For a long time I didn't want to talk about my eating disorder with other people because I knew I couldn't construct the narrative they'd form in their heads. I was ashamed to have "food issues," and I was so much more receptive to judgment than I was compassion. It's important to me to contribute to the conversation about how eating disorders happen and to say the things that could've made a difference for me in hopes that they will for someone else.
This is an informational account of how my eating disorder unfolded, including its beginning and its after effects, so I want to include a brief trigger warning: If you think reading this is not in your best interest, go ahead & skip it.
By Susannah Emerson
Five years ago, I began a poem.
I’ve become a body/My fingers perform with mechanical precision/I can come undone at my own hands/Give me two minutes.
I'd learned how to manipulate my body, learned that I could make myself orgasm or throw up with the same two fingers in the same short timeframe. This discovery of agency was a long time coming, and though it damaged as much as it empowered me, I can't regret learning that I could shape myself and my world. I took to poetry to explain how my eating disorder both ruined and saved my life. The shortest story is that I lost some weight, practically by accident, and liked the results enough that I learned how to keep losing weight. I picked up an eating disorder.
I had an exceptional, charmed, and miserable adolescence. I also was mostly unaware that my body existed at all. I’d subscribed to the fixed model, that things - everything, appearance included - were as they were. It was all fate and mystery, until I stumbled upon this tiny glimmer of agency: the food I ingested and the energy I expended factored not only into what I looked like, but also what I felt like. It was the honest revelation that there were variables in my life I could control. Control felt so good to my 18-year-old self that it didn't occur to me that it was something that could be abused.
As an 18-year-old, I spent my first year of college by myself, on my bed, eating M&M cookies I’d take home from the dining hall, watching Robert Pattinson press junkets for Twilight on YouTube. I was not happy. After school let out in May, I got out of my car after a 10 hour drive on Route 95 and decided that it would feel really good to run. I was not a runner (at all) until this little thought came in to change my life. I ran a 3 mile loop, taking a break to walk the middle, and loved it. I ran every day (that's a literal every single day) for the next seven months.
It’s hard to say when exactly my running habit turned into the beginning of my eating disorder. There was a lot at work in those four ambiguous months; much of it did me good. I took to running right away, and knew that I’d found something special. On each run, I was treating my depression, anxiety and Obsessive Compulsive Disorder for the first time in my life. As I continued running, I made some conscious micro changes to my diet. For example, I learned to time my meals so that I could run without feeling sick. I lost weight. My body responded well to ingesting less and less. The less I ate and the more I ran the better I felt mentally and physically, and the less I wanted to eat. I noticed, and didn't mind. The clothes that had gotten very tight over the winter fit well again, and soon they hung loose on me, which I loved, but I'd always loved big clothes.
In August, 3 months into running, I was nervous going into my physical with my homeopathic doctor; I had the sense that I had been doing something wrong, and that she was going to be the one to tell me. She noted how low my resting heart rate was and how well I looked. I took care to mention that I’d been running a lot, and I asked for her recommendations. Were there any dietary changes I should make now that I was an athlete? Her answer: “No. Eat lots of fruits and vegetables.” I took that as permission to eat only fruits and vegetables, and a month or two later, I was eating six apples a day, some nuts and raw vegetables. Definitely no bread, definitely no pasta, definitely no rice, definitely fat-free.
Back at school in the fall, all these good things started happening: I was making friends. I was getting vitamin D, very good grades and praise from professors whose approval meant the world to me. I was wearing the beautiful clothes I'd always coveted that were made for bodies just like my new one. I was productive. I could get myself out of bed, and had enough motivation left over for things like putting dishes in the dishwasher which was new. I was more focused, more efficient than I’d ever been before. I was as happy as I’d been since I hit puberty. I also had the confidence of the invincible: there was no fat on me for anyone to point out, no lumps or rolls to look at, nothing about me or my body to object to. I felt so powerful. I was within reach of being perfect from every angle: the kind angle, the smart angle, the wise angle, the athletic angle, the poetic angle, the sane angle, the beautiful angle, the skinny angle.
That turned out to be the hardest thing for me to let go of, the feeling that none of my other accomplishments would matter without the skinny angle, that I couldn’t be so impressive if I wasn’t so skinny. It was like my thinness closed the circuit - I thought that all of that shine, all of the qualities that other people loved and admired, would disappear if I couldn't see this one particular bone in my shoulder.
Most of the science behind what was going on in my body was hazy to me. I thought that my body would settle at its preferred weight with my new exercise habits. While yes, that is exactly what should happen when you feed yourself properly, I didn’t quite realize that my pathology was overruling my body and its requests for food. I somehow missed that my weight could get lower and lower still as I increased the length and intensity of my runs and decreased the amount I ate. I thought that I had to run that much and eat that little in order not to gain weight. I don’t know whether this borderline unbelievable naïveté was one of the chemical changes in my brain brought on by anorexia, or if it was a personal quirk.
Science can’t help me with all of my questions. Not only is eating disorder research grossly underfunded as compared to alcoholism, schizophrenia, depression and sleep disorders (none of which claims as many lives as eating disorders), eating disorders are convoluted and maddeningly multiform. Every decade there’s a new theory that dominates public opinion of how and why they happen, and why they are on the rise. Genetics are a popular culprit, as are peer influence, media, personality type, trauma and cooccurring psychiatric disorders. Since the government doesn’t like funding studies that yield ambiguous and inconclusive results, I've taken it upon myself to find my own answers where I can.
Leading researchers disagree about the mechanism through which anorexia advances. That endorphins and calm come along with physical activity, and that the combination can be addictive, is agreed upon (and probably not news to you). But few people who haven't experienced it know just how good the beginning stages of a restrictive eating disorder can feel, and the best guesses we have as to why are just theories. I once went eight days without eating, and euphoria set in around day four. Many people who fast, for any reason, report similar highs for a period after the body adjusts to not taking in any calories. That said, my personal experience (which is only one of many) supports two hypotheses. The first is that starvation might lower serotonin levels at a few critical sites in an anorexic’s brain, thereby producing a sense of calm in place of the hyperactivity the sufferer has grown accustomed to. The second is that chemicals released during the brain during starvation are themselves addictive, and might be related to those released during physical activity.
In all outer ways, my case of anorexia is a classic one: I was and have always been as at risk as anyone can be for developing an eating disorder. I am white. I am a girl. I grew up hyper-privileged, surrounded by and large by the hyper-privileged, all of us immersed in a culture of assumed thinness. I developed my eating disorder in late adolescence (on the brink of 19) during college, a time of loneliness and transition. I struggle with the mood and behavioral disorders anxiety, depression and Obsessive Compulsive Disorder. I have a family history of addiction and mood disorders. I am a runner and a wanna-be dancer. I love fashion and fashion magazines. I am introverted, obsessive, a perfectionist, risk-averse, highly sensitive to criticism, highly critical, competitive and hyper-vigilant about many things, but especially self-improvement. And I am thin, so my weight loss was noticeable, alarming, and easy to diagnose.
In that light, it’s remarkable to me that I didn’t develop an eating disorder earlier. Many of my friends did. There were opportunities, of course, but they mostly floated above me and never took the shape of something I could grab onto. At age seven, I asked my mom if I could go on a diet after learning about them at a friend’s house. I was a small girl, and my mom was alarmed enough that she started taking me to a homeopathic doctor to help me develop a notion of health that might serve me better. I was excited by my older cousin’s description of baby fat as something that would disappear. As a senior in high school, I wrote a barely fictionalized essay on Beauty, revealing that “somewhere, sometime, I learned that a tortured soul is beautiful, and I haven’t yet been able to abandon that concept. I must have internalized all of the tacit proclamations that mutilation begets beauty.” I always hoped and assumed that one day I’d grow into a beautiful, sad, thin person, but I didn’t actively pursue this metamorphosis. I was also a body positivity crusader by eighth grade, and would bring my friends to lectures by Jean Kilbourne, who's been exploring the link between advertising and body image since the seventies. I did pretty well in a very weird world.
But by November of 2009, my weird world had caught up to me, and I met all of the diagnostic criteria for anorexia nervosa. I returned home to concerned parents over Thanksgiving break. I knew for certain that they were talking about me, and above all was terrified I was going to get in trouble; that they weren’t going to respect me anymore; that they'd confirm that my eating disorder was straight vanity and a moral failing.
Though so much in my brain was not quite working, my intuition was plenty strong, and I was right that they had been discussing what to do about me. I had become their problem and a cause for concern, and I was destroyed, furious and ashamed to be on the receiving end of anyone’s suspicion. My dad sat in a chair across from me, addressed some of my most alarming behavior and why it concerned him, and then allowed me to crawl into his lap and choke out a partial admission that got enough of the truth across, but preserved a bit of my dignity. Through my pride, I told him I felt like a shell of a person. I asked him for permission not to cook all of the sweet potatoes we’d bought the day before, asked him if he wouldn’t mind relieving me of the meal planning reigns I’d been gripping so tightly.
It was a successful intervention. I promised to see a doctor and a nutritionist when I went back to school. On the day of my appointment, I ate two breakfasts and drank at least a gallon of water, because I was afraid of being scolded for weighing too little. I was put on a meal plan that I started over Christmas vacation, and I gained back the weight I was told to. Over the break, I suffered a labral tear in my left hip flexor from running 8 miles on ice through 2 feet of snow, and the injury facilitated my weight gain cause I couldn't run on it. I went a year maintaining the weight that I was supposed to, and though I was still militant about how, what and when I ate, I was eating enough, kind of.
The following year over Christmas vacation at my grandmother's house, I discovered a little piece of black magic: if I ate dinner rolls and all of the english toffee bark in the tin and then ate nothing the following day, on day three I would still see all the same bones in the mirror. Weeks later, I went to Florence, Italy to study art for the semester, and to compensate for a weekly plate of pasta, I’d double my daily 8 mile run. The time I ate pizza in Naples, I lived off of cabbage soup for a few days just to be safe. One day in Paris, after picking up one of each of the Algerian pastries I was interested in, I ate until I felt sick. I tried throwing up in the bathroom of the McDonald’s by Canal St. Martin. It took me about 30 minutes to get a few teaspoons of pistachio confection to come up. Vomiting didn’t come easily to me, but over the summer, I had a few opportunities to practice, so by the time September and my senior year of college rolled around, I knew what to do and would throw up as needed which was often. By then, I'd started to binge eat in response to any and all forms of anxiety.
Bulimia felt like an eating disorder to me, and in its utter inconvenience, brought me to terms with the extent of my problem. As an anorexic, I’d been part victim, part agent. I hadn’t wanted to get sick or sicker, but even more than that, I hadn’t wanted to gain weight. Anorexia helped me fend off weight gain (and then some). I was doing my own bidding, and the sickness was completely consonant with my conscious self.
Bulimia felt like torture, and its cycle had me totally trapped. All I wanted was not to eat (or as I phrased it to myself, not to eat too much), but I’d spontaneously be compelled to eat more calories in desserts than I was used to eating in weeks or even months. I would eat and eat, and waddle to one of the six reliably abandoned bathrooms on campus where I would vomit for hours in relative secrecy.
Most of my horror stories come from my senior year of college. That was the year that I forced myself to masturbate every night to burn extra calories, the year I would unexpectedly throw up in my mouth or projectile vomit if I wasn’t careful. I worried incessantly about my esophagus rupturing. My jaw got stuck open with my fingers still down my throat twice that year, so while I was in the middle of disgorging myself, I had to plan how I would walk across campus in the snow to the health center while covered in vomit with my jaw unhinged without anyone noticing. My teeth turned grey. I regularly went entire nights shaking, not sleeping. Two of my friends dissuaded me from dropping out of school a month before my graduation.
I did graduate though, and a few months later I moved to Madrid, Spain, where the pursuit of pleasure replaces perfectionism as a virtue, and I began a slow, largely self-directed climb to what I intend to make a lasting recovery. In Spain, I stopped throwing up in response to binges. I became increasingly (though not totally) transparent with friends and family about the extent of my problem. Binges gradually became less frequent, less life altering and smaller in size. But the patterns of thinking were insidious. The behaviors I could discipline away, but I couldn’t quite judge myself into relinquishing judgment. I took laxatives once, and it wasn’t hard not to take them again. When I told myself I was done throwing up for good, I stopped throwing up for good. I could make myself exercise when I wanted to, and I could make myself stop when I needed to. I could even go a week or two or three without bingeing.
I wanted to do right so badly, especially by the people who loved and supported me. And I wanted to protect myself from other peoples' judgment. I was and am very aware of how people talk about girls with eating disorders. I didn't want anyone's pity, concern or condescension. I didn't want to be told what to do, what to eat, or to allow anyone to believe that they knew what was best for me. Any agency and independence I'd had were gone, and I wanted them back.
The traits that led me to my eating disorder also led me to want recovery, though it took me a while to want more than the appearance and apparent peace of recovery. My perfectionism got me my eating disorder, got me to wanting to get myself out of it, and kept me trapped within it. Said perfectionism will also likely be around as long as I am.
So, I am in recovery from an eating disorder that has taken so many forms. I'm doing quite well, but I struggle with trusting myself and my own impulses. Sometimes it's hard to decline dessert when I don't want it because I feel the need to prove a point. Or I'll worry if I eat too much (Was that a binge? Am I still okay?) or over whether I leave enough room for spontaneity in my life. This last part's particularly tricky: I like the way thin people look. Sometimes, I'll see the bones in my sternum and puff out my chest in pride. It’s hard to determine which part of me is proud - whether that’s my eating disorder acting up, or a conditioned response based on societal norms which are also not so healthy, or just an aesthetic preference. It may well be all three, and as long as I can put that thought in its place and move right on, liking the way that bones look can't really do me any harm.
In most instances, in order to recover from an Eating Disorder, you have to cede control of your body to someone else for a time because your eating habits must be stable and nourishing before your brain and body can heal. And if you're severely underweight, you have to regain enough weight to reestablish normal brain function. These are the least ambiguous findings of all research in the field. Unfortunately, what this means is that Eating Disorder patients get told what to do a lot. Eating Disorder treatment does a number on the piece of confidence that's related to intuition.
When I checked myself in to an Intensive Outpatient Treatment facility, I was put on meal plans, force-fed milkshakes when sick with a stomach virus, followed into the bathroom when I had to pee, told that the foods I eat are too healthy, told to avoid all exercise, told that I might need to rethink my vegetarianism (which was 17 years standing) if I really wanted to recover, told that enrolling in fashion school in Paris in the fall was a bad idea, told that I think too much before I speak. There were good intentions behind each of these orders/recommendations, but they all felt terrible. They also scared me into thinking that there was a right way to be as a recovered person, and that to be well I would have to eradicate (or at least question) all parts of my personality. Now I'm recovering from the fear that my judgment is irrevocably impaired.
I tend to take everything very seriously, and though life gets better when I don't, it's sensible to stay vigilant, to look twice at behaviors and pathologies that have hurt me before. I've been trained to think that I can only lighten up to a point responsibly, which makes lightening up at all difficult. The question of where I start and where my pathological predilections end is the undercurrent of every day.
So going back to liking the bones in my chest sometimes and then moving on: I'm pretty sure I'm right to do so. I hesitate to admit that in conversation, or even here, because I don't want to be misunderstood as advocating for bony chests. That's not my point. I would love nothing more than never to have been enchanted by a bony chest. Instead, I want to note what a big deal it is - what a good tool it is - to take a break from trying so hard to do right, eradicate and organize. For some of us, it's active, difficult and revolutionary to say "whatever."