When your weight is your world

Chris Kemp

Looking at herself in the mirror, Liza Huber sees a healthy, confident college freshman. However, her path to that stage in her life was difficult.

At the beginning of her 9th grade year, Huber started to feel unhappy. This, she said, was the first sign of what was to come – her battle with anorexia nervosa.

“I sat down one day and thought about how I could make myself happy,” Huber said. “I thought that maybe if I lost a little weight I would be happier.”

She started by cutting out just a few things from her diet, she said. She lost a little weight, so Huber said she thought it would be good to lose a little more. This went on for a few months, but by December her parents started to notice her weight loss.

“I think there were a couple of things that we noticed right away,” Huber’s mother Nancy Huber said. “We first noticed that she was not happy and that there was a change in her behavior.”

They sat down with her and asked her what would make her happy, Nancy said. Things like a phone in her room, Huber said, would make her happy, but her parents realized that wasn’t going to help.

“Then we started noticing the weight loss,” Nancy said. “After we noticed the weight loss, we took her to a pediatrician.”

The doctor told her mom it was adolescence, and that her body was working itself out, Huber said.

Something is wrong

Around Christmas, Huber’s eating disorder became apparent.

“I was always cold because I was losing all of my fat and muscle,” Huber said.

There was an assignment in her health class where she had to write down everything she ate for four days, she said.

“I wrote down everything that I ate, which averaged about 400 calories per day,” Huber said. “My teacher saw it and said, ‘Way to watch what you are eating.’ How could a red flag not have gone up, especially for a health teacher?”

The disease made her withdraw from her friends and social life as well, she said.

“I didn’t want to be around them because they were eating,” Huber said.

In February, her mom asked her if something was wrong, and she said no. Around that time her mom also started weighing her, she said.

“A couple of months passed and she was still losing weight,” Nancy said.

Her parents called the pediatrician again, who told them to monitor her weight.

“Every Saturday after lunch I would get weighed,” Huber said. “The eating disorder started playing games with me and I would put weights in my pockets so that it looked like I was the same weight.”

Her mother brought her to the doctor for a regular check-up in April and the doctor gave her a surprise weigh-in, which she was not prepared for, she said.

“My parents freaked out and brought me to the hospital emergency room (because of my weight),” she said. “They said I was medically stable so they released me, but they told us to call the Methodist Hospital eating disorders unit.”

Huber called the ED unit and the receptionist asked her some questions, like how much weight she had lost and how she was feeling about herself, she said. The receptionist told her she should come in for a physical assessment.

Days before treatment

Her friends noticed the changes as well and had gone to her guidance counselor three days before her assessment, Huber said.

“She told my friends not to worry about it,” she said.

Huber said she went in for an assessment on May 22, her 15th birthday, and talked with a psychologist, a dietician and a doctor.

Huber said she was weighed at her lowest weight of 105 pounds for her 5-foot-8 1/2-inch frame.

“I had gone from being medically stable to medically unstable,” she said, which means her vitals were so dangerously low that she was admitted as a patient to the ED unit.

At the hospital

“You had half an hour to eat each of your three meals per day and 15 minutes to eat each of your three snacks per day,” Huber said. “When you are in a hospital, no matter how much fluff you put on the walls, in the end, it’s still a hospital.”

You meet with your psychologist and psychiatrist two to three times a week, your doctor everyday and a dietician to set-up your meal plan, she said.

“It’s huge compared to what you were eating before,” Huber said. “But it’s small compared to the meal plan you end up with at the end.”

If you don’t gain weight steadily, the doctors increase your meal plan, she said.

“We were weighed backwards everyday so we didn’t know how much weight we were gaining,” Huber said.

You have to eat everything on your plate and there are people watching, she said. There were girls who tried to be sneaky by sticking their butter pads to the underside of the table.

“Some people would try to do anything and everything to not eat,” Huber said. “If you didn’t eat everything, they would give you a type of energy drink. If you didn’t drink that, they force-fed you through a feeding tube.”

Long term effects?

Susan Krueger, a senior lecturer of Biology, said anorexia nervosa might start out in a few cases as a diet, but there are much deeper concerns.

“Concerns include the need for control and in many cases, low self-esteem,” she said. “It’s very, very difficult to treat. They need not only physical treatment, but emotional therapy as well.”

The severity of long term effects of anorexia, Krueger said, depend on the length of time the disease goes untreated.

“If it is caught early and they get nutritional help and get that weight back on, there is not necessarily long term effects,” she said.

The big if, is if it is caught early, and they gain enough weight to get their menstrual cycle back, the effects will be less severe. The loss of their menstruation, however, leads to early osteoporosis and possible reproductive problems, Krueger said.

“In long-stage anorexia, eventually it is going to take a toll on some of their vital organs,” she said. “Especially their heart muscle, as the body will use those lean tissues as an energy source.”

Inpatient treatment

In the beginning of treatment, you spend most of your time in the Day Room, Huber said, where you can only do activities sitting down so you don’t burn any calories.

You are constantly being monitored at the hospital, she said. The door is cracked when you use the bathroom and showers so they can hear if you are making yourself sick or exercising.

“Some girls tried to do jumping jacks in the showers,” Huber said.

If you followed the rules and you were improving, you were allowed to spend some of the day in your room, she said.

If visitors brought gifts, they were searched Huber said.

“We weren’t allowed to have magazines or watch television,” she said.

You had individual therapy a few times each week and family therapy once a week, Huber said.

People who have an eating disorder, Nancy said, go through stages. The first one is denial of having a problem.

She wanted to help her child so much, but she realized she couldn’t. They have to want to get better, Nancy said.

“The hardest thing for me as a parent was just kind of that helplessness,” she said. “But we knew that because she was in treatment, it was the best thing for her.”

Even though her disease has taken a large toll on her, Huber said she feels terrible about hurting her family.

“I was lucky that my family lived only half an hour away from the hospital,” she said. “They were very supportive and I really appreciated them visiting.”

Her friends also visited her throughout the process.

“I realized who my friends really were,” she said.

After treatment, though, her relationship with her friends didn’t really go back to “normal,” partly because she had changed, Huber said.

“When I first came back it was kind of weird,” she said. “We never really talked about (the disorder).”

Huber said the average stay for inpatient treatment is three to six weeks. Her stay was for 30 days.

“It got really frustrating, because I was ready to be done and move on,” she said.

Partial to outpatient treatment

From inpatient treatment, Huber went to daily partial treatment, which included group therapy and trips to restaurants to get her accustomed to the real world setting again.

“It was like ‘OK, here’s what real people do,’ ” she said. “It was relearning what normal eating was like and what normal activities were.”

Huber was in this program for another 30 days. She said it was better than inpatient treatment because she slept in her own bed. Then she started outpatient treatment.

At first you meet with your doctor once a week, Huber said. Then, once every other week, then once a month, until it is no longer necessary to meet. Huber stopped her outpatient treatment in the winter of her junior year in high school.

“I am proud now,” she said. “If I am hungry I eat something.”

Rebuilding

Huber said it was a very difficult experience with many ups and downs that she had to work through.

“I’ve just accepted that it has been part of my life,” she said. “I look at it now and I can use my experience to help other people.”

Huber said she and her family want to help spread the word about eating disorders. Last year they took part in a community video which focused on eating disorders, obesity and dieting, she said.

“If we get information out to people, that is our mission,” Nancy said.

Now in college, Huber said she is part of the university organization Students Against Eating Disorders.

“We have a weekly support group,” Huber said. “It’s helpful because until you have actually had an eating disorder, you really can’t relate.”

She said it’s discouraging to see some Web sites out there that say anorexia is simply a lifestyle choice.

“Anorexia is not a lifestyle choice and it shouldn’t be anyone’s choice,” Huber said. “Stepping on the scale 20 times per day is not a life.”

She said some people don’t understand that when you have an eating disorder, you can’t just eat. Huber said it was like another person was with her inside her head.

“It’s so frustrating because people are like, ‘She just did it for attention,’ ” Huber said. “It’s not like you sit down one day and decide, ‘I want an eating disorder.’ ”

Huber thought losing weight would make her happy, but it didn’t, she said.

“There is a cycle that you get into where you’re never going to be good enough,” Huber said. “You can always lose five more pounds.”

After her struggle, Huber said she is optimistic about the future.

“I know what I need to have,” she said. “I know that an eating disorder is not the way to go.”