My Anorexia Recovery Transcended my Cuban and Working Class Roots

My weight plummeted to a skeletal 60 pounds after nearly a year of self-starvation

Anorexia Carmen Cusido

Photo courtesy of Carmen Cusido

My weight plummeted to a skeletal 60 pounds after nearly a year of self-starvation. It was March 1997, and I was being admitted to an eating disorder hospital in suburban New Jersey. At first, I felt I stood out as a 13-year-old Latina from a working-class town compared to the young white women walking around the unit. But soon, my race and class status were irrelevant.

I had been a gluttonous and slightly overweight child, but a combination of bullying and a bout of food poisoning kick-started my rapid weight loss. The fact that my parents were Cuban worked in my favor during the initial descent into my eating disorder: they couldn’t fathom why their American-born daughter would willingly starve herself. They took me to several doctors and even considered booking a visit with an oncologist, thinking my weight loss could be related to cancer.

After I was officially diagnosed with anorexia, many of my teenage Latinx peers from Union City, New Jersey, dismissed it as a “rich girl’s disease.” But, my eating disorder transcended race and class. Anorexia made me feel like I finally belonged and had friends after constantly feeling like I stood out. Since fifth grade, I became the favorite target for bullies. While some of my pre-teen peers were flirting with boys (some even getting their first kisses) and coasting in class, I boasted about playing with dolls and proudly identified as a nerd. I stood out when conformity was king. When I spoke to fellow anorexics, we had a shared language: discussing “fear” foods (foods we avoided for fear of gaining weight), showing off about how much weight we’d lost, and exploring ways to outsmart the staff so we could continue feeding our eating disorders.

The Eating Disorder Unit (EDU) I eventually went to shifted from feeling like a prison to an exclusive social club. Though my mother took early retirement due to her health issues, she worked as a teacher for many years, and her health insurance was better than most. That’s how I was accepted as an in-patient at such a nice hospital. I’d never slept over at a friend’s house or gone to summer camp. This was the first time I’d be away from home for an unknown period. Though the hospital was about an hour’s drive, it felt like a million years away in terms of culture shock.

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Most of the hospitalized teen girls and women were white and at least a few years older. Until then, I had primarily interacted with fellow Cuban American kids during summers in Miami or children from various Latinx backgrounds in my hometown.

My mom, Magaly, befriended a Puerto Rican woman while the hospital staff registered me. We were in front of the nurse’s station with my father when the smiling 30-something woman walked by. The older woman was there for a binge-eating disorder and had mentioned to my mom that she had a 12-year-old daughter. While Mom focused on the similarities and looked visibly relieved to find a fellow Latina who could watch over me, I was racked with anxiety: twisting my chest-length hair and fidgeting in my wheelchair, still too weak to walk.

“Puedes sentarte con mi hija cuando almuercen? ¿La puedes vigilar?” my mom asked her.  “Claro que sí, no te preocupes, yo la cuidaré,” the woman responded.

I smiled politely but was furious. I wanted to scream at my mom for intruding – asking the woman to watch over me and not giving me any choice. My mind was so consumed with my disorder – with my quest to remain thin, even if it killed me – that I assumed I would just become fat by association. If I sat with the that woman, I’d balloon up to her weight, I thought.

After lunch, I met my roommate, a 17-year-old fair-skinned brunette from rural New Jersey. While most other girls that age are eager to choose a college from among their acceptance letters or get ready for prom, as I imagined I’d be doing in a few years, this teenager proudly stated she hadn’t had her period in the last two years. She’d been in and out of hospitals for four years and seemed enamored with anorexia. And she was one of the first to teach me “tricks” to help cheat the system at the EDU.

“You’re allowed to drink up to two cups of water before bed,” the brunette said. “Make sure you hold in your pee the next morning before the weigh-in. It’ll seem like you weigh more than you do.” She also gave pointers on hiding food on your plate to make it seem like you’re eating more and how to sneak food to the bulimics or binge eaters.

My identification with anorexia quickly overshadowed race and class issues. Whenever we didn’t break for mealtimes or group therapy sessions, the other young women and I would swap tips and tricks. When choosing meals for the week, it was important to primarily pick proteins, as eating too many carbs can make you gain weight. Others discussed vigorous exercise rituals to prevent pudgy stomachs.
The other patients and I self-segregated based on which eating disorder we had. That became our primary affiliation. Soon, the staff noticed that I was easily influenced by my 17-year-old roommate and decided to pair me up with another person.

I dubbed my second roommate the “belligerent bulimic,” or BB. She tended to self-harm and had been transferred to the EDU from a different psychiatric unit where people who were a danger to themselves got everything from pencils to shoelaces removed. The staff at the other psych unit noticed the 13-year-old vomiting everywhere. BB would unsuccessfully try to hide the foul-smelling “evidence.” The team there wasn’t equipped to deal with her bulimia, so she was transferred to the EDU.

The only similarities between my second roommate and me were our skin tones and ages. She was also 13 but was of Mexican heritage, adopted by a friendly Italian American couple, and lived in the suburbs. BB didn’t speak Spanish. Unlike me, a child who was always respectful to adults, even when I disagreed with them, my new roommate seemed angry at the world and herself, as evidenced by her past self-inflicted cut marks and cursing out nursing staff repeatedly.

My initial alliance with her — and other bulimics — was one of self-preservation. During our heavily monitored mealtimes, where staff walked around each table to see what and how much we were eating, I’d find a way to sneak food under the table to hand off to my roommate. It would appear as though I were eating more, and BB would find a way to purge somewhere (though thankfully more in the common areas and never in our bathroom-less room).

But the dietitian placed me on a 4,600-calorie meal plan: a way to help restore me to a healthy weight sooner. No amount of sneaking food under the table could help me. Neither did the fact that my plate sat mostly untouched meal after meal. The medical team there, including a clinician, psychiatrist, dietitian, medical doctors, and others, decided it was time for more drastic measures: a nasogastric tube that went from my nose to my stomach and would be connected to an IV-like bag attached to the pole. Inside the bag was a milky Ensure-like substance meant to supplement whatever calories I wasn’t eating naturally.
Initially reluctant, my parents consented to the nasogastric tube since I was near death.
Meanwhile, though I had eschewed race and language barriers, they were still major issues for my parents regarding my treatment. Both my mom and I had to translate everything for my dad, who not only needed help with the language barriers, but he had trouble understanding my mental health needs and why I became anorexic in the first place.

“Why would she choose to starve herself in a rich country like this?” was Dad’s go-to phrase in Spanish.

After a full year at the unit and two additional years of outpatient treatment, I eventually recovered. I learned universal therapy fail safes in the process: practice self-care, eschew toxic relationships, and focus on what you can control. My recovery took years of unlearning negative cultural stereotypes about women’s bodies: the American message about thin bodies and the Cuban message preferring curves.

In the past two decades, we’ve learned as a society that mental illnesses, including eating disorders, are intersectional. People ranging in age, ethnicity, gender and sexual identities have experienced eating disorders like anorexia, yet the media still predominantly portrays white, cisgender, heterosexual women as the de-facto face of eating disorders. I’ve also since recognized how difficult it was for my parents — especially my dad — to overcome linguistic and cultural barriers to my care.

Since my initial diagnosis and struggle in 1997, I’ve also learned that my identity has gone beyond both my anorexia and my working-class background. Though my experiences have shaped who I am, ultimately there’s more to me than my past struggles. My body doesn’t exist to live up to the expectations of others.

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