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Rachael Golden⁄The GazetteTina Malament works on T-shirts to raise awareness about eating disorders in her dorm room at American University last month. ‘‘It’s not glamorized,” she said. ‘‘It’s saying, I’m anorexic and it’s not a good thing and I’m going to do something about it.”
Then 15, she had already passed out twice that morning at her home in Gaithersburg. She hadn’t eaten for two days.
Malament, now 19, remembers looking into the bathroom mirror and saying out loud: ‘‘I guess maybe I am anorexic.” Then, she resigned herself to the truth.
‘‘You stop fighting it once it becomes your identity,” she told The Gazette during an interview near her college campus.
Malament, who recently completed her freshman year at American University in Washington, D.C., and was crowned queen of the 2005 Montgomery County Agricultural Fair last August, is a recovering anorexic. She has struggled with an eating disorder since she was 10 years old.
‘‘My hobby became starving. My hobby became counting calories,” she said, adding that she still knows how many calories are in a single bite of certain foods.
But now she’s more vocal about her battle and its consequences.
For the past several months, Malament has designed, painted and sold T-shirts to raise awareness of eating disorders and their silent truths. She wears the T-shirts around AU’s campus and the city.
In their lifetime, an estimated 0.5 percent to 3.7 percent of females suffer from anorexia, which is characterized by self-starvation and excessive weight loss, and an estimated 1.1 percent to 4.2 percent suffer from bulimia, according to the National Institute for Mental Health in Bethesda. An increasing number of males also suffer from the illnesses.
‘‘People think it’s very easy just to eat,” said Carolyn Weiss, an advanced practice registered nurse at the Suburban Center for Eating Disorders and Adolescent Obesity. ‘‘It’s truly a very, very dangerous disease. People die. That’s important for people to know. ... The sooner you get treatment, the sooner you are able to turn it around.”
Malament’s T-shirts reflect the statistics. The front of one pale pink shirt reads: ‘‘20 percent will die from their anorexia.” Some research indicates that anywhere from 5 percent to 20 percent of people with anorexia nervosa who don’t receive treatment die.
The back of the shirt asks ‘‘Is it worth this?” above a list of 18 side effects associated with the illness, including ulcers, hair loss, infertility and kidney failure. Other side effects Malament lists include fatigue, depression, shame and isolation.
The last side effect she lists is heart failure.
Malament, who now lives in Washington, D.C., is studying psychology and literature at AU with hopes of one day helping girls just like her.
‘‘I’m trying to get myself under control so I can do that,” she said. ‘‘It’s hard to say eating disorders are bad when I still have this relationship with mine.”
That’s what makes the T-shirts so important to her.
‘‘I’ll often wear it when I have a bad day,” Malament said. ‘‘That’s why I put the question on the back. Because I need that reminder more than anyone else.”
She said friends and acquaintances are surprised to learn Malament has an eating disorder.
‘‘It’s not glamorized,” she said of the T-shirt. ‘‘It’s saying, I’m anorexic and it’s not a good thing and I’m going to do something about it.”
Malament raised her voice in April during a book discussion at Barnes and Noble in Rockville. A crowd of about 100 gathered to hear Germantown resident Frank Warren talk about his project and book called ‘‘PostSecret,” which shares the secrets strangers send him on post cards.
Malament, who wore one of her shirts, stood up and talked about her illness and the T-shirt project.
At the end of the book discussion, several teenaged girls approached Malament. One petite girl with blond hair pulled back in a ponytail quietly asked Malament to send her a T-shirt, but she didn’t have the money to pay for one.
Malament told her she would send her one for free.
The girl hugged her. Malament hugged her back.
‘‘It will be OK,” Malament whispered. ‘‘It will be OK.”
Malament took an active role in 4-H and Montgomery County Agricultural Fair activities. She was home-schooled, which made it easier for her to hide her problem from friends.
‘‘It’s a tough disease,” said Carolyn Weiss, the nurse at Suburban Hospital’s center for eating disorders. ‘‘It’s also a very secretive disease. It’s hard to talk about it with your friends. It’s hard to talk about it with your therapist.”
When friends asked Malament if she was hungry, she would go through the typical responses to hide the truth: she already ate, she didn’t feel well, she would eat later. Once, a friend asked if Malament was anorexic and she laughed it off.
‘‘If you can keep projecting who you are and you’re happy about it, they’ll accept it,” Malament said. ‘‘Or at least they’ll accept that you’re not going to talk about it.”
When she was 16 she told her parents she wouldn’t eat with them at the table anymore.
After an unsuccessful year with a pastoral counselor, Malament bounced between several other professional therapists during her middle teens.
But still the need for control was there.
‘‘A lot of it was I wanted to be invisible and fade from view,” she said. Baggy clothes and long hair helped her ‘‘disappear into myself.”
These are indicative of larger issues that can lead to an eating disorder, Weiss said.
‘‘Sometimes it’s triggered because you need to lose some weight to fit into your bathing suit,” she said. ‘‘But then you go beyond that and there are other issues that have nothing to do with weight.”
Abuse, depression, anxiety disorders or mood disorders can all play a role in developing an eating disorder.
Malament said she struggled with depression. She saw controlling what she ate as a form of punishment.
‘‘You turn shock into ‘Wow, I can do something that no one else can.’ You believe that you’re stronger than anyone else,” Malament said, while sipping a drink at Starbucks. ‘‘But, it’s not strength, it’s weakness, and you don’t realize that.”
A turning point came in 2004. Malament was depressed and hit her lowest weight.
‘‘It was really desperation that made me seek therapy,” Malament said.
Weiss said more people are seeking treatment than ever before. The center sees people of all ages, from girls as young as 7 to those in their 60s.
Therapy is crucial to recovery.
‘‘Until we can address those symptoms and manage those things, you aren’t going to be able to control it,” Weiss said. ‘‘It takes a lot of work. It can be a five- to seven-year process.”
The therapist will work with the patient’s doctor and a nutritionist.
‘‘It’s a very scary process. It’s a process that you want to get better but you might not like to get better,” Weiss explained. ‘‘As you gain weight, it’s very scary.”
Now, Malament, still very thin, sees a therapist in Bethesda once a week.
‘‘It feels like I’ve been good forever,” Malament said. ‘‘In reality, it’s just been a couple months of maintaining my weight. ... There are good days and there are bad days.”