I’ve blogged about it for years, but this is the first book I’ve written about recovery from anorexia. Well, that’s not quite true: It’s the first book I’ve published. I wrote a fairly unreadable and clearly unpublishable one when I was 22, and it was unreadable mostly because I was so ill, and it makes me very uneasy now to think of what it might have done if it had managed to get published—had gone out into the world instead of staying stuck on my hard drive where it belonged.
I mean, probably it would have languished unread. But maybe it wouldn’t have. Maybe it would have tightened the same sorts of nooses around some of its readers that were choking me. Much of the research I’ve conducted more recently suggested that it might well have.
The idea for this book was always to make that hard. Of course, no author can ever control what any reader does with their book: from burning it to misreading it to taking beautiful kinds of inspiration from it, it’s all up for grabs. But I tried, throughout the writing of this book, to make it very difficult to come away from it either with tips for “doing anorexia better” or with the slightest desire to do it better.
Then, I got to the end of the writing and realized I had no idea whether I’d succeeded. So I ran a very time-consuming (and quite expensive!) experiment to find out. The publish/don’t publish criteria were crystal clear, and the book passed the test.
The results of the experiment were published in the Journal of Eating Disorders; you can read the paper here.
The book is published in paperback and ebook forms on Amazon; you can buy them, for example, on Amazon UK and US, or or search for “troscianko very hungry anorexic” on any other marketplace.
If you read it, do please let me know what you make of it, via an Amazon review or by messaging me on my contact page.
The book is written mostly in dialogue form, initially as a conversation between two voices whose identities may or may not feel clear to you. Essentially, the book is about one example (my own) of what makes it possible to leave behind forever the desire to eat less, be thinner, subsist rather than exist. And the most crucial of the prerequisites is, of course, a huge amount of food.
I hope that the many interleaving dialogues manage to trace some of the resolutely natural magic of what happens when you let real, sugary, fatty fuel do its work, in every grandest and tiniest aspect of what it means to be alive.
Meanwhile, you can scroll down for a bit of the first chapter to whet your appetite.
Or if you’re interested in the rationale and process of writing the book and carrying out the experiment, or just want to get a sense of the book’s structure, you can download a PDF of the front matter (including the table of contents and preface) and back matter (the afterword) here. Or read this short account of the experimental design and results from my newsletter here.
I’ve also written and talked about the book and the associated experiment in various venues since their publication. You can check out these takes on the project too if you like!
- A brief news item for the UC Santa Barbara magazine The Current: https://news.ucsb.edu/in-focus/author-measures-memoirs-potential-impacts-readers-eating-disorders
- A conversation with Chris Sandel for his Real Health Radio podcast. (It’s a long episode, and we turn to this as our final topic, around 01:19:00.) https://seven-health.com/2024/10/308-interview-with-emily-troscianko/
- A guest post for June Alexander’s Life Stories Diary blog: https://lifestoriesdiary.com/2024/10/28/straddling-the-literature-and-eating-disorder-divide/
1 The basics
CATCHING ANOREXIA RE-EMERGING
BE: So, what was it like, heading off to university age 18 with the all-clear from the child psychiatrist?
AY: Um, pretty bleak.
BE: That’s it? Bleak?
[a pause] …
BE: OK, what kind of bleak?
AY: Ugh, the room, the horrible little room they gave me. As soon as I walked in the smell of depression hit me like nausea. And when my parents left and I went off to buy milk and then I was back there again, waiting for the kettle to boil—god, it was almost over before it began.
BE: Couldn’t you just have tried a bit?
AY: I did. And I was excited as well. And I guess it kind of worked for a bit. I mean, I cooked pasta with some of the others on my corridor, and we ate in my room with Radiohead on. And we had hot chocolate with marshmallows in the JCR on some jazz evening. I fucking hate jazz, but the hot chocolate was nice. And I remember nice chats, sometimes, under the tree by the river, the quiet evening air, laughing a lot. I guess there were some little moments when it all just felt right.
BE: Like how it was meant to be, being a student?
AY: Yeah. Like one morning in October, the sun was shining, I was listening to Massive Attack, writing about Voltaire—I felt happy, I felt like a real student, or how I’d imagined it being like, being a student. It was good—just for a few minutes. And then the sun went behind a cloud, or I lost my inspiration, or the track came to an end or something. The magic was so fragile. I suppose right from the start I had to keep reminding myself I was lucky to be there.
BE: Well, you’d worked hard for it.
AY: Sure. But it’s all just luck really. Being able to work hard, being encouraged to, your hard work actually paying off—that’s all just luck.
BE: True.
AY: Probably I’d just had ridiculously sky-high expectations, too, of what university would be. Occasionally they came true: scintillating company, copious amounts of cheap food and drink, one evening where we were discussing Middle English pornography and people kept getting up to improvise jazz on the piano in between gulps of beer. OK, so more bloody jazz, but apart from that fairly cool.
BE: So what was the problem, apart from your room not being painted the cheeriest shade of magnolia?
AY: No need to be nasty about it.
BE: Sorry. It’s just frustrating sometimes, the endless negativity. How did you feel, though? What did the problem feel like, I mean? What was the problem?
AY: Oh, I don’t know, like it was way too easy to slip from being an actor to being a spectator, from just doing stuff to questioning it all the time. Like, I didn’t know how much I should get involved in stuff. I’m sure if I’d asked anyone they would’ve said just try as much as you can—Jayne and Stan did say that, when they were trying to give me their good parental advice before I left. But I didn’t feel any enthusiasm about anything—but also somehow I couldn’t just be happy doing nothing on my own anymore, where I’d always used to love it. It’s like there was so much pressure to be having an amazing time that it didn’t feel OK just to be doing my own thing, quietly, like at home.
BE: Pressure from trying to be a proper student, you mean?
AY: Yeah. It’s actually quite a lot like what happens when you try recovery and suddenly you’re not allowed to feel any hunger at all without responding to it. Now being alone felt like it was off-limits too, from trying to do the whole student thing. It was spoilt because—it wasn’t legitimate anymore. I couldn’t store up solitude like hunger until my need to be with people had grown and grown to be really like a need. I felt I had to be with them all the time at normal times like everyone else seemed to just straightforwardly want to.
BE: But with food, things were OK, at least to begin with?
AY: Well, sure, I had the all-clear, I knew what to look out for; things were kind of OK for a while. But the end of anorexia was never going to be that neat, that soon. Maybe I’d always known that. … Actually, no, that’s not true. I think I really did think it was over, like a bad dream. Just not for long.
BE: Do you think you were actually still ill at that point, then?
AY: Well, I didn’t meet the bodyweight criterion for anorexia anymore, sure, and the questionnaires made things seem OK. But it’s tricky, knowing whether you’re ill or not, whether you’ve managed to get fully better and this is just the adjustment phase where you have to get used to living differently, or whether it’s creeping back in and you need to catch it before it does.
BE: You really think it’s so unclear?
AY: Well, I don’t know. Probably it’s not unclear at all if you’re actually better and you actually don’t care about any of this shit anymore. But I don’t know why the psychiatrist didn’t say, “Emilia doesn’t have anorexia nervosa anymore, but she sure as hell has EDNOS” or whatever else. Just to make clear that I still needed to take this stuff seriously.
BE: Would that have helped?
AY: Who knows. Maybe it shouldn’t matter what anyone else says. Maybe I’d have ignored him anyway. It’s like when you read definitions of anorexia, and you see how much they’ve changed over time, and it makes you realize how relative all this stuff is. Maybe no one’s opinion ever matters except your own.
BE: But isn’t there also something more than just endless subjectivity there? Like in the diagnostic criteria: Isn’t there something there, something they’re all trying and maybe not quite managing to pin down the essence of?
AY: Yeah, I guess.
BE: Do you think you could have caught it sooner, maybe, when it came back, and made it stay just a brief teenage thing, instead of it becoming the thing that defines your whole 20s?
AY: I don’t know. [sighs] I wish I could have. There’s so much obsession about everything now, so much anxiety and cold, and loneliness, and hunger, stretching so far back.
BE: Do you think it ever works, though, catching it before it really gets bad?
AY: Second time round, I mean like on the first relapse, I can imagine it could, yes. I don’t know about first time round, when you first get ill. I mean, if you don’t feel trapped yet, why would you really be looking for a way out?
BE: But people always seem to assume that early intervention is the most likely thing to make full recovery happen, don’t they? You think they’re wrong?
AY: I know, nip it in the bud, catch it before it gets too bad. But that’s always seemed implausible to me. Anorexia feels great to begin with. It’s like with addictions to anything else that feels good: Why would you believe anyone who told you it would end up like this? Everyone thinks they’ll be the one who can manage the tightrope walk, and keep managing it. Also, there’s the flipside: If you’ve been ill a long time, and tried and failed at recovery more than once, it makes you feel pretty hopeless, constantly hearing how you need to catch it early. I mean, if my chances were so much better earlier on, and even then they weren’t great, then how could there be any hope at all left for me now, nearly ten years on?
BE: Yeah, I guess they never really think about that.
AY: Also, I always wonder whether maybe all the failed recovery attempts are necessary, for the one that works in the end. Maybe failing isn’t failing but more like—preparing for success?
BE: I hope so.
AY: … If you treat every recovery effort as though it’s the last, at some point it will be.
BE: Do you believe that? Or are you just quoting someone?
AY: I don’t know. I can’t imagine it—it being the last time, the time that works. I can’t even completely want it, but that’s another thing, isn’t it. The change that has to happen to make you actually want to change, to get better in the first place. And again, I don’t know how that’s meant to work if you like all the things about your shiny new anorexia: being thin, feeling in control, everyone jealous of you, all the compliments, nothing else mattering so much.
BE: You need that addiction thing that people say about quitting smoking: the guy on 60 a day who’s tried quitting 20 times before, but then one day something clicks into place, some mental shroud falls, and he says: OK, fuck it, this time I mean it. I don’t actually want to be a smoker anymore. I want to stop now. I intend to. And then he just does it.
AY: And maybe the smoking 60 a day, the having tried to quit 20 times before and having learned something from each attempt, maybe they’re not incidental, maybe they’re not arguments against him succeeding this time, but arguments for…
BE: Not effortlessly, but with that new steel of conviction to carry him through the withdrawal, out into the strange new territories of life without nicotine.
AY: Life without nicotine. Christ, if only it were as simple as one tiny little chemical to get rid of.
BE: Simple, maybe, but not easy.
AY: Sure, but it’d be nice to have at least one of the two!