I was reading an article in the December 11, 2006 issue of People magazine entitled “Anorexia, Again”, which chronicles the relapse of Jennifer Shortis into her eating disorder. When I first began reading it, I felt removed from the disease, like watching a science fiction or horror flick on TV. It didn’t occur to me to remember until after I’d finished the article that I’d once been anorexic for years. I saw my prior eating disorder as just a dumb decision made out of ignorance of the functions of the human body. It was a regret, and had I known then how much it’d affect my body’s weight regulation system and metabolism even decades after I’d stopped, I would never have done it. My body is quick to store fat and slow to burn it; skipping a couple of meals drops me into “starvation” mode and my blood withdraws, I’m suddenly freezing, and I know any food I take in at this time would go straight to fat as my body prepares for a perceived famine. It sucks. I do three times the energy output at the gym and lose less than one-third the weight (if any) of a normal person on a normal workout. So the fact that I feel distanced from anorexia now means that I’ve learned how to be healthier and that I’ve recovered, right?

That’s what I thought until I got to the end of the article — an insert giving anorexia nervosa facts:

According to a study published this year in the International Journal of Eating Disorders, one-third of anorexia patients will recover fully, one-third will have a functional recovery, and a third will battle the illness constantly. Experts offer opinions as to why.

One-third gets a full recovery? Only one-third? Was I just lucky? Was I never in as deeply as I thought? The insert goes on:

When is treatment seen as successful? “This tends to be a chronic illness,” says Dr. Esther Dechant, medical director of the Klarman Eating Disorders Center at Harvard. “Full recovery means you are fine with your body, have no [anorexic] behaviors and can eat normally and follow hunger cues.”

Uh-oh. If I’m not fine with my body (I don’t remember ever actually being “fine” with my body; even at my lowest weight point I always thought I could lose just a few more, like at least 5 lbs, despite coworkers saying I’m now “too” thin), am I being healthy and realistic, or is this a problem? And as far as anorexic behaviors, I still skip meals fairly often, but that’s cuz I feel like I’ve created a caloric surplus somewhere and need to “even things out”. I still feel massive amounts of guilt when I eat certain things and want to punish myself. Yesterday, I binged through half a bag of Trader Joe’s version of Cheetos, the reduced fat version, which gave me almost 500 calories, and then after the workout I ate more than several servings of raw nuts which I know have “healthy fats and proteins” good for me, but not in the quantity I consumed them, so I didn’t have lunch, and for dinner I had Kashi cereal because it’s the lightest thing I had at home. This morning I just had a cup of coffee. Is this a problem?

What keeps a recovery from lasting? “Relapse is based on a number of factors,” says Dr. Marcia Herrin, cofounder of Dartmouth’s eating disorders program. Among them, she says, is the weight at which patients can be released from inpatient care. “I think it is way too low. If the weight isn’t fixed, nothing else gets fixed.”

Well. No problem there. I can afford to lose about 25 lbs and still outweigh most Asian girls my height. Altho I did hear recently that Asia is just starting to have an obesity problem. Guess I’ll see when I go to China in a couple of weeks. I’d be delighted if I could be a normal sized or small girl in Asia. The last time I was in Asia, a friend of the family observed to my mother that she’s open-minded enough to see that my figure is “standard” or “correct” (biaow dzwen in Mandarin), but that to Asian standards, I’m still fat. Asians have a way of talking around their offspring as if the offspring are not there or don’t understand the language. Actually, I think she meant it as a compliment.

How long is enough time to reach a healthy weight? “Most programs recommend 90 days,” says Dr. James Greenblatt, medical director of Walden Behavioral Care. “It’s frustrating. If we had two patients at the same weight, one [insurance] company might provide two weeks of care, another a week. Once it stops being life-threatening, [insurers] feel it can be treated in an outpatient setting. We used to keep patients until they were at or about 100 percent of their ideal body weight. Now there are no set criteria. It is clear that readmission rates increased as length of stay has decreased.”

If body weight is the indicator of anorexia now, instead of the previous markers of psychological thought and habits like it used to be, then I have no problem. It used to be that someone was not clear of anorexia just because he/she is not emaciated, and the treaters of the disease used to emphasize that just cuz you’re not 70 lbs doesn’t mean you’re not anorexic or bulimic; if you constantly see yourself as fat, you overcontrol food intake or you binge-eat and then throw it up or take laxatives to eliminate, you are anorexic or bulimic.

Even in the age of HMOs, is there hope for recovery? “I see people recover,” says Herrin. “The part that ends up being key is when a client says, ‘I really want this.’ “

Since we’ve established that I’m not “anorexic” cuz I’m not starving to death, I don’t see anything about “wanting” or “not wanting” as an issue. Except that I really really want to be small(er).