A Politician’s Disclosure Offers a Lesson in Eating Disorders

Christine C. Quinn, the City Council speaker and a Democratic candidate for mayor, revealed in The New York Times on Tuesday that she battled bulimia for over a decade, from her midteens until she entered a rehabilitation program at age 26. Though other public figures have discussed their struggles with bulimia - Katie Couric and Jane Fonda are two examples - it’s a rare disclosure for a politician. Ms. Quinn also said she considered herself a recovering alcoholic, which is a less unusual distinction.

I’ve written about my own experience with anorexia, and edited a book of essays about anorexia and bulimia. Because of that, much of what Ms. Quinn told me in the course of two emotional interviews, including her shame and denial about her illness and how important it was to finally accept that she needed help to deal with it, was familiar. My experience also made me it easy for me to understand that Ms. Quinn’s bulimia was about much more than wanting to lose weight.

In the last year or so, as Ms. Quinn has been gearing up for her campaign for mayor, she has talked about how she has lost 25 pounds through healthy eating and exercise. Her bulimia was something quite different, though, and quite a bit darker.

A frequent and understandable misconception about eating disorders is that they are simply an extreme and slightly dysfunctional form of dieting. Bulimia â€" which is characterized by bingeing and purging, usually by self-induced vomiting â€" is particularly misunderstood. When it’s invoked on television or in movies, it’s often a joke and a marker of superficiality: A character who is a model or an actress eats a normal meal and then disappears to the bathroom to throw it up. In real life, many people respond to the idea with disgust.

Bulimia, like anorexia, begins with an effort to lose weight, but it only takes hold and becomes a serious illness if bingeing and purging start to fulfill an emotional need. In Ms. Quinn’s case, when she was 15, her mother was dying of cancer, and she shouldered more and more responsibility in her family. Her description of her family during the two interviews suggested that they had trouble talking about her mother’s illness and its consequences, including her mother’s heavy drinking.

In a typical case of a child’s magical thinking, Ms. Quinn believed that if she were more perfect, her mother would get better. As her mother’s health deteriorated, she heard girls at her Catholic high school talking about purging to lose weight. This was the early 1980s, when eating disorders were just starting to be talked about. Ms. Quinn said this weight-loss trick sounded like “the greatest idea I had ever heard.”

As it turned out, purging didn’t help Ms. Quinn lose weight, she said, but it did something more powerful: It gave her a sense of control over her out-of-control life and brought her a momentary relief from pain and stress. As she explained, though, the relief got briefer and briefer, which caused her to binge and purge more and more often, in an effort to recapture the feeling.

Although the physiology is not well understood, researchers have compared the experience of bulimia to that of drug addiction. Some research suggests that people with bulimia have brain abnormalities similar to those of people who suffer from cocaine or alcohol addiction. What Ms. Quinn described about the feeling of relief becoming briefer is what is known in drug addiction as building tolerance.

In my book, “Going Hungry,” one writer, Latria Graham, traced her bulimia in part to her parents’ fractious marriage. She was also a cutter. Cutting herself, she explained, offered her a form of relief from her roiling emotions like the relief from bingeing and purging.

(Interestingly, the family story in one of the book’s essays, “Hunger Striking,” by Maura Kelly, bears a strong resemblance to Ms. Quinn’s past: Irish Catholic family, mother dying of cancer, parents not telling daughter that mother is dying, daughter feeling to blame for mother’s illness and death.)

My own anorexia arose in a much less gothic context, out of more mundane conflicts. I first developed anorexia when I was 10. I had changed schools and was lonely and unhappy, and putting myself on a diet - though I was not fat - seemed like a sensible way to improve myself and perhaps fit in better. With the help of a doctor and a therapist, I regained weight by the time I entered high school (though not before missing my chance for a growth spurt).

I relapsed in my freshman year of college. The immediate trigger was performing in a play in which I was to appear in my underwear. But, on a deeper level, I was struggling with adapting to college and with my inchoate ambitions, for which I had not yet found a productive outlet. So the outlet I chose was starving myself. Being hungry sharpened my concentration and made me feel capable of great intellectual feats; soon I was addicted to it. In the long run, though, as my body wasted, the high gave way to depression. As in Ms. Quinn’s case, the decision to seek inpatient treatment in my junior year of college, as difficult as it was, was critical in helping me recover. Now, at 33, I have been healthy for many years. Although therapy helped, I feel as if my career as a journalist played as important a role, since it finally gave me the outlet that I had been seeking.

Ms. Quinn said that her need to be perfect drove her professionally, as well as contributing to her bulimia - and while she was still suffering from bulimia, her professional success was a solace.

“My mother had a clear message to Ellen and I that we were to succeed as women,” she told me, referring to herself and her sister. “And in the times in my life when I thought that the extent of my personal happiness might not be what I would have wanted, I always knew that I could be professionally successful.”

Over a long period, beginning with her time in rehab, she said, she let go of her need to be perfect, along with her guilt about her mother’s suffering and death. She said the final step in her healing was meeting Kim M. Catullo, who is now her wife.

Asked how that changed her professional life, she said: “It made my work more fun. It made me most of the time ease up on myself, not in how hard I work but in my frustration when things don’t work all the time.”