05/04/2007 01:47 pm ET Updated Nov 17, 2011

Gaining : A Gift For Moms and Daughters

As the ads for Mother's Day flowers and gifts began crowding my mailbox recently - "Your mother gave you the gift of life. Give her the most beautiful gift of all," a cheesy brochure from a jeweler read - I started thinking about all that mothers give to their children. Love. Adoration. Patience. Wisdom. Then I got an email from a 14-year-old girl, who asked about another maternal bequest: "Can you get an eating disorder from your mom?"

She was wondering whether her mother's history of "extreme dieting" might be contributing to her own "anorexic tendencies," which included, she explained, exercising twice each day and skipping a meal if she ate what she felt was too much at the previous one.

Having suffered from anorexia at age eleven and having worked with teen girls as an adult, I wasn't quite sure how to answer this 14-year-old's question. Not all children of moms with disordered eating behaviors develop eating disorders themselves, and many girls who have anorexia were raised by mothers who never struggled with it. And while there does seem to be a correlation between mothers with disordered eating patterns and daughters who cross the line from complaining about their thighs while trying on bikinis to obsessing about every morsel of food that enters their bodies, it turns out that it might not be just the poor modeling around body image and eating habits that contributes to this correlation, but also a genetic predisposition to a certain type of temperament.

Confusing? You bet.

A friend who became a psychiatrist told me during her residency that she didn't want to take on patients with eating disorders because, she said, nobody understands what causes them, so nobody really knows how to treat them. She said that so many theories had been bandied about that eating disorders seem as likely to be caused by a certain type of mother-daughter relationship as the phase of the moon. And she's right: The prevalence of eating disorders in our culture has been blamed on culprits ranging from media images to societal pressure to personality factors to biochemical imbalances to family dysfunction to socioeconomic class. As a result, those who suffer from eating disorders seem to have little understanding of their illness, even after they've recovered, because during treatment, little is done to connect the dots between the myriad possible contributing factors. Meanwhile, parents talk to other parents. Psychiatrists talk to other psychiatrists. Young women talk to other young women. Parents and therapists and patients read memoirs about the experience of struggling with an eating disorder (my own included) but, depending on the author's perspective, the causative issue might be something as serious as emotional or sexual abuse to something as mundane as a tenth-grade boy making an off-hand comment about a student's weight.

Recently, though, I came across a truly unique book that explores the various theories, then, impressively, integrates them into meaningful whole through memoir, anecdotal evidence and extensive research. The book is aptly called GAINING: THE TRUTH ABOUT LIFE AFTER EATING DISORDERS, and is written by Aimee Liu, who published Solitaire, one of the first "anorexia memoirs," back in 1979. Liu's journey over the past three decades serves as the inspiration for Gaining, but I don't know why a book like this hasn't appeared earlier. It is, to my mind, the most comprehensive, candid, revelatory, and thought-provoking look at eating disorders to date. In fact, the answer to that 14-year-old's question is eloquently addressed in the book, in all of its complexity. Finally, some understanding.

Our mothers are a wonderfully powerful force in all of our lives. Maybe this Mother's Day, GAINING should be on every daughter's gift list.