady intoxication. And when intoxicated, didn’t one risk dropping his or her guard and wandering toward the cupboard?
Since then, however, I’ve read a number of articles about how people with eating disorders are increasingly using alcohol in destructive ways, articles that usually employ the cutesy term “drunkorexia” to describe the behavior. The articles mostly focused on how people with eating disorders would save their calories for alcohol, thereby getting drunk twice as fast. By this point, I unfortunately had some personal experience with the issue, and no longer believed it odd that an anorexic would allot herself one glass of wine every evening. The foundation of the problem was created like this: during my later years in college, in periods of health, I had been able to engage in what was then normal social activity: keg parties and bar hopping. I therefore associated drinking with the carefree sensation of being able to fraternize as a “normal” twenty-something, which I had always opined when I was lonely and ill. When I began to relapse after college, I kept drinking as if doing so would prevent others from knowing something was wrong. (Spoiler alert again: didn’t work.) My tolerance dropped alongside my weight, which dropped in tandem because I often had wicked hangovers during which I couldn’t keep my food down––an added bonus for someone who had no interest in digestion. Fuzzy from a glass of wine, I’d experience a burst of energy that my nutritional reserves couldn’t afford me on their own. Occasionally I’d drink until I got an enormous case of the screw-its and attacked a jar of peanut butter left carelessly in my kitchen. Oh well, I’d say by means of self-comfort, that’s a good thing, right? Because you should be eating more.
All this to say that I had in many ways come to see alcohol as something associated with social normalcy and eating––which I was constantly told I ought to be doing more of––and had learned to appreciate the calming salve of booze on my usually fretful mind. But as I began to recover from my anorexia in earnest, I didn’t find my need for sedation lessen; in fact, it grew exponentially. In many ways, the anorexic life is quite simple, and a healthy life––one that can include complex relationships, employment, and emotions galore––requires way more managing, or drowning, of anxieties. Drinking was remarkably effective at that. I found myself approaching alcohol the way I still, admittedly, approach food: voraciously. I imbibe quickly, the same way I shovel food into my mouth, the complete opposite of the methodical, crawling way with which I used to consume. There is an interesting biological factor here, at least when it comes to the nutritional part: as Dr. Shan Guisinger writes in a 2012 paper, the hypothalamus, which registers appetite and satiety, continues to send out elevated hunger levels long after a person has resumed normal eating. (Authorial intrusion: the hyperlink doesn’t seem to be working, but the paper is readily findable via Google, and is a very interesting read.) This is an attempt on the brain’s behalf to protect against a state of famine, in retrospect or in advance. The emotional equivalent of this, I believe, can be translated to many aspects of ingestion. It was as if I believed that at any second, the ability to eat or drink––or relax––might be snatched away from me. Better take advantage now, I would think, because you might never have this chance again.
After a few particularly disastrous experiences with drinking too much, I decided I needed to address the unhealthy way in which I was using alcohol, but I, like many people, believed that there was only option for problem drinkers, and that was attending Alcoholics Anonymous and becoming abstinent. In truth, the abstinence part didn’t really bother me. I had periods of self-imposed sobriety before, and in many ways had enjoyed them. What frightened me more was the all-or-nothing tenets of AA, which gave me unpleasant flashbacks to when I had lived a life according to fanatical rules involving eating or drinking. It was, in some sense, a trauma survivor’s reaction: when considering the idea of indoctrinating myself into a belief system that espoused rigid intake requirements, I simply panicked, feeling as if in some way I was in the presence of a beast that had once ruled me. (This isn’t entirely logical, I know, but nobody said the brain––or heart––handles trauma rationally. There is a correlation here with exercising, but I’ll save that for another post.) The concept of complete abstinence wasn’t unappealing to me; rather, it was seductive in the sense that the Spartan anorexic lifestyle and credo were, and anything that reminded me of living that way made me feel small, powerless (which I suppose is the idea) and terrified. For years, I had been taught that achieving moderation in all things was the ideal, and, hard as I found it to achieve this in any capacity (it’s quite a difficult endeavor for many people!), I wanted to believe it was possible. I also felt like if moderation was something I had trouble maintaining throughout my life––living without was never really the issue––it was perhaps the thing I ought to work hardest at. On January 1st, nursing the most intense hangover of my life, I stumbled across Gabrielle Glaser’s op-ed about moderate drinking in the New York Times, and decided to give a group therapy program called Moderation Management a try. I’ve been working at the program––which requires one to mindfully monitor alcohol consumption––for almost two months now, with a good deal of success. I can say, at the risk of jinxing my progress, that I am very hopeful about my future as someone who can snack and drink casually but thoughtfully.
This is not to say that I deny the enormous impact Bill Wilson and the 12-Step program has had on the lives of so many addicts and their loved ones. I am not in a position to tell anyone that the way they choose to alleviate their struggles is misguided. But neither, I believe, is the spirit of Bill Wilson or other 12-step adherents, or, indeed, moderation proselytizers. Part of the idea of living a moderate life, far beyond having balanced habits, is being able to accept all shades of virtue, from black to white to anywhere in-between, and respecting the unique challenges that every individual faces, and the unique solutions they find.