Kathy Carey used to rise each morning before her husband and children, even before the sun, to go on a ten mile run. Many of her friends admired her for her athleticism and physical appearance.

She often heard people comment "I'd love to have legs like yours." Her husband frequently told her how proud he was of how she looked. Even her doctor said that she was impressed with her ability to drop the weight so quickly after giving birth to her third child.

What these people did not realize was that they were reinforcing Kathy's beliefs that she had to be athletic and thin to be accepted. They did not realize that Kathy, at 5'4'', had gradually dropped from 115 to 85 pounds. They were feeding into her obsession about her weight that resulted in a 35-year addiction to what she calls "bulimarexia," or limiting her food intake while purging herself through exercise. Statistically, although anorexia and bulimia primarily affect people in their teens and twenties, doctors have found cases of children as young as six and adults as old as 76. And the disorder is usually rooted in childhood difficulties, as was the case with Kathy.

It's not good enough

As the daughter of an alcoholic father, Kathy feels that she learned at an early age to be a "people pleaser." She and her siblings were taught to not bring out their father's bad temper, which their mother wrote off as just letting off steam. In addition, Kathy says that her parents often pushed her and her siblings to be the best at whatever they did, emphasizing excellence in academics and athletics. She has said that anorexia is "the disease of the perfect little girl."

"I went to a private school, which was very difficult," Kathy said. "One time I brought home a report card with five A's and one B, and all my dad could say was 'what's with the B?' I immediately felt defeated."

Situations like that caused Kathy to study long and hard to meet the expectations of her parents. She said that she spent all her free time studying, during which she would nervously play with her eyelashes until they all fell out or bite her nails until there was nothing left. To make sure she knew the answers for tests, she would memorize entire chapters of her textbooks.

Although she places no blame on them, Kathy feels that her family environment taught her to force herself to meet everyone's expectations without making her own standards. She had a difficult time finding a peace within her life, or herself.

"The unspoken message was that 'this wasn't good enough,'" she said.

In high school, Kathy was an all-around athlete, participating in field hockey, volleyball and soccer. During her entire high school career, her parents only came to one of her field hockey games, which she did not mind because it removed the pressure to be perfect. The day that they did come, though, she remembers that it was raining and the field was wet, causing the girls to slide and fall constantly.

"When the game was over, all my dad could say was 'you fell all over the place.'"

In college, which she adds was before Title IX, she played a variety of club sports. After college, she brought her athleticism and drive to please others with her into her adult life.

Running on empty

After college, Kathy's desire to perfect herself manifested itself in running and swimming. Besides obsessively exercising, she would go for days without eating and then go on binges of about 1,000 calories, which she says is still a binge for an anorexic. Afterwards, she would feel extremely guilty for eating at all.

She recalls one time when she just could not suppress her hunger anymore and began bingeing on rice cakes and peanut butter. "As I was eating I saw my reflection on an appliance and saw the pieces of rice cake and peanut butter on my face and felt guilty," she said. It was a winter day, so she threw on a sweat suit and began doing laps in her pool. "I was thinking 'you have to do this, this is what you deserve. This is your punishment,'" she said.

She describes exercise as her "fix," similar to the addiction of a drug user.

"Running was such an endorphin release. It was the high of using my drug, the drug of choice being not eating and then exercising," she said. "I had to have my fix."

Kathy ran every morning, and often competed in local 10-kilometer races. She usually averaged a 6:45 mile pace, a decent time for a 34-year-old woman with three children, and often went home with age-group awards.

One time, she and her husband decided to run a 15-kilometer race together in Tulsa as a way for them to spend time with each other. Instead of bonding, Kathy says that she was obsessed with how the race would affect her eating habits. Because it was longer than she was used to racing, she hoped she would be able to eat more afterwards without feeling guilty.

"It wasn't a bonding or romantic time," she recalls. "My only thought was how many calories I would burn. I was going to allow myself to eat a hamburger and fries for dinner afterwards. I had been planning that dinner for weeks."

Surprisingly, Kathy said that despite dropping below 100 pounds, her frailness had no effect on her ability to run. "There is an endorphin release when you don't eat," she said. "And I think it was easier on my joints, especially since I was only pushing around 85 pounds."

Despite the highs she received from her addiction, Kathy started to accumulate medical problems. She stopped having her period and started having heart arrhythmias, which she said felt like heart attacks. As an athlete, though, nobody seemed to notice the correlation with her eating habits, exercise obsession, and health problems.

"I could tell she had a problem, but she would hide that. I didn't see what she was doing to herself," her husband, Stuart, said. "She got to a point, she was so frail, just a shadow, but I was so close to it that couldn't see it because it was a gradual loss."

Kathy describes herself at this time as having a "boyish figure" with very muscular legs. Although other parts of her body may have hinted at her disorder, she was constantly receiving complements from both friends and strangers. She felt that she could not stop her habits because she wanted to maintain this positive view to everyone. She did not want to look like she had given birth to three children. Kathy wanted to look like a winner would look.

"Human Doing is not Human Being"

Kathy said that it was not her health problems or appearance that made her realize that she had a problem, though. It was her lifestyle. "It wasn't because of the eating disorder -- my life was bigger than I could handle."

Many people with eating disorders are also obsessive-compulsive, as was the case with Kathy. "I always had to make it bigger and better than everything. I needed praise, that's what I lived for," she said. She recalls that before she was treated for her disorder, she would vacuum her 10,000 square foot home in lines and would use an industrial-strength buffer on her wood floors, often scolding her children for walking on them when she was done. (She admits that this was silly, because where else were they supposed to walk but on the floor?)

Each Halloween she would hand-make her children's costumes simply because she loved the complements she received. She also would invite 50 or so friends and neighbors to her home for dinner, and then the kids would all go trick-or-treating together.

"I didn't enjoy the time with the people," she said. "The enjoyment came from planning it. There were always these huge plans, but by the actual day, I was so tired of it. It was so big that it just wasn't fun."

Also, after family vacations, Kathy would not be able to rest until she re-cleaned her house, looked through all the mail and then paid all the bills. "There was little joy in my life, no peace, no serenity, no quiet moments," she said. "It's hell on earth, a self-made jail."

Kathy was a very active member of her community when she lived in Oklahoma City. While she was spending her time exercising and serving the community, she realized that she was not doing anything for herself. As she describes it, "Human doing is not human being." Looking back, she realizes that because of her eating disorder, she might not have been the easiest person do deal with.

"My actions were angry and I was not committed emotionally."

Kathy says that she had an aversion to intimacy that made her difficult to work with within the community and at home. Instead of taking the time to play with her children, she felt that her involvement in their schools and the community was enough. She later realized that she and her children missed many opportunities to create happy memories.

"When I was running, it was the only time I felt alive, had a purpose. I put all of my energy into my run and the rest of the day did not count for anything. I didn't care about my kids or my husband." She fixed meals and did other things that wives and mothers are expected to do, not because she wanted to, but because she felt they were measures of judgment. She also adds that she and her husband's intimacy level was non-existent, simply because she was too fatigued. "She just went through all the motions of motherhood and wifehood," Stuart said.

The negative effect she had on her family, she says, was the worst part of her disorder and one of the things that she came to realize when she hit rock bottom. She believes that although she did it in a different way, she had the same relationship with her children that her parents had had with her.

"It was that same demanding that my parents did," she said. "I withheld love and spent more time scolding and shaming. [If I kept going,] I would have achieved what my parents did." "It was heartbreak," she recalls. "I didn't want to be that person. I had to change this."

Hitting Bottom

At the age of 35, Kathy finally reached her turning point when a friend presented her with a book about the adult children of alcoholics. She was skeptical at first, but soon came to realize that she had a problem.

"My friend said, 'Kathy, I think you have an eating disorder,' and I was like 'no, I'm a runner.' She really made me mad," Kathy remembered.

Kathy is not sure why, but she eventually picked up the book and began reading, and then began weeping as she realized that it was indeed the story of her life. For example, because of her obsessive-compulsive tendencies, she would do things like not answering the telephone when it rang.

"I started reading about things like isolation keeps people from answering the phone," she said. She realized that she had a problem, but still did not understand that it was an eating disorder. At this point, Kathy put herself into counseling, which she adds was not that popular 15 years ago. She found her counselor to be very beneficial. "He just revealed things to me," she said.

She knew that her problems stemmed from the experiences of her childhood, but even her therapist did not tell her that she had an eating disorder. He did promise her that there was a way for her to stop hurting and recover, and she quickly agreed to follow his plan.

He sent her to the Sierra Tucson ranch for 30 days of individual and group counseling. Even at this point, she recalls telling people who told her she was anorexic that she did not have an eating disorder; she was a runner. It did not take her long once she was in the program to realize that she did indeed have an eating disorder.

"She finally got confronted enough with it," Stuart said. "She finally broke."

For one week during her stay, Sierra Tucson hosted a family week and invited her children, who ranged in age from six to 10 at the time, and husband to participate in the healing process. The experience was a real revelation for Kathy.

"My children told my about a woman they lived with that I didn't know," she said. And the kicker, "My husband asked me for a divorce." Although they began dating when they were both 15, just sophomores in high school, he told her, "I can't do this anymore. I don't want to be a part of it."

Stuart had not gotten in touch with his anger over the situation until arriving at Sierra Tucson, which made the situation difficult. Towards the end of the week, Kathy began to come to terms with recovering on her own, without her husband or her children. "I realized that all I could do was change me," she said. But towards the end of the week, in a group session, couples were asked to make a "what do I love about you most list." As he was going through his list, which included things like the smell of her hair in the morning, Stuart started crying, and they decided that they would work together towards recovery.

"I started thinking about it: it was so romantic. I realized at that point that I am not giving this up. I'm going to beat this thing," Kathy said.

The Road Ahead

After returning from Sierra Tucson, Kathy did everything she was told to. She entered a 12-step program and drove an hour each week to an eating disorder specialist. She stopped her excessive exercising and she and her husband began marriage counseling.

"When she came back from treatment, it was excruciating the way we had to deal with things. It was like learning a new language," Stuart said. He added that they were able to pull through as a family because, as parents, they realized that they had to break the cycle of dysfunction so that it wasn't passed on to their children.

The Careys also became practicing Christians, and Kathy believes that her therapy and God both pulled her out of her addiction. "I never believed in anything but myself," she said. "As I hit bottom, I came to the Lord and built myself around faith. It made recovery bearable to do." "It certainly was a spiritual experience for all of us," Stuart said. "The first 35 years were golden, but I all of a sudden came to realize that I couldn't control the chaos that was there. I got in touch with how powerless I was. We all got in touch with our own weaknesses and became Christians as a result."

Over time, Kathy lost the obsessive-compulsive urges she had, and best of all, she stopped worrying about what she ate. Two years after she began counseling, food was no longer an issue for her.

"The lifestyle difference is so incredible," Stuart said. "We're so close as a family, and so close to our kids. The quality of life and the relationships we have now are just incredible."

Statistically, Kathy says, not many people recover from eating disorders and it has the highest incidence of relapse among addictions. With treatment, 60 percent of people recover, 20 percent make partial recoveries, and 20 percent never recover.

"She looks great," Stuart said. "She's very athletic looking, slim but shapely. She doesn't look like she's 50 -- most people think she's 35."

During her recovery, the Careys moved from Oklahoma City to Tucson to start over. "Allowing yourself to start over in a new physical environment best thing we ever did," Stuart said.

Stuart said that he and his family are now able to look back and appreciate the entire experience for its educational value.

"You don't know what you had until you lose it," he said. "I learned so much about what I didn't want to be as a man or a husband. As painful as it was, it really was a blessing."

Sharing Her Experience

Kathy has been able to turn her experience around to help others who are struggling with eating disorders. She currently spends her time performing a two-person play on eating disorders at high schools and colleges. She describes the plot as "the story of my life."

She is encouraged by the fact that she is able to make a difference in the lives of some of the girls who see her perform. At the conclusion of the presentation, Kathy says that audience members are often crying, and that local counselors usually see an increase during the following week of students who decide to seek help with their addictions. According to ANAD, one percent of female adolescents suffer from anorexia and four percent of college-aged women have bulimia. Kathy has been doing this service for the past three years.

Kathy also is known around her town as a survivor of an eating disorder. She will often get calls from girls or their families. "They just come out of the woodwork," she said. She always makes time to talk to these girls and introduces them to a therapist with an eating disorder certificate.

"A lot of girls I talk to do go into treatment," she said. "It's nice to be able to talk to someone and to see the realization in their eyes that 'I'm not crazy.'"

In addition, Kathy works with counselors in Tucson by meeting with people who have sever cases of eating disorders in hope that they will benefit from hearing her story.

"They can see where it has taken me," she said. "And it's not just 18-year-olds, some are 40-year-old women."

"The way she gets them to open up and share is a gift," Stuart said.

Seeking help

Kathy has much advice for those who think that they might have an eating disorder. She tells people to "just get honest with it instead of running and hiding from it." The longer someone waits to seek help, she believes, the worse it will get.

Kathy warns that many people know very little about eating disorders, including school counselors. She recommends that people seeking help make an appointment with someone who specializes in eating disorders.

She also says that athletes are particularly in danger for developing eating disorders without anyone realizing it, especially college athletes under pressure to perform well. Sometimes, they will be doing so well that they think the eating disorder is helping them, when it will only get them worse later.

"It really is a meat market. It's almost like a golden handcuff. It's a prison with a lot of perks," she said of Division I sports. "Athletes are doing something so healthy, and that can be a fooling thing."

According to the NCAA, 93 percent of eating disorders occur in women athletes, and those most at risk are participants in cross country, gymnastics, swimming, and track and field for women, and cross country and wrestling for men.

Breaking the Cycle

Ever since she began treatment, Kathy has become extremely close with her family. Her oldest child is now 25, and her daughter is playing Division I volleyball in North Carolina.

"The good news is that it is a cycle that can be broken," she said. "I've got incredibly healthy children."

Although she no longer rises before everyone else to get her run in, Kathy still exercises to stay healthy. But she looks at it very differently now.

"I have to make myself go to the gym now," she said.

Teresa Joerger

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