Skinfold measures. Skinfold calipers, discussed above, can be used as a measure of fat distribution as well as a total fat measure with specific body sites (such as subscapular) being used for relative measures of fat loss.

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“Who made me such a pig?”

“Why is my child starving herself?”

“Why am I so disgusting?”

“How come I’m such a loser?”

“Where did I fail as a parent?”

“What did I do?”

“What didn’t I do?”

If an eating disorder has shattered your life, questions like these constantly bewilder you. All of these questions derive from one dominating issue:

“Whose fault is it, anyway?”

The question is simple. The answer, however, is complex. We all want to know who’s responsible. For every problem, there must be an identifiable cause, or someone to take the blame. At the end of our favorite television shows, guilty criminals always blurt out: “Yes, your honor, I did it! I killed the man!” Simple, tidy endings that resolve all the riddles and tie up all the loose ends make us feel better.

Eating disorder victims want desperately to solve the mystery of their illness. The urge to place blame is so strong that a bulimic often “confesses” to a crime she didn’t even commit: “It’s all my fault,” she thinks. “If I were stronger, I’d be more in control. I’d be thin.”

Others sometimes step forward to share the guilt. When a child develops an eating disorder, family members search frantically for information about it. They talk to friends, scan magazines at the checkout counter, or listen to health experts on radio and television talk shows.

Unfortunately, they often wind up with wrong information. They might read, for example, that children starve themselves because their parents give them too little attention, or too much attention, or the wrong kind of attention. Given such conflicting signals, who wouldn’t be confused? The parent thinks, “It’s all my fault. If I were a better mother [or father], I wouldn’t have caused my child to act this way.”

Or they might hear that children are more prone to develop an eating disorder if their families have a history of psychiatric disorders, such as depression or substance abuse. Parents naturally conclude that their child’s illness results from their own troubled situation. They torture themselves by thinking, “It’s all our fault – we should never have had children.”

Round up the suspects, book ‘em, and throw away the key. Let me assure you: Self-blame is wrong, dead wrong. Such mistaken thinking only contributes to the severity of an eating disorder. Even worse, such attitudes can actually interfere with therapy, making it more difficult for a patient to seek, receive, and respond to treatment.

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“Food was everywhere,” Maria recalls. “Fast food at every corner. Snacks anytime you wanted them. It was great.”

What Maria got hooked on was not burgers, however. It was soft drinks. She drank 10 cans of sugar-laden cola a day. She went from a trim 130 pounds to 162 pounds in a year. Then, she discovered that her cola habit was costing her 150 calories a can. At 10 sodas a day, that was 1,500 calories a day, or 10,500 calories a week!

Maria quit the colas cold turkey, trading them for calorie-free water. She also cut back on fried foods and started eating more fresh foods, especially fruits and vegetables, just like she used to do in

Venezuela. And she took a full-time job as a nanny for triplets, which gave her plenty of exercise.

In 2 years, she was back to her former weight.

“I still’drink at least eight glasses of water every day,” says Maria, now 28. “Soda doesn’t cross my lips.”

W INNING A C T I O N

Can the soda pop. One of the easiest ways to reduce your calorie intake is to substitute water or flavored water for sodas and sugary fruit juices. What about diet sodas? Researchers at the Centre for Human Nutrition in Sheffield, England, found that people who drink beverages loaded with artificial sweeteners such as aspartame actually eat more food.

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