COLUMBIA — Alexis Katchuk won't tell you, for instance, how much she weighed at the lowest point in her 12-year battle with anorexia. That number is dangerous: Katchuk doesn't want others who are fighting the disease to see it and falsely believe they're OK if they weigh more than she did.
She won't tell you how much she did or did not eat, either. She's not interested in comparing calorie counts, she said, adding that those suffering from eating disorders tend to get into weight and diet competitions.
That doesn't mean Katchuk won't tackle tough questions about eating disorders, though: In fact, she fields dozens of them on the blog she maintains to share stories of her recovery.
"When will the recovery weight stop feeling like you're walking around in a fat suit?" one reader asked in July.
It takes time, Katchuk responded, adding that everyone is different. For her, it was important to change the way she spoke, ridding herself, for instance, of phrases like "fat suit." She's become more honest, too: At 33 years old, Katchuk realizes her body is different than it was 15 years ago. Acceptance is key.
After years of therapy, heart problems that might have been worsened by her eating problems and a successful, although rocky, recovery from anorexia and bulimia, Katchuk is — as her blog is so aptly titled — surfacing after silence. Now, instead of keeping words in and food out, the MU graduate student is talking about the full recovery she's made from eating disorders.
Katchuk knows some will say there's no such thing as a full recovery from anorexia, but she won't describe it any other way.
Between classes that she both takes and teaches as a doctoral candidate and maintaining her blog, Katchuk is writing an autobiography about her recovery in hopes of reaching a wider audience.
"Someone has to talk about it," she said. "There's a misperception that somehow we choose to do this. It's not a choice. It really is an illness."
Nearly 10 million Americans, including a million men, are struggling with anorexia or bulimia, according to the not-for-profit National Eating Disorders Association. Some experts estimate that without treatment, up to 20 percent of people with anorexia die. With treatment, 2 percent to 3 percent die. Katchuk has known at least 10 of those people. She's since stopped counting.
Katchuk has seen all demographics in treatment with her, from children as young as 10 to adults as old as 60. She's seen men, too, although she also thinks male anorexia is underreported. It's tough enough to be a 25-year-old woman having to admit to an eating disorder, but imagine, she said, being a 30-year-old man having to get treatment for what's considered a "teenager's" disease.
College students seem particularly vulnerable.
"Although people compare themselves to others throughout their lives, it seems that college is a time in which many young women and men do feel extra pressure to fit in, be successful and look a certain way," said Jenny Lybeck-Brown, a psychologist at the MU counseling center who counsels students with eating disorders. "I think living with large numbers of same-sex, same-age peers can certainly contribute to this comparison and over-emphasis on appearance."
Her advice to students? Don't worry about weight.
"As long as they are eating reasonably healthy diets and getting some moderate exercise, there are so many more productive and fun ways to spend time at MU other than thinking about eating and weight," she said. "If appearance and/or food take up more than a small fraction of time, it might be worth getting some help — either through counseling or reading quality self-help materials."
Katchuk wasn't interested in losing weight to become attractive — quite the opposite. The upstate New York native didn't want to attract attention from the opposite sex. After being raped and abused by a friend's father when she was a young girl, having curves that garnered looks was the last thing she wanted.
Instead, Katchuk traces her early adulthood anorexia to both her abuse and an obsession with exercise. She participated in four high school sports, including track, and running gave her a sort of high.
The obsession followed her to college. At Moravian College in Pennsylvania, she participated in track and remembers losing a meet that she decided she could have won had she been thinner.
"I have no idea where that thought came from," she said. "Looking back, I had been one of the smallest. But I had the idea in my head that had I been smaller, I would have won."
Katchuk began running solo in the morning in addition to her afternoon track practices. She cut milk from her diet, then milk products. She stopped dining out with friends.
Thoughts evolved during her early dieting phase. She realized that, for the first time, she was in control.
She also decided if she lost enough weight, she'd become invisible.
"I wanted to be so small people wouldn't notice me," she said. "I wanted to disappear."
Baggy clothes helped her hide her disease, although a trip to the hospital after a suicide attempt brought it to the surface. Doctors confronted her about her weight, but if Katchuk did admit she had an eating disorder, she saw nothing wrong with it.
In late 1999, she was at her lowest weight — the one she won't disclose other than to admit it was well under 100 pounds — and was hospitalized. A three-month treatment program forced her to eat but without getting accompanying treatment for mental issues.
Katchuk gained enough weight to return to school, graduate and begin working in an outpatient mental health clinic. After a couple more trips to the hospital, she realized she wasn't in a position to help anyone else and returned to school. Treatment had helped her stop purging, but she continued to resist food.
The pattern of weight gain, loss, hospitalizations, dizzy spells and irregular heartbeats was getting old by the time Katchuk was a graduate student at American University in Washington, D.C. But her whole identity was wrapped around being anorexic.
"I knew I did not want to be sick, but I didn't know how not to be sick," she said.
With the support of professors, she called a treatment center and checked herself into the Center for Eating Disorders at Sheppard Pratt in Maryland.
It was tough. Treatment spanned 12-hour days, seven days a week. Because it wasn't close to her home, Katchuk had to stay in a hotel. To resist the urge to exercise, she'd pile everything she needed — remote, laptop, phone — on the bed with her so she wouldn't get up.
An occupational therapist had to sit with her to make sure she ate. At times, Katchuk would hold her breath before taking a bite.
"I saw the number on the scale going up with every fork load of food," she said. "The scale would go up, which meant I was getting bigger."
One of her "a-ha" moments came during treatment. It was Christmas 2005, and Katchuk's brother brought her then-18-month-old nephew to see her.
"I love that boy," she said. "I didn't like the idea of him visiting me in the hospital. I couldn't be an active part of his life in and out of the hospital. I didn't want to be known as the 'sick' aunt."
Katchuk credits the center for her recovery, although she had a relapse.
Today, Katchuk no longer has the option to be anorexic.
Last year, she had an internal defibrillator put into her heart to combat a rare genetic disorder — a disease unchecked for years because doctors assumed her irregular heartbeats and circulatory problems were the sole result of anorexia.
She caught herself trying to restrict her dietary intake earlier this year but immediately stopped herself. That's when she knew she'd made a full recovery.
She still struggles with body image, but these days Katchuk has begun to focus less on herself and more on others. As a doctoral candidate, she's teaching two classes at MU and has worried about students who have shown signs of similar problems. A couple of students have even reached out to her for help.
She also hopes the blog shows others that a life after anorexia is possible.
"I want people to know they can recover," she said. "Recovery doesn't mean bliss — it's still real life out there — but I want to give people hope and shed light on steps I took to recover from eating disorders. The main thing is to let people know you can do it. At some point, it's up to you to choose whether or not you want to recover. That doesn't make it any easier, but it is a choice."