Present Tense: The Long Shadow Of An Eating Disorder 

Maggie Slepian | Longreads | February 20, 2025 | 6,707 words (25 minutes)

I was 13 the first time I remember refusing to eat. I don’t remember what set me off or why refusing food was my form of rebellion, but I remember the stab of hunger soothing something I couldn’t name. 

I called it “crash dieting” throughout high school. This was the early ’00s, so no one batted an eye when I said I was on a diet. The body positivity movement hadn’t fully integrated with general society and we were expected to hate our bodies.

I drew grids on printer paper and wrote out what I ate each day. One box for breakfast (nothing), one box for lunch (a rice cake), one box for dinner (carrot sticks). I was more concerned with not eating than I was with being skinny. Hunger was a proxy, a way to redirect bad feelings I didn’t know how to cope with. 

Anything could send me into a crash diet—lunchroom tension that put my already low social standing at risk. The classroom bully making fun of my socks. A tearful argument with my mom. My bouts of restriction were always preceded by a jittery, head-spinning buzz. I would later learn that this was a physical manifestation of anxiety, but all I knew at the time was that focusing on hunger helped alleviate my shaky nausea.

Each episode lasted a few days, a week at most. The bad feeling would fade, I’d become tired of feeling hungry, or my friends would start talking to me again. I never confronted my anxiety or developed skills to deal with my feelings. 

Then, in the winter of my sophomore year of college, I found out my boyfriend was cheating on me. If you’ve ever been a sophomore in college with a boyfriend who cheated on you, you are aware that this is the worst thing in the entire world. 

I dove headfirst into a full-blown eating disorder. Do not pass go, do not collect $200. Instead of confronting the ravaged ache of my teenage heart, I turned to what had always been there: restriction.

While eating disorders can (and do) develop on the basis of body image, they are often adaptive, which means the person engages in those behaviors for reasons other than weight loss. Focusing on pain within my control—hunger via restriction—was my panicked attempt at reclaiming power.

I picture myself at 19, walking out of the daylight down a wooded pathway that rapidly closes in, becoming narrower and more twisted until I am so tangled in branches I can’t move forward or turn back. If I’d known that 17 years into the future, at the age of 36, I would be sitting hunched over to hide my stomach, cringing at mirrors, and sobbing at the sight of my body in a dress, maybe I would have done something differently. Maybe I would have dedicated more energy to therapy, found healthy ways to process, accepted that sometimes life feels hard and then you get over it.

But I was 19 and did not know the future. I did not know patience. I had no way to understand that the shock of heartbreak is like riding a tidal wave that eventually loses momentum, settling back to the swells of daily life. At 19 I couldn’t imagine I’d ever be on the other side, so I did nothing except starve myself. And for the first time, I lost weight. 

At first, my refusal to eat flew under the radar. Restriction is aligned with diet culture, making it a fairly acceptable form of behavioral control, at least to a certain extent. Plus, you get a lot of positive reinforcement when you lose weight. So when I started seeing physical results, something flipped in my brain and an already unhealthy coping mechanism turned into something more insidious, like a nest of snakes cracking through shells, flicking their forked tongues in the air. 

But I was 19 and did not know the future. I did not know patience. I had no way to understand that the shock of heartbreak is like riding a tidal wave that eventually loses momentum, settling back to the swells of daily life.

The soft padding of flesh around my hips shrank, then vanished. My D-cup chest shriveled to a C, then a B. I stood in front of the mirror one morning, dizzy with hunger and awe, tracing a finger around my protruding collarbone. I raised my arms over my head and saw the shadowed curves of one, two, three ribs. If I stood at just the right angle, I could glimpse air between my thighs. 

Before this, restricting had been about being hungry. But with this rapid weight loss, the snakes uncoiled in my brain, coming to life in the success of measurable metrics. I went from never weighing myself to stepping on the scale a dozen times a day. The hunger cramps and lightheadedness were worth it, as long as the number continued to drop. It wasn’t easy though—I craved food from the moment I woke up to the moment I curled around my gnawing, empty stomach and tried to sleep. 

A common misconception about eating disorders is that the person doesn’t want to eat. That isn’t always true, and certainly not for me. I thought about food all the time. I stared at girls eating—not in disgust but in envy. Sharing pastries outside coffee shops, tearing open energy bar wrappers in the gym lobby. I walked through the dining hall with my tray of food substitutes—fat-free Cool Whip, iceberg lettuce doused in ketchup—trying not to gape as I passed a dining hall employee shaking salt over a tray of french fries and sliding a pan of cheeseburgers under the heat lamp. But eating meant failure, and the earth-shaking loss of my relationship was already enough failure. 

I developed strategies for keeping the hunger at bay, gnawing on bowls of air-popped popcorn and dry Fiber One cereal, mentally subtracting the fiber from the overall calories. I drank decaf instant coffee from morning until night, dumped packets of Splenda over bowls of slimy sugar-free JELL-O, did anything I could to create the illusion of flavor and food. 

Adhering to my own rules for what (and when) I could eat became increasingly stressful. Whispers spread through my social group about my weight loss and bizarre habits, and I started going to the dining hall alone, sitting at a two-top against the wall so no one could see my disordered facsimile of a meal. 

My brain, which had always felt sharp, became confused and groggy. I felt trapped between sleep and wakefulness, unable to focus in class. I heard my sentences trail off through an echoing tunnel. I scanned my body obsessively every chance I got. I peered into the mirror to make sure I could still see the correct collarbone depth and angular bones jutting from behind my shoulders.

But eating meant failure, and the earth-shaking loss of my relationship was already enough failure.

When my weight loss slowed—the body’s desperate bid to cling to calories—I doubled down on the rules that governed my life. No solid food until 12 p.m. After noon I could chew a piece of gum, and if I was about to pass out, I was allowed a bite of fat-free cottage cheese. In the evenings, I ate one green apple cut into 32 slices. I drank Diet Coke and instant coffee to fool my stomach into thinking it was full. I set impossible-to-reach standards of success that would finally let me be happy: a perfect day of restriction, a new and lower number on the scale. But the goal post kept moving.

By late spring, all my waking hours revolved around not eating. I trailed behind my friends one evening, starving and exhausted as I pulled myself up the railing toward the student union building. It was late in the day and I had been “good,” following the rules without slipping up. This meant I’d had just half a cucumber, my allotted apple, and so much instant coffee my teeth were covered in fine silt.

“I’m not waiting three hours for her to cross campus,” one of the girls snapped, tossing her flat-ironed hair over the collar of her North Face fleece. I paused and shoved a piece of gum in my mouth, trying to ease the sting of her words. The truth was, while being skinny was the most important part of my life, I was getting a little sick of feeling dull and starving.

I hadn’t eaten bread or butter or cookies or pasta or salad dressing in six months. I missed being able to walk up a flight of stairs. The thick wool around my brain was both maddening and alarming. OK, I thought, watching my friends disappear into the building as I slowly ascended the steps. Maybe it’s time to start eating again. 

The next morning I carefully folded a slice of wheat bread around a dab of peanut butter: a sad, eating-disordered version of a sandwich. I saved it for that afternoon, feeling the weight of it in my pocket as I crossed campus.

I pulled the sandwich out of my pocket when I arrived for my shift at the gym. But then I froze, unable to pick it up. If I eat this sandwich, what next? Bagels? Pizza? Cake? Ice cream? All of this discipline and success for nothing? Who will I be if I’m not skinny? 

Panic flooded my chest. I pinched off a piece of bread and rolled it between my fingers until it became a spongy marble. The desk phone rang shrilly, echoing the ringing in my ears. 

I ignored the phone and stared at the sandwich. I tore it in half, then in half again. I shredded those four pieces until the sandwich lay scattered on the desk in 12 mutilated chunks. The phone rang again and I ignored it, my heart racing as I stared at the crumbled bread and peanut butter.

My coworker hurried out of the back room balancing a pile of folders. He glared at me as he grabbed the phone. 

I swept the sandwich into the garbage without taking a bite. My head swam from hunger, but something else, too: the dark seed of fear that I’d gone too far, the snakes embedded in every crevice of my brain.

Eating this sandwich should be my choice, right? 

No? OK then, what now?

I somehow passed my finals and went home for the summer

My parents were horrified when they saw me, a skeletal shadow of the daughter they’d dropped off after Christmas break. My mother immediately booked a slew of appointments with a nutritionist, a primary care physician, and a therapist. I was over 18, but my parents paid my college tuition and the appointments were nonnegotiable.

I slumped mutely in the backseat of the minivan, ignoring her as we rode elevators up and down columns of identical office buildings, feeling nothing except a dull flash of pride the first time I heard the word anorexia in hushed tones. At least I’d succeeded at something.

My summer at home was a nightmare for everyone. My family begged me to have dinner with them, my mom pinched and pleading and my younger siblings staring silently at their plates. My dad was more understanding. He had quietly fought his own battles with body image and restriction throughout my childhood, but he was still helpless seeing how far I’d plunged down the rabbit hole.

I didn’t have the words to say how I wanted to join them, or explain why I couldn’t. I would have loved to go to the ice cream stand or yell out topping suggestions when we called for pizza. I wanted to pile my dad’s famous meatballs on a heaping mound of pasta and elbow my sister for the green shaker of powdered parmesan. But I hovered in the doorway like a ghoul of an eldest daughter, desperate to be near food and warmth but too scared to take a bite. 

“I’m not hungry,” I said.

One night in August, I did join them for ice cream. We’d driven to an event together and I was too woozy to walk back to the house alone. Or maybe that’s not true. Maybe I didn’t need a ride back, but I was tired of arguing about food. Maybe I wanted to pretend I was normal. Maybe I just wanted to eat some fucking ice cream. 

When it was my turn to order, the bored high schooler in a pastel baseball cap hovered her pen over the ticket. I opened my mouth to order the tasteless, sugar-free frozen yogurt from the back of the case, covered in ice crystals from neglect. 

“Can I have a large sundae, with mint chip, rocky road, sprinkles, and extra hot fudge?” I asked, my voice high-pitched and unfamiliar. 

A few minutes later my order appeared in the window. A sloppy, overflowing bowl of ice cream with hot fudge dripping down the side and a maraschino cherry leaking electric red dye down the sagging pile of whipped cream. 

I inhaled the sundae in a frantic, bug-eyed rush. My siblings pretended not to stare, but I could feel the tension drain as I ate. She’s eating ice cream. Maybe she’s going to get better; maybe this is over. They chattered over each other as they dug into their cones, the rise and fall of  conversation a backdrop to the dopamine receptors firing so hard I could barely see straight. The taste of real food made me swoon: thick, creamy ice cream, crunchy sprinkles, gooey fudge hardened into sticky clumps. I scraped the bottom of the dish so hard I bent the plastic spoon. 

The colors of the outdoor patio felt saturated, like my vision was turned up to superhero level. My voice sounded like it was coming through a tunnel as I said: be right back.

The little dairy hut had a one-stall private bathroom. And ice cream, as it turned out, was one of the easiest things to get back up.

Wherever I’d been before—the on-and-off restriction, the full-blown anorexia, somewhere in between—bulimia was so much worse. 

There is a certain purity in restriction, an ethereal perfection in refusing food. You are elevated, you don’t need like others do. In the hierarchy of eating disorders, anorexia is at the top. To be diagnosed with anorexia is a symbol of willpower and control. Bulimia is the opposite. It means giving in to hedonistic, animal cravings. You are always doing something wrong (eating), then atoning for it (purging). It is a descent straight to hell and I was powerless to stop it.

Once I ate the ice cream, there was no going back. Every morning I woke up and prepared to battle my mind and body, begging the two to cooperate and not wind up in an out-of-control nighttime binge. 

I’d make it through most of the day, then fall apart at night. Soon there were multiple fugue-like binges each day. My electrolytes became so skewed I’d see stars when I stood up, and I built a mental map of single-stall campus bathrooms where I could jam my fingers down my throat until blood vessels burst in my eyes and the corners of my lips split apart. 

To be diagnosed with anorexia is a symbol of willpower and control. Bulimia is the opposite. It means giving in to hedonistic, animal cravings.

I lost whatever remained of my brain power. My head was so fuzzy I’d set the shampoo outside of the shower door after I’d used it, then put the conditioner out afterwards. Otherwise I’d have no memory of what stage of hair washing I was at, repeating the lather and rinse so many times I’d start crying from confusion and frustration.

My world was reduced to fear, hunger, and shame. There was no self anymore. I feel like everything is gray and I miss color, I scrawled in a barely legible journal entry, one of only a few coherent thoughts in a notebook filled with run-on sentences panicking about food and weight and sadness and self-loathing. 

To understand (or even perhaps empathize with) the eating-disordered mind requires some suspension of disbelief. You have to accept that after a certain point, very little of it makes sense. 

I felt like a rat trapped in a maze with no finish, running into walls and getting electrocuted at every turn. I wanted out of the hellscape I’d created, but I had formed a whole identity around the latticework of visible bones and tendons; my days were structured around the denial of food. To give up the eating disorder meant losing the core of who I had become. If I lost control over the core of my being, it would mean I failed. If I failed . . . I didn’t have an answer for what happened after failure. It was too terrifying to think about.

My family lived within driving distance, and one night my mom dropped me back on campus after my sister’s birthday dinner. I’d swayed in a chair all night, shifting from side to side on my bony butt, spots dancing in front of my eyes as I tried to resist binging on ice cream cake.

My mom was quiet on the drive, but as we pulled up to my apartment building, she pushed a trifold pamphlet into my chapped hands. I tilted it toward the window, squinting at Walden Center for Behavioral Health printed in black over a watercolor of two people walking a flower-lined path.

“What is this?” I asked, pinching it between two fingers. 

“It’s a residential program,” she said. “A special program for eating disorders.” She flinched almost imperceptibly as the words hovered between us. I was prone to eruptions at any mention of doctors, therapy, or eating, so I can’t imagine the guts it took for her to hand me this pamphlet, how she must have felt on the drive to campus.

“You talked to them?” I hissed, flinging the seatbelt so hard over my shoulder it hit the door. 

“Maggie,” she said, her voice shaking but measured. “You need help. We are terrified. Do it for your siblings, dad, myself. School, riding horses, running. Please, we miss you.”

“I’m. Fine.” I could hear the low pitch of my voice building into simmering rage. 

She held her ground. 

I lunged out of the car, slamming the door as she sat with her hands curled around the steering wheel, staring at her lap.

Two months later, I pulled the pamphlet out of my desk drawer and called the number. 

I don’t remember the exact moment I called, or what made me do it. I told people that I’d fainted in the shower and hit my head hard enough to be scared for my life. I didn’t want to lie, but I felt the need to justify giving up the eating disorder. It wasn’t enough to just want my life back. 

But I did want my life back. Desperately. I felt like being dead would be better than continuing to exist. I weighed less than 100 pounds. It hurt to sit and to stand, my knuckles bled from scraping them against my teeth, and I nearly fainted every time I stood up. My friends couldn’t stand me, my family was scared of me, I couldn’t put together a full sentence, and I missed who I used to be as a person. That was it. Those were my reasons. 

I checked into Walden the day after Christmas of my junior year. I’d wound up following a not-uncommon trajectory: More than 50 percent of women diagnosed with bulimia have a history of anorexia. The rigid restriction I’d put myself through was unsustainable in the long term, and like other patients, had led to binge eating and compensatory purging. By the time I dragged my floral duffel through the sliding doors of Walden, I fit the criteria for “restrictive bulimia.”

Walden Center had four units on the ground floor of a beautiful apartment building in eastern Massachusetts. Residents moved apartments as they progressed through the program, rewarded with less supervision and more privileges at each stage. I started in the first apartment, with open-door bathroom monitoring, no outside walks beside a brief daily dose of fresh air, and one slow, supervised yoga session every week. 

Walden’s program was fairly standard for a residential facility. Along with weight restoration and interrupting eating disorder behaviors, treatment emphasized relearning how to have a normal relationship with food. With supervision, we made shopping lists and cooked our own meals. It was a far cry from the trays of hospital food I’d imagined. 

Each resident had their own daily requirements, which included portions of grains, proteins, fats, fruits, and vegetables. There were no mentions of calories, just a list of foods under each category. 

The list of grains alone contained a cornucopia of illegal food: oatmeal, bagels, english muffins, bread, cereal, granola bars. Proteins were even more thrilling: Greek yogurt, string cheese, cream cheese, bacon, hamburgers, beans. Foods I hadn’t eaten outside of hollow-eyed, guilt-ridden binges in more than a year. 

I settled in quickly, determined to learn the rules and do everything well. Each week we huddled around Stop & Shop delivery forms, consulting each other as a counselor sat at the table with one ear tuned to the conversation. We had to create a weekly grocery list that would stock the pantry for our meals. It was a simple task that stretched our brains to their limits.

I stared at the list of food, moving a stubby pencil between rice, honey, half and half, chicken. What does a normal meal look like? It doesn’t look like stewed tomatoes eaten from the can, but it also doesn’t look like a pint of Ben and Jerry’s, a bag of Goldfish, four bowls of Frosted Flakes, and half a jar of hot fudge followed by 30 minutes in the bathroom turning my stomach inside out before collapsing with a tear-streaked cheek pressed to the tile.

Three times per day, each apartment’s residents gathered in the kitchens to make meals that fulfilled our requirements. Emotions ran high and the counselors were present to both calm us and approve our choices. 

If I need three grains, two proteins, a vegetable, and two fats for dinner, this could mean a baked potato, a hamburger on a bun, a side of baked beans, and two servings of butter on the potato. Once I explained the meal to the counselor and showed them each measured component as I added it to my plate, they’d jot their initials next to my name and I could take a seat at the table.

I dutifully fulfilled my meal requirements. I held my arm out for blood pressure and vitals checks each morning and night and was weighed on a blind scale every other day. I participated in nutrition classes, suffered through weekly family therapy, and shoved my clothes into my bag every 10 days as I moved to the next apartment. The second apartment had closed-door bathroom privileges, the third had a longer outdoor walk each day. It was progress. 

We’d all voluntarily checked in, but we clung to shreds of control where we could. One of my roommates did push-ups in the bathroom. We lifted food packages surreptitiously to the light, trying to find an angle that allowed us to see the Sharpied-over nutrition facts. I circled the fountain on supervised walks, chatting with another girl who had also been a runner. A counselor always called us back, clocking the attempt at exercising. 

I still hesitated at the table, under-measured the butter for my mashed potatoes, filled the measuring cup with water and a splash of milk for opacity before turning to the counselor to check off my protein category. I still nodded slightly when one of the girls, wearing compression socks for edema, gave a tiny head shake as I reached for the refried beans for my protein one night. I drifted my hand toward the black beans: lower calories and fat. She nodded just perceptibly before going back to preparing her own meal. 

It was a tiring push-pull, releasing the hold of a psychiatric disorder. But other than the occasional miserable family therapy session or rapidly corrected eating disorder behaviors, the program was calm and quiet. None of us had much energy, and the emotional toll of weight gain kept us low-key. The days blended together, the passage of time marked by each meal or completing another 1,000-piece puzzle. The misery of restriction, the monstrous feeling of a binge, the desperation of a purge—they were all replaced by new emotions. There was the minor frustration of a tangled, lumpy knitting project, the glee at placing the final jigsaw puzzle piece, the spark of pride during a joyful moment in group therapy. 

I left Walden after four weeks, having regained enough weight to medically stabilize. I had a plan for outpatient counseling and dietitian checkups, and my own set of measuring cups so I could continue my restoration plan at home. 

I drove myself to my nutrition appointments between classes and horseback riding at the university stable, and I started running again, relishing the clear-headed energy and swell of muscle in my quads. I slipped up here and there, but within two years of leaving Walden, I was declared recovered. There were no rampant eating-disordered behaviors and the number on the scale stayed within a reasonable range. The coil of snakes lay dormant, and as far as I and my medical team were concerned, we’d eradicated them.

I was good for a time. I moved out west after graduating, and I devoted my next decade to a newfound love of the outdoors. My social life revolved around activity: I was a strong climber, a capable mountain biker, and I backpacked at a punishing pace, covering hundreds of miles of mountainous terrain alone and unafraid. None of these elements would have been possible without a strong body, and because I was so fit, I effortlessly maintained that lean strength. 

There was no fear of food or body shame during those years. But the shadow was still somewhere in my brain, the coiled snakes stilled by my multi-sport fitness and high mileage in the mountains. 

Looking back, I see my eating disorder still showed up in sneaky ways. I joked about how I didn’t enjoy cooking, fielded comments about the speed at which I ate, and attributed the fact that I cleaned the kitchen completely before eating to being tidy. In reality, I still associated food with guilt. I ate fast to get it over with and remove any evidence I had made food. Additionally, my high level of activity meant I was constantly trading calories back and forth in my mind, a background abacus with the beads click-clacking back and forth. 

If I thought my eating disorder would stay quiet forever, I was wrong. A few years ago, the combination of a naturally slowing metabolism and pandemic-induced lifestyle change altered my body. My pants stopped buttoning smoothly, my outline softened. I couldn’t tell you exactly what was different, but I knew something had changed. 

At first I was confused. I opened a slew of tabs on my phone, scrolling through piles of unhelpful SEO clickbait. Was seltzer making me bloated? Was I biking too much and not running enough? The dormant shadow, the coil of snakes in my brain woke up, stretched, shook themselves out.

I started obsessing over my body in a way I hadn’t since college. I avoided mirrors, kept the lights off in the bathroom, and wrapped a towel around my body before stepping out of the shower. I went from wearing dresses, skirts, crop tops, and matching workout sets to baggy shirts and high-rise leggings with wide elastic waistbands. I stood slightly bent over and pushed my hands into my pockets to hold my clothes out from my body, walking down the street like a polyester circus tent. It didn’t help that the body positivity trends of the past several years seemed to have vanished in the blink of an algorithm, and suddenly I was being spoon-fed a steady stream of thin-is-in videos that sent me reeling back to the magazine covers of my college years.  

Body dysmorphia flared as fast and hot as my eating disorder had 15 years before. The all-consuming thoughts stretched back to my 19-year-old self, sobbing on the floor, vowing never to eat again after being cheated on. Now, here I was in my mid-30s, my brain short-circuiting on a trip to Europe because there were too many store-window reflections, I’d packed the wrong clothes, and the restaurants made me feel full. I spent an hour-long bus ride deleting every photo of myself where my arms were visible, my thighs were touching, and the outline of my stomach showed through my shirt. I pulled away from my boyfriend and stared at the floor in the claustrophobic elevators, the mirrored walls a reflective torment. Everywhere I looked, there I was.

I broke down in my therapist’s office when I returned, gesturing at my body as I grasped for a pillow to hold over my stomach. 

“Look at me,” I sobbed, “what’s happening to my body?” My brain writhed, hot, like a rock had been pushed aside to release the pit of vipers. My therapist was quiet for a moment, letting my words echo in the small office. She passed me a box of tissues. 

“I think what we’re looking at is body dysmorphia,” she said. I hiccuped and shook my head. 

“No,” I said, “I know what I look like.”

But I didn’t know what I looked like, I still don’t. Present tense. The unfortunate truth of eating disorders is that no matter how “recovered” you feel, act, and look, there are some elements that might never go away. Body dysmorphia is the last thing to go, if it ever does. To be trapped in this mind is like revisiting the most potent mental and emotional elements of the eating disorder without the physical symptoms and behaviors. And it’s all inward facing—I do not judge bodies of different shapes and sizes. This cruelty is solely reserved for me. 

The internet sands down the edges of body dysmorphic disorder. Except for the most severe cases (in which people might undergo cosmetic surgery), search results tell you that someone with body dysmorphia might avoid mirrors, or perhaps compare how they look to other people. It sounds like someone having a bad hair day. 

These surface-level explainers don’t reveal what it’s like to exist in that brain. To be unable to concentrate because of your waistband rolled down, to have your day ruined by the wrong angle in the wrong mirror, to leave your partner alone on the couch because oops, you remembered that you have a body and that they might touch it. As long as you are awake, you are aware.

I understand how stunningly stupid it is to spend this much time thinking about the softness of my stomach or the width of my arms. Throw a dart anywhere on a map and you’ll find someone having a worse day, week, month, or life than me. But I cannot convince my disordered brain this battle is not worth fighting. 

As long as you are awake, you are aware.

They weighed me at the doctor’s office in 2008 and declared me recovered, but in reality, eating disorder researchers cannot agree on how to define true recovery. It’s easy to measure “healthy” weight with simple metrics to determine medical stability. It’s somewhat harder—but still relatively straightforward—to determine whether the person is engaging in eating disorder behaviors. Severe restriction? Binging and purging? Creating “meals” with foods that should not be combined? That’s all pretty obvious. But what about panic at the sight of mirrors, distress at the cling of clothing? Eating so fast you almost choke because you need to get it over with? Spiraling because your sleeves felt tight? 

San Francisco-based psychotherapist Erika Bent is a certified eating disorder specialist supervisor. She studied anorexia as a researcher before transitioning to clinical and residential work. 

“The psychology that you’re describing is harder to measure,” Bent tells me as I describe limiting my access to mirrors and leaving the lights off lest I catch a glimpse of my reflection. 

“Body image distress is one of the last things to be resolved in eating disorder recovery,” she says, adding that this is such a standard experience for people with a history of eating disorders that it even has a name: “normative discontent.” 

I feel better in that I’m not alone. I feel worse in that this might be how my brain works forever. 

One fall morning, I scan the address numbers above a sidewalk I’ve walked every week for years, following the blue dot on my phone screen to a door I’ve never noticed. The Eating Disorder Center of Montana has two locations, and this one is right off the main road on a busy side street.

I find myself anxiously rehearsing my introduction as I climb the stairs, even though I’ve already told Lauren Stille, the lead dietitian, that I’m here as a journalist. 

There is a lot of literature but not a lot of consensus about long-term recovery, and I have many questions. I’m so trapped in my head I’m secretly hoping she’s going to give me some good news: Body dysmorphia has a timeline, that I will soon wear the dozens of outfits in my closet and not the same (safe) pair of baggy sweatpants-and-sweatshirt combo. That I can move on after eating a large meal and not dissolve into hysterics because I feel full. 

“Dysmorphia is a terrible, crippling thing,” Stille says. She is relaxed in a leather chair while I’m hunched on the couch across from her, leaning forward to hide my stomach. 

I reiterate throughout the conversation that I’m only here for this essay, but she’s a therapist and an expert in the field of eating disorders. She knows. 

“We’re seeing [body dysmorphia] become more and more common,” she continues, telling me that it can escalate by how often the media draws attention to our bodies, insisting everything can be improved and modified. “You don’t like something about yourself? You can fix it and that’s the ticket to happiness.” I circle back to my eating-disordered thoughts from 15 years ago. If I just have a perfect restriction day, if I just reach this new number on the scale. Then I’ll feel good. 

She tells me what I already know: Recovery is complicated. And these days, they’re trying to emphasize that there is no straightforward way to say I’m recovered. 

“It’s more that ‘my eating disorder is currently quieter,’” Stille says. “Your entire future is about continuing that work of recovery.” 

“Oh god,” I say, tapping the recorder to check the time, but really to avoid eye contact. “That is grim.”

There’s little data on the mental and emotional outcomes in long-term eating disorder recovery, especially past the 10-year mark. One 22-year study describes a shift in the therapeutic approach. Rather than treating for strict recovery guidelines, treatment should match a patient’s goals, which might not look like traditional recovery. This is a start, and helps encourage the idea that success doesn’t always operate on a binary. If anything, this could help minimize treatment and counseling dropouts.

Additionally, the long-term studies that do exist mostly follow patients with the resources to be in treatment, or to get diagnosed in the first place. Everything from clinical therapy to inpatient treatment is expensive and exclusive. To even begin untangling the process requires understanding complex medical systems and insurance providers. I had the privilege of my family’s health insurance, but people in less advantaged circumstances don’t have the same resources. 

Until my body dysmorphia spiked in the last two years, I rarely thought about my oddly fast eating habits or that I was subconsciously using exercise as a projection for feeling good about my body. It’s pretty crushing to learn that this might be the way my brain works for the rest of my life. 

It does, however, make me feel marginally better to learn that some elements might not have been within my control. While the cultural fixation on thinness is an important and disturbingly prevalent factor in the development of eating disorders, only a minimal percentage of people are affected to the extent I was. Given that so many people are exposed to the same cultural messaging, why aren’t more people affected to the same degree?

Genetics seem to play an increasingly large role, and research is starting to indicate that some people may have a latent vulnerability to eating disorders, similar to alcoholism. These tendencies might never be “turned on” without the right combination of environmental factors, but that genetic potential—plus a high instance of comorbidity with anxiety—created the perfect petri dish for me. 

My brain should be full of wonder and gratitude for my life: joy at finally keeping my houseplants alive, excitement as I plan next season’s travels, pride after finishing another rugged backcountry trip.

Instead, I plan trips around whether or not I’ll have to wear a bathing suit. I fling clothes onto the floor in a heap if they fit the wrong way. I crumple to the ground because my stomach touches my overalls in a way it didn’t last summer. 

I traveled to the desert this fall to help connect shuttles and food caches during a five-day backcountry trip. My partner and I led the group through sandstone arches, slot canyons, and desert oases most people will never see. I carried 60 pounds of supplies on my back and hiked alone into the canyon to set the cache, quads and glutes and back and shoulders moving fast over miles of cracked mud flats under a punishing sun. 

I was proud of my strong, capable, dust-caked body in the Southern Utah backcountry. I am tough on the trails where I’ve found my footing over the past decade. I’ve seen places on this planet I could have never imagined as I stared out the window of Walden Center that winter 15 years ago. 

But the pride is conditional, and I can’t predict when the switch will flip.

Back in town I shed my reeking layers in a dingy Motel 6. The flickering bulb cast a sickly fluorescent light on my stomach, thighs, and arms. My body—which felt so powerful climbing out of the canyon just hours before—was reduced to a slab of pale, dimpled flesh, the before picture on a social media slideshow or 2006 diet-ad billboard. All I did was flick the light on, and my joy from the desert dissolved in the reality of being myself, chained to the dregs of a decades-long eating disorder. 

Shame and disgust at my body turned to tears as the water ran gritty and brown down my filthy legs. I stare at the rust around the drain and think: Someone, please, get me out of my head.

It feels painfully indulgent to have had an eating disorder, even more so to still be held captive by it. To have had all the privilege and food in the world, yet spend untold hours thinking about the imperfections of a body that has tried so hard to be good for me. 

When I think about the elements that make up a life, will any of my accomplishments include skipping dessert? Do I get an award for having a salad instead of a burger? I will never be remembered for the two years I had a thigh gap or that I dragged myself to the gym 100 days in a row. Saying no to food didn’t make my problems go away, it replaced them with other problems—when I came through the other side, the original problems were still there. If I’d known what this would have looked like in the future, would I have tried harder at 19 to avoid it? Would I even have been able to? 

Today, more than 15 years after being declared recovered, I can tell you that sometimes there’s no tidy, closed loop with a psychiatric disorder. And that talking about it in the present tense can be the most realistic way to address it. For now, my hope is that someday I can return from the desert or the mountains, turn on the bathroom light, glance at my body in the mirror, and just say thank you.

Maggie Slepian is a full-time writer based in Montana. Her work focuses on the intersection of outdoor culture, travel, and mental health, and has appeared in the New York Times, Outside, Lonely Planet, the Strategist, Barren Magazine, and elsewhere. If she’s not abroad or in the backcountry, she’s probably hanging out with her cat.

Editor: Krista Stevens
Copyeditor: Cheri Lucas Rowlands
Fact checker: Julie Schwietert Collazo