Wasting disease

I ate nothing but cottage cheese and rice cakes. I was a set of bones hunkered over a tiny saucer. What was I feeling? What was I trying, so desperately, not to feel?

Editor's note: From the book, Appetites: Why Women Want, by Caroline Knapp. Copyright 2003. Reprinted by arrangement with Counterpoint Press, a member of the Perseus Books Group. All rights reserved. - - - - - - - - - - - -

May 22, 2003

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What is this drive to be thinner, prettier, better dressed, other? Who exactly is this other and what does she look like beyond the jacket she's wearing or the food she's not eating? What might we be doing, thinking, feeling about if we didn't think about body image, ever? These are the questions that pain me when I think of myself at twenty-one and twenty-two and twenty-three, a set of bones hunkered over a tiny saucer, nibbling at those miniature squares of apple and cheese. What was I feeling? What was I trying, so desperately, not to feel?

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I have probably grappled with the matter of appetite my whole life -- a lot of women do; we're taught to do battle with our own desires from a tender age, and reinforcements are called in over time on virtually every front -- but if I had to pinpoint a defining moment in my own history, I'd go back twenty-three years, to an otherwise unmemorable November evening when I made an otherwise unmemorable purchase: a container of cottage cheese.

Innocuous as it sounds, this would actually turn out to be a life-altering event, but the kind that's so seemingly ordinary you can't consider it as such for many years. Certainly, I didn't see anything remarkable happening at the time. I was nineteen years old, a junior at Brown University, in Providence, Rhode Island, vaguely anxious, vaguely depressed. I was also, less vaguely, hungry. This was 1979, Thanksgiving weekend. I'd gone home to see my family, then returned to campus the next day to write a paper. My roommates and most of my friends were still away, I didn't especially feel like slogging over to the campus cafeteria to eat by myself, and so I put on my coat and walked up the block to a corner grocery store, and that's what I bought: a small plastic tub of Hood's cottage cheese and a solitary package of rice cakes.

Cottage cheese, of course, is the food God developed specifically to torture women, to make them keen with yearning. Picture it on a plate, lumpy and bland atop a limp lettuce leaf and half a canned peach. Consider the taste and feel of it: wet, bitter little curds. Now compare it to the real thing: a thick, oozing slab of brie, or a dense and silky smear of cream cheese. Cottage cheese is one of our culture's most visible symbols of self-denial; marketed honestly, it would appear in dairy cases with warning labels: this substance is self-punitive; ingest with caution.

I didn't know this back then, which is important to note. Naturally thin, I'd never given my weight much thought before, and although I knew plenty of women who obsessed about their thighs and fretted over calories, I'd always regarded them as a rather alien species, their battles against fat usually unnecessary and invariably tedious, barely a blip on my own radar. I, in turn, had very little personal experience with cottage cheese. I'd never bought cottage cheese before, I'm not sure I'd even eaten cottage cheese before, but on some semiconscious level, I knew the essential truth about cottage cheese -- it was a diet food -- and on some even less conscious level, I was drawn to it, compelled to buy it and to put it in the mini-refrigerator in my dorm room and then to eat it and nothing else -- just cottage cheese and rice cakes -- for three consecutive days.

And a seed, long present perhaps but dormant until then, began to blossom. A path was laid, one that ultimately had less to do with food than it did with emotion, less to do with hunger than it did with the mindset required to satisfy hunger: the sense of entitlement and agency and initiative that leads one to say, first, I want, and then, more critically, I deserve. So as inconsequential as that purchase may have seemed, it in fact represented a turning point, the passage of a woman at a crossroads, one road marked Empty, the other Full. Not believing at the core that fullness -- satiety, gratification, pleasure -- was within my grasp, I chose the other road.

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One of the lingering cultural myths about gender is that women are bad at math -- they lack the confidence for it, they have poor visual-spatial skills, they simply don't excel at numbers the way boys do. This theory has been widely challenged over the years, and there's scant evidence to suggest that girls are in any way neurologically ill-equipped to deal with algebra or calculus. But I'd challenge the myth on different grounds: Women are actually superb at math; they just happen to engage in their own variety of it, an intricate personal math in which desires are split off from one another, weighed, balance, traded, assessed. These are the mathematics of desire, a system of self-limitation and monitoring based on the fundamental premise that appetites are at best risky, at worst impermissible, that indulgence must be bought and paid for. Hence the rules and caveats: Before you open the lunch menu or order that cheeseburger or consider eating the cake with the frosting intact, haul out the psychic calculator and start tinkering with the budget.

Why shouldn't you? I asked a woman that question not long ago while she was demurring about whether to order dessert at a restaurant.

Immediate answer: "Because I'll feel gross."

Why gross?

"Because I'll feel fat."

And what would happen if you felt fat?

"I hate myself when I feel fat. I feel ugly and out of control. I feel really un-sexy. I feel unlovable."

And if you deny yourself the dessert?

"I may feel a little deprived, but I'll also feel pious," she said.

So it's worth the cost?

"Yes."

These are big trade-offs for a simple piece of cake -- add five hundred calories, subtract well-being, allure, and self-esteem -- and the feelings behind them are anything but vain or shallow. Hidden within that thirty-second exchange is an entire set of mathematical principles, equations that can dictate a woman's most fundamental approach to hunger. Mastery over the body -- its impulses, its needs, its size -- is paramount; to lose control is to risk beauty, and to risk beauty is to risk desirability, and to risk desirability is to risk entitlement to sexuality and love and self-esteem. Desires collide, the wish to eat bumping up against the wish to be thin, the desire to indulge conflicting with the injunction to restrain. Small wonder food makes a woman nervous. The experience of appetite in this equation is an experience of anxiety, a burden and a risk; yielding to hunger may be permissible under certain conditions, but mostly it's something to be Earned or Monitored and Controlled. e = mc2.


During the acute phases of my starving years, I took a perverse kind of pleasure in these exhibitions of personal calculus, the anxious little jigs that women would do around food. Every day at lunchtime, I'd stand in line at a cafe in downtown Providence clutching my 200-calorie yogurt, and while I waited, I'd watch the other women deliberate. I'd see a woman mince edgily around the glass case that held muffins and cookies, and I'd recognize the look in her eye, the longing for something sweet or gooey, the sudden flicker of No. I'd overhear fragments of conversation: debates between women (I can't eat that, I'll feel huge), and cajolings (Oh, c'mon, have the fries), and collaborations in surrender (I will if you will). I listened for these, I paid attention, and I always felt a little stab of superiority when someone yielded (Okay, f*ck it, fries, onion rings, PIE). I would not yield -- to do so, I understood, would imply lack of restraint, an unseemly, indulgent female greed -- and in my stern resistance I got to feel coolly superior while they felt, or so it seemed to me, anxious.

But I knew that anxiety. I know it still, and I know how stubbornly pressing it can feel, the niggling worry about food and calories and size and heft cutting to the quick somehow, as though to fully surrender to hunger might lead to mayhem, the appetite proven unstoppable. If you plotted my food intake on a graph from that initial cottage cheese purchase onward, you wouldn't see anything very dramatic at first: a slight decline in consumption over my junior and senior years, and an increasing though not yet excessive pattern of rigidity, that edgy whir about food and weight at only the edges of consciousness at first. I lived off campus my senior year with a boyfriend, studied enormously hard, ate normal dinners at home with him, but permitted myself only a single plain donut in the morning, coffee all day, not a calorie more. The concept of "permission" was new to me -- it heralded the introduction of rules and by-laws, a nascent internal tyrant issuing commands -- but I didn't question it. I just ate the donut, drank the coffee, obeyed the rules, aware on some level that the rigidity and restraint served a purpose, reinforced those first heady feelings of will and determination, a proud sensation that I was somehow beyond ordinary need. I wrote a prize-winning honors thesis on two hundred calories a day. The following year, my first out of college, the line on the graph would begin to waver, slowly at first, then peaking and dipping more erratically: five pounds up, five pounds down, six hundred calories here, six thousand there, the dieting female's private NASDAQ, a personal index of self-torture.

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Who has the best features? This was a little game, conducted several times and always with the same results, in seventh grade, the time when so many of life's little horrors begin. A very pretty and popular girl named Jill, a leader of the in-crowd, organized the event during recess, gathering seven or eight of us around her on the steps by the school's entrance and beginning the scrutiny. My friend Jen always got best skin, rosy and smooth. My friend Nina got best hair, thick and blond. Jill gave herself best eyes, I think, but I may just be guessing (she did have beautiful eyes, large and dark and framed with the most naturally thick lashes). Me, I got prettiest hands, which felt bitterly disappointing at the time. Hands? Hands didn't matter. Who cared about hands?

If you could change any one thing about your looks, what would it be? We played this, too, frequently: Oh, I'd have Jen's skin, we'd say. I'd have Nina's hair, I'd get rid of these freckles. Once, I mentioned something about wanting curly hair instead of straight hair, and a girl looked at me and said, "If I were you, I'd get rid of those little nostril veins." I didn't even know I had little nostril veins, but as soon as I got home from school that day, I looked in the mirror and sure enough, there they were: several tiny distinct red squiggles, horrifyingly visible, creeping down the skin from inside my nose to the base of each nostril.

These were early exercises in gaze-training, a way of coaxing the eye outward instead of inward, of learning to experience the body as a thing outside the self, something a woman has rather than something she is. From seventh grade on, we would hone this skill, breaking the body down into increasingly scrutinized parts, learning to see legs and arms, belly and breasts, hips and hair as separate entities, most of which generated some degree of distress, all of which were cast in hierarchical and comparative terms, viewed in relation to others: my hair versus Nina's hair, my eyes versus Jill's eyes; this needs fixing, that needs hiding. Pore by pore, we learned to take ourselves apart.

There's no question that this way of thinking is reinforced in the world beyond seventh-grade school yards, that the art of self-dissection receives constant visual support, that it's part of consumer culture's lifeblood. Thick auburn tresses cascade across a magazine page, shiny and rich with Pantene shampoo. An enormous Maybellined eye stares out from a TV screen, each lash glossy and distinct. A calf stretches across a billboard, lean and taut in an $800 Jimmy Choo pump. American companies spend more than $200 billion each year hacking women's bodies into bits and pieces, urging comparisons between self and other, linking value to air-brushed ideals, and as the girls in my seventh-grade class graduated to high school and beyond, the imagery around us would only grow more specific, more pummeling, more insidious. Models would become more thoroughly eroticized, presented in more states of obvious arousal, with more full-out nudity and more undertones of violence; the ideals they presented would become more specific and out of reach, with more and more body parts exposed and subject to critique (butt, arms, hips, and abs as well as the traditional breasts and legs) and ever more Byzantine configurations of beauty presented (bodies with no fat but huge breasts; delicate bodies with muscular limbs; fifty-year-old bodies that still look twenty-five).

Even more dramatic would be a shift in the pitch of imagery, the level and nature of the bombardment. Around the time I began starving, in the early eighties, the visual image had begun to supplant text as culture's primary mode of communication, a radical change because images work so differently than words: They're immediate, they hit you at levels way beneath intellect, they come fast and furious. When televisions first appeared in the 1950s, the image on the screen used to change every twelve to fifteen seconds. By the eighties, the speed of change had increased to about seven seconds. Today, the image on the average TV commercial can change as quickly as once every 1.5 seconds, an assaulting speed, one that's impossible to thoroughly process or integrate. When images strike you at that rate, there's no time to register the split-second reactions they generate, no time to analyze them or put them in their proper place; they get wedged inside, insidious little kernels that come to feel like truth.

The hunger artist

Caroline Knapp's final book is both the smartest anorexia memoir ever written and a fascinating journey along the tortuous pathways of female desire.

By Laura Miller May 22, 2003 |
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The late Caroline Knapp was not Everywoman, but there were enough women -- and men -- who felt that her writing spoke directly to them to put her first book, the memoir "Drinking: A Love Story," on the bestseller list. Her second book, about the relationship between people and dogs, did nearly as well. Her third, "Appetites," published now, a year after she died at 42 from complications arising from lung cancer, may seem like the culmination of her writings just because it is the last one we'll have from her. But the scope of the book, its effort to root out all the ways that women's desires get twisted, thwarted, redirected and obliterated, using her own youthful bout with anorexia as a case in point, suggests that "Appetites" was a keystone work for her.

It's also a heart-rending one, because despite the manifest intelligence and sensitivity of Knapp's writing -- this is quite possibly the smartest and deepest anorexia memoir ever written, and it's also more than just a memoir -- she only occasionally manages to grasp the source of the agonies she details so well. It's as if she's trying to describe a yard behind a tall fence, a scene she can only catch glimpses of by jumping as high as she can. There's a flash of the other side here, and again there, but often she's just telling us about the fence. Yet you can't help but think that Knapp almost made it over that barrier, and that if she had been given a few more years she would have arrived in full.

In "Appetites," Knapp sees eating disorders as one in an array of screwed-up responses to the fears stirred up by women's cravings: for food, yes, but also for sex, love, recognition and power. She touches on everything from compulsive shopping to obsessive love affairs to self-cutting, but self-starvation remains for her the most eloquent acting out of that fear. In her early 20s, during a period of flux in her life, Knapp subsisted on a daily diet of one plain sesame bagel, a carton of coffee-flavored yogurt, an apple and a one-inch cube of cheese. At the lowest point in her illness, she weighed 83 pounds, about 40 pounds less than her normal weight.

After years of therapy, Knapp did recover, though she confesses that she never entirely shook the tendency toward "weighing, measuring, calculating, monitoring" her eating and exercise habits. (She also wrestled with alcoholism later on, as she recounted in "Drinking: A Love Story.") And as the author well knows, she has plenty of company in that self-scrutiny, even among women who have never suffered from full-blown eating disorders. "It's hard to think of a woman who hasn't grappled to one degree or another with precisely the same fears, feelings and pressures that drove me to starve."

There are several theories about what causes anorexia, but they tend to break down into one of two categories: Either the illness is triggered by a culture that demands slenderness in women while remaining profoundly ambivalent about womanhood itself, or it's a reaction to a particular kind of family dynamic -- overprotective, rigid, suffocating. Knapp doesn't subscribe to either theory; she believes that more than cultural factors are at work, and her own family doesn't match the classic profile. She does, however, feel that both elements contribute to anorexia, which, "like all disorders of the appetite, is a solution to a wide variety of conflicts and fears." Or rather, "it starts out resembling a solution: something feels perversely good, or right, or gratifying about it, some key seems to slide into place, some distress is assuaged, and the benefits of this are strong enough to outweigh whatever negative or painful feelings are aroused."

Knapp's ability to articulate the haze of neurotic thinking helps lift "Appetites" above the run-of-the-mill anorexia memoir. She writes of "the strange solace of starving -- the cocoon of safety it seemed to offer: in my own blind terror, anorexia beckoned, the memory of those early sensations of mastery and control seemed to promise exquisite relief." And also of the anorexic's "proud sensation that I was somehow beyond ordinary need" and "coolly superior" to other women. She describes the less pathological, commonplace version of feminine body-loathing as "slithering, poisonous, laced with self-contempt ... it can hit like a slap, a reflexive, often wholly irrational jolt of self-disgust that rises up from a place so deep it feels like instinct."

Knapp isn't, however, perfectly immune to cliché. She begins the book with a favorite device of writers protesting contemporary body image woes, a paean to Renoir's "Bathers," a painting in which "there is love for women in each detail of the canvas, and love for self, and there is joy, and there is a degree of sensual integration that makes you want to weep, so beautiful it seems, and so elusive." If Renoir's women could speak, perhaps they'd elaborate on the elusiveness in their time (1918) of effective birth control, meaningful and remunerative nondomestic work, and the vote, among other things. It's been damnably hard to get both forms of liberation at the same time.

Knapp knows this. She describes herself as belonging to a generation of Americans who were "heiresses of the women's movement, of the sexual revolution, of relaxed gender roles, of access to everything from abortion to education, and to a large extent, that legacy blasted open female desire." An unabashed, if somewhat baffled feminist, Knapp observes that "we had more opportunities and freedoms at our disposal than any other group of women at any other time in modern history; we could do anything, be anything, define our lives any way we saw fit. And yet by the age of 21, I'd find myself whittled down to a skeletal form." All of the energy and attention she might have spent on doing or being "anything," she instead devoted to getting through the day on 800 calories or less.

I think Knapp hits the bulls-eye when she attributes her anorexia and the other distracting and soul-sapping disorders and addictions that sidetrack her generation (and mine) to "the anxiety that crops up alongside new, untested freedoms, and the guilt that's aroused when a woman tests old and deeply entrenched rules about gender and femininity." She's less convincing when she's railing against media imagery and "seeds of self-denial" that "are still planted and encouraged" in girls during childhood.

It's not that these forces aren't noxious -- the imagery is manipulative and phony, the subtle cues to put others first are real. But the world is rife with sabotage, conflict and temptation no matter who you are, and that's not likely to change, ever. Society may eventually overcome its "ambivalence about female power," but power, whenever it's exercised, tends to push aside someone else's ideas or plans, and that's seldom wholeheartedly welcomed. It's hard to do anything significant in the world without making yourself unliked in some quarter (even if it's only among the ranks of the ineffective). Accepting that is part of the art of exerting authority, and it will never be easy. The real question is less "Why doesn't society encourage women to exert their will?" than "Why are women so easily discouraged?"

Is the lack of "entitlement" Knapp detects everywhere among her cohort imposed from without or assumed from within? The author herself seems unsure. She can readily see that her own anorexia provided an overarching and all-consuming structure for her life at a time when she literally did not know what to make of herself: "I did not think, during those years, about how scared I was of the world, or how lost and shapeless I felt." The lifting of many of the traditional rules and regulations of femininity led to this sensation (surely unknown to Renoir's bathers, or any previous population of women) of being "untethered."

For a feeling of "power and competence" to really take hold at the "visceral level," Knapp insists, "entitlement must exist beyond the self; it must be known and acknowledged on a wider plane." When it's not, as was the case with her generation, the result is a freedom that is "both incomplete and highly qualified, full of risks." But how can freedom ever not be risky? And whose freedom is ever "complete"? The dilemma facing the youthful Knapp and millions of other Western women is universal to the human condition: Freedom is not safe.

Sometimes Knapp seems to get this. "The freedom to choose," she writes, "means the freedom to make mistakes, to falter and fail, to come face-to-face with our own flaws and limitations and fears and secrets, to live with the terrible uncertainty that necessarily attends the construction of the self." On the other hand, she keeps slipping back into victimology, blaming the media for beating down women with "images of femininity that infantilize them, render them passive and frail and nonthreatening." Yet passive and frail and nonthreatening is often exactly how Knapp describes herself and the afflicted women who populate her book, so crippled by anxiety and the addictions and disorders that arise from it that they can barely keep themselves alive and functioning.

Furthermore, though Knapp complains that when "women get psychically larger ... they're told to grow physically smaller" by "a culture that was (and still is) both male-dominated and deeply committed to its traditional power structures," every instance she lists of the monitoring and dunning of women is perpetrated by other women. From the gang of friends she hung out with in high school who occupied themselves with detailing other girls' best features and worst flaws to mothers who chip away at their daughters' self-esteem to the semi-deification of model Elle MacPherson on the cover of Shape magazine, it's always a female hand that's holding the lash. The photograph of the preternaturally gorgeous MacPherson is, Knapp maintains, "as inviting to men as it is shaming to women," but let's face it: Men don't buy or read Shape magazine.

If the image of MacPherson feels like a "visual slap" to the women who see it -- and, by all accounts, for many it does -- then why do they keep coming back for more? (Memo to the disgruntled women's magazine readers of America: Stop buying this stuff, and they'll stop putting it out there.) If it's true that "ads tell us who we are supposed to be," is it also true that we have to obey them? Even the very personal factors that contribute to anorexia, what Knapp sees as a widespread inability of mothers to sufficiently love their daughters and "model" a life of fulfillment and confidence, are not ironclad determinants of women's lives. It's possible to come to terms with a difficult childhood and still attain a good measure of happiness, after all.

Or maybe we're just unlucky, born at the wrong time. Knapp laments that she "missed the feminist boat" and writes that she has "always believed, perhaps naively, that if I'd reached my college years in 1968 instead of 1978, I might have turned out quite differently, developed a more radicalized view of myself and other women." Is this -- wishing that a movement had come along to direct her life in a good way -- so very different from wishing that women's magazines would stop trying to direct it in a bad way? Either way, she would still be what she jokingly calls a "zeitgeist sheep," clay to be molded by someone else's hands.

Here's another way Knapp might have looked at it: The previous generation of feminists had the task of fighting with an entrenched power structure to secure for women the freedom of first-class citizens. It was (mostly) a public, external battle, and they triumphed on many, if not all, fronts. Knapp's generation is the first of many charged with figuring out how to live the life that's been won for them, to expand its perimeter a bit further here and there, but mostly to inhabit a liberty that is scary, confusing, perilous and demanding -- as all liberties are.

The dilemma is textbook existentialism. Some preferred the predictability and anonymity of the old prison and found a way to return to it, or, failing that, forged a new set of chains, this time imposed from within. Knapp started out wearing just such a set of self-created bonds, but eventually managed to work her way free -- almost.

Knapp is such a thoughtful and big-hearted writer I wanted her to end "Appetites" on a note of sharper clarity about women's responsibility for their own misery in this area, an inkling that she can do more than just fret about it, if only by resolving to stay away from women's magazines and abstain from participating in critiques of other women's bodies (two simple ways of counteracting the negative forces she decries). Instead, she ends on a tremulous note of hope: Maybe "feminism" will someday explore the "least-touched frontier" of female appetite, maybe her newborn niece will get to participate in "a new tide of agitation." In turn, I found myself hoping that sometime after she finished writing those words, Knapp realized that she was gazing out over a well-tended stake on that frontier, and gave herself credit for just how far she'd come.

Thank you for posting this. I had no idea Caroline had died. I used to read her column in the Boston Phoenix, years ago, and it seemed that she had no shortage of demons to contend with.