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March is Women's History Month!

Mother Speaks Out After Losing Daughter To Bulimia

JACKI LYDEN, HOST:

This is TELL ME MORE, from NPR News. I'm Jacki Lyden. Michel Martin is away. Coming up, he's walked the runway in both menswear and women's wear. He's even modeled as an haute couture bride. We'll learn the secret to Andrej Pejic's unconventional beauty and gender-bending in just a moment.

First, we go behind closed doors, as the program often does on Mondays. That's where we talk about issues people usually keep private, and eating disorders are that kind of issue.

Up to 24 million Americans of all ages and genders suffer from these illnesses, according to the National Association of Anorexia Nervosa and associated disorders.

Today, we want to focus specifically on bulimia. It's when people go through frequent cycles of binge eating, followed by purging. Judy Avrin lost her daughter, Melissa, to this illness in 2009, and she helped make a documentary about her teen daughter's battle with bulimia to help other families and educators and health care workers understand this disease.

In the movie, Judy Avrin admits that she spent some time in denial about her daughter's condition. Here's a clip.

(SOUNDBITE OF MOVIE, "SOMEDAY MELISSA: THE STORY OF AN EATING DISORDER, LOSS AND HOPE")

JUDY AVRIN: And then I found, in her drawer - in her dresser drawers - glasses with chewed up and spit out food in it. Melissa was absolutely and totally resistant to even talking about it.

LYDEN: That was Judy Avrin in her film, "Someday Melissa: The Story of an Eating Disorder, Loss and Hope." And she recently showed the film about her daughter at the National Institute of Mental Health here in Washington, D.C. It's also being screened at colleges and community groups.

Judy Avrin joins us in the studio now. Thank you so much for coming in, and we're very sorry about the loss of Melissa.

AVRIN: Thank you. And I'm proud and happy to be here and share her story.

LYDEN: This film was inspired by many things, by this devastating illness within your family, by the writings you found in your daughter's journal about the arc of her life. There's one entry that so gets to the heart of the matter. It's a poem that she wrote. Judy, would you please read it for us?

AVRIN: Someday, I'll eat breakfast. I'll keep a job for more than three weeks. I'll have a boyfriend for more than 10 days. I'll love someone. I'll travel wherever I want. I'll make my family proud. I'll make a movie that will change lives.

LYDEN: Which is exactly what you've done here. How did it feel to find that poem, and was that the inspiration for the film that you've made?

AVRIN: The poem, I actually didn't see the first time I read through the journal. I had finally gotten up the courage to read it about two months after she died. And after I did, I honestly thought about putting the journal in a drawer and forgetting about what she'd written. And it was sometime later when I was speaking to the director, he mentioned someday, and I went back and read the poem, and I got chills.

LYDEN: It isn't only this poem, which is so remarkable, but her writings in her journals throughout the arc of her illness really got quite profound, and there's a lot of recognition there, which sort of goes to show the grip of something that she was in. She died in May of 2009, but you start the film, really, with her childhood.

AVRIN: Melissa was a happy, healthy, creative, funny, very normal child. And it was around the age of 13 that she began struggling with the body image issues that ultimately led to the depression and the eating disorder that took her life. It was even certainly harder for my husband to understand it, but I do talk in the film about my own history with bulimia. I battled with it for many, many years. But my eating disorder was not as severe as Melissa's, so I think it allowed me to minimize the early warning signs.

LYDEN: In this arc of her life, things start to change, and she's withdrawing in school and she's about 14. So what were some of the things you were seeing?

AVRIN: She would start wearing baggy clothes, and that's a really classic sign of somebody who's just not comfortable with their body. Large amounts of food would start to disappear, but we were the house that a lot of the kids would come to. So both of my kids had, you know, friends in and out of the house and then the really, really classic sign that I didn't know until much later was she developed really severe constipation. And if the food is - and if it's going in and coming out, or if it's not going in at all, you're not going to have a normal digestive system. And we had many, many visits to doctors and gastroenterologists before anyone ever uttered the word eating disorder.

LYDEN: And what was your husband's reaction when that diagnosis was made?

AVRIN: He did not understand, as many people do, that it's something really serious.

LYDEN: And people also think it's a choice?

AVRIN: Which is one of the biggest misconceptions there is. It's not a choice, and as hard as this is to understand, it's not about the food. It may start as wanting to lose a couple of pounds, but it can transform very quickly into disordered eating and turn into a full-fledged eating disorder. And at that point, it is a mental illness.

LYDEN: I want to talk about that aspect of its being a mental illness, because I don't know much about bulimia, but I will say here that I grew up very much with - in the presence and with - and love - a mentally ill mother. And there's a clip in this film that I think really links it to the profundity of mental illness itself and how someone becomes someone else.

And this is where your son, Melissa's brother, is talking about seeing your daughter out on the sidewalk in front of the house at night.

(SOUNDBITE OF MOVIE, "SOMEDAY MELISSA: THE STORY OF AN EATING DISORDER, LOSS AND HOPE")

UNIDENTIFIED MAN: In the bitter, freezing cold, she's going through the garbage out on the curb looking for something to eat. And I went outside, and I yelled her name. Just the way she looked back at me was so empty, vacant. It was a deer in headlights, but that doesn't explain it.

LYDEN: At this point, even you say she's in the grip of something that feels like a demon.

AVRIN: She really wanted to get healthy and get well, but it would so control her and she wouldn't be able to eat moderate amounts of food.

LYDEN: You had to lock up food. You couldn't leave anything in the house. The cupboard had to be either bare or, you know, have a lot of shots in the film of a lock over a trunk of food. And that made the house - the fact of you locking the food, Judy Avrin, was like it made the house less of a home.

AVRIN: It did. And what I want you to understand, that came years into her illness, and it would be at times when she was, as I said, so in the grip of this eating disorder that she would consume anything. And if she did, it meant she would have to purge it.

LYDEN: If you're just joining us, this is TELL ME MORE, from NPR News. I'm Jacki Lyden. We're talking with Judy Avrin about her documentary about her daughter, "Someday Melissa: The Story of an Eating Disorder, Loss and Hope."

One of the things that you did for Melissa was send her to a kind of self-confidence camp in Idaho, and that becomes kind of a celebration, in the end, for your family. Let's listen to how that goes for her in Idaho.

(SOUNDBITE OF MOVIE, "SOMEDAY MELISSA: THE STORY OF AN EATING DISORDER, LOSS AND HOPE")

UNIDENTIFIED WOMAN: (as Melissa Avrin) Dear Mom and Dad, I finally made it through my first week here, and so far what I've worked on is realizing what I do and why I do it. I'm not going to justify my past actions. They were wrong and dangerous and careless, and I'm so sorry I hurt you.

AVRIN: It's a wilderness program that works with kids with all kinds of problems, drinking and drugs and eating disorders. And by the end of - I believe it was six weeks - she was so incredibly proud of what she had accomplished. She rediscovered the joy of being healthy.

LYDEN: Which is one of the things you show in this film, and I think that's so great, Judy Avrin, that we don't only see her as a collection of symptoms. Did you feel, after the wilderness camp, that you'd turned a corner?

AVRIN: Absolutely did. And she was about to turn 18. And, generally, kids who come from programs like this need a transition, and it's better not to come right back home. And we had selected a therapeutic boarding school for her to go to. And while she was there, she truly rediscovered the joy of her brain. She was incredibly bright, an amazing writer. She tutored other kids. So in that sense, that next stage was positive, but the eating disorder came back in full force.

LYDEN: But she would eventually get into even the college she wanted.

AVRIN: Yeah. She wanted to be a filmmaker, and Emerson College was her dream school. And a week before she died, she got a phone call. And then a week after she died, the big envelope came.

LYDEN: Why did you want to make this film? You must think that there are many misconceptions about bulimia.

AVRIN: There are so many misconceptions. The general public, I think - to them, the face of an eating disorder is somebody with anorexia, extremely underweight, malnourished, the bones protruding. A typical bulimic generally will be within normal weight ranges, and that makes the eating disorder invisible.

LYDEN: Melissa was within normal ranges?

AVRIN: Absolutely. You know, her weight varied from time to time, but people would tell her she looked so great, you know, not knowing that she was purging and...

LYDEN: And I think perhaps another thing that's not known is the devastating toll that it takes on the internal organs. The lack of potassium weakens the muscles. This is really not precisely starvation as we may think of it, but you are doing devastating things to your organs.

AVRIN: Right. And that's ultimately what took Melissa's life. She had a heart attack because her body chemistry was so out of whack. And you also don't have to be sick for a long time. All it takes is one time that you purge and your electrolytes or your potassium are out of whack, and you can have a heart attack.

LYDEN: Had you worried - I want to ask you frankly, Judy Avrin - that she might succumb? That she might die?

AVRIN: Never. Never. I always believed she would recover. Even as difficult as it is to go through this cycle, I always believed she would recover.

LYDEN: So what has been the most helpful thing? She passed away May the 6th, 2009. What do you think - as you've had some time now, several years, nearly, to live with this?

AVRIN: Making the film, first of all, was an incredibly therapeutic way for me to channel my grief. And what has come from the film - and I say I would trade it all in a heartbeat to have her back.

LYDEN: Obviously.

AVRIN: But she is so inspiring others around the world, and I get emails, truly, on a daily basis. I got one the other day from a young woman in Texas. I'm 26 and I realized months ago, after hearing Melissa's story, that I have so many somedays I still want to live, and I'm fighting for my recovery. Or I'll hear from people - from families who say watching this film made me understand my child's eating disorder unlike anything else has.

And therapists are using it for treatment and intervention. And she's giving other people hope.

LYDEN: You've really made her live again.

AVRIN: Thank you.

LYDEN: Judy Avrin is the co-executive producer of the documentary about her daughter, "Someday Melissa: The Story of an Eating Disorder, Loss and Hope."

Thank you so much for making this documentary about your late daughter and for coming in and sharing your story with us.

AVRIN: Thank you. It's been an honor. Transcript provided by NPR, Copyright NPR.