Preface I have carried this book around inside of me for years. At age twenty-five, far from the gluttony of college and even further from the angst of adolescence, I suspected I might finally be rid of the gagging noises echoing in dorm bathrooms and the scrape of plates sliding against Formica tables. I thought I might be able to feign ignorance about the next wave of thirteen-year-old girls discovering the ritual language of self-hatred -- fat, disgusting, weak, worthless . But then my best friend -- one of the few girls I had ever been close to who had not had an eating disorder -- looked at me, eyes wet with tears, and admitted that she had been making herself throw up after meals. I felt the hope leak out of me, like air out of a punctured balloon. Then my small-town cousin came to visit me in the big city, and as we wandered the echoing halls of the Met, she admitted that she felt, as I had in college, often on the edge of an eating disorder. I felt rage. Over coffee and some history homework, a fourteen-year-old girl I mentor told me that her friends thought about nothing so much as their weight. I felt dread. My students at Hunter College, working-class, first-generation American, ethnically diverse, shocked me by standing up in front of the class and admitting to struggling with undiagnosed eating disorders for years and watching their mothers take out loans for tummy tucks. It wasn't just my private world either. Though few talked about it, Terri Schiavo was suspected to have had a heart attack and gone into a coma as a result of her battle with bulimia. Lindsay Lohan and Nicole Richie shrank down to nothing in plain view. Anorexic fashion models in Uruguay and Brazil, both in their early twenties, died. On websites, girls from all over the country pledged their devotion to Ana (aka anorexia) and Mia (aka bulimia) -- sharing starvation tips with anyone old enough to type in a URL. Evidence was everywhere, yet people were not talking about the cultural causes or the larger implications. Few were expressing public outrage at the amount of time, energy, and emotion being displaced onto diets and disease. When I thought about starting the conversation, it scared me. I could already hear the critics in my own head: You are making vast generalizations. You are unprepared, untrained, unqualified. How can you tell other people's stories for them? What about men with eating disorders? What about older women? Queer folks? What about the obesity epidemic? But the critics could not speak louder than the voices of my best friend, my cousin, my mentee, my students. The risk of having critics, I realized, could be no greater than the risk of losing more young women -- metaphorically or physically. And so I sat down at my computer and did the only thing I know how to do when I am in great pain and feeling powerless: I wrote. In the process of writing and reading and talking and thinking, I have been compelled to make generalizations. I know no other way to talk about culture. I recognize that there are women, young and old, who feel great about their bodies and won't connect with the mental and physical anguish I describe in this book. These lucky, rare women have sidestepped the cultural imperative to be perpetually unsatisfied with their form. I hope they will share their secrets of self-protection with the rest of us. I am not an expert on eating disorders, nutrition, health, or psychology, but I do have expertise in quiet desperation. I can spot the light fuzz that covers an anorectic's body, the mysterious disappearances that signal bulimia, the dull cast in the eyes of a teenage girl who feels bad for eating too many cookies, the real story behind the stress fractures sustained by an avid runner who can't take it easy. In this book, I act as an observer, an outraged idealist, a storyteller, a bleeding heart, an eavesdropper, and an ordinary young woman. A writer takes great responsibility when trying to speak for another -- whether that other is a best friend or a whole generation of women. While some of the stories in this book are based on my memory of past events, I am also honored to have been trusted by many women whose interviews fill this book. I can only hope that I do their stories and their beauty justice. Most of them have asked for pseudonyms (signaled throughout the text by asterisks). In some cases, certain identifying characteristics have been changed. A few of them have bravely opted to use their real names. I not only welcome but implore other young women to add their voices to this conversation. I do not intend to be a voice in the wilderness; I intend to be instead the first note in a chorus. So many are suffering from food and fitness obsessions -- the victims are becoming younger and younger, older and older, male, gay, lesbian, and transgender. In order to explore even a fraction of this terrain with any clarity, I had to construct limits (however artificial), and so focus on the ways in which young, heterosexual women feel and fear. What they believe men find "hot" feeds their obsessions with food and fitness. A version of this dynamic exists also between lesbian women and between gay men, but I have not gathered the evidence necessary to address the ways in which it is undoubtedly different. This is intended to be not the definitive book on food and fitness obsession, but a beginning. The obesity epidemic, which I explore in Chapter 8, is in truth the flip side of the same coin. Being underweight or overweight so often stems from the same roots: a society of extremes, struggles for control, learned behavior, self-hatred. I talk throughout this book about food and fitness obsessions as existing along a spectrum. Being on either end of the spectrum -- totally obsessed or completely unengaged -- is hazardous to your health. These extremes are crippling our society's collective economic, intellectual, and even spiritual health. Copyright (c) 2007 by Courtney E. Martin Excerpted from Perfect Girls, Starving Daughters: The Frightening New Normalcy of Hating Your Body by Courtney E. Martin All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.