1,503. What if I subtract a strawberry? I run the numbers. Nope, that won’t do it. OK, I’ll halve the dill in the chicken salad and change 1/2 cucumber to 1/3 at snack time. I recalculate again. 1,500. Perfect.
For at least a half hour, I’d been tallying calories for a meal plan from a registered dietitian. It was for my job at a women’s health magazine — the Flat Belly Day column I edited was supposed to feature a day’s worth of food totaling 1,500 calories. My research chief was a stickler for precision, so the number had to be exact. While, in this instance, I was doing obsessive calorie math for work, it just as easily could have been for personal use.
At 25, I’d lived with anorexia nervosa for a dozen years. Counting calories was second nature to me, and thanks in part to my column, I could rattle off nutritional stats for spinach, skim milk, oil and a host of other foods. I could also share tips for curbing hunger, rank “fat-blasting” workouts and list recently anointed superfoods. I had to stay on top of diet trends; it was simply part of my job. But it also fed into my eating disorder and hampered any efforts at recovery.
There’s no one reason why someone develops an eating disorder. A mix of genetic, biological, social and psychological factors seem to be at play. Regardless of the underlying cause, the breaking point for me was moving from Pennsylvania to Georgia the summer before seventh grade. Doctors diagnosed me as anorexic about a year later, and I saw psychologists, doctors and a dietitian on an outpatient basis until I left for college.
Even before I set foot on campus, my plan was to study journalism, and I never wavered from it. During my junior year, I got an internship at a women’s magazine that turned out to be a crash course in health reporting. Within a few weeks, I knew I’d found my thing. I geeked out talking to researchers about the latest studies on exercise, sex and mental health, but I was especially drawn to nutrition. And at the time, covering the nutrition beat meant covering weight loss.
After graduating, I worked at a few different publications before landing at the women’s magazine where I was tasked with Flat Belly Day. As a nutrition editor, I published stories on the best fruit for slimming down, good vs. bad carbs, the right way to juice and every fad diet that cropped up. While I rolled my eyes at some assignments (There’s no magical “weight loss” fruit!), I still internalized the fat-phobic messages that my work promoted: I planned out my food every day and religiously counted calories. If I didn’t exercise, I’d eat less to compensate. If I decided to change my snack, I’d rerun the numbers so that I met but never exceeded my self-imposed daily allotment.
My coworkers didn’t seem fazed by my food fixation; no one asked me if I was OK or said anything to indicate concern. Maybe they felt uncomfortable raising the issue. But given the environment we worked in — where no one thought twice about recommending intermittent fasting to people without weight problems — it’s also possible they just didn’t notice that anything was wrong.
My next job took me to New York City, where my formerly listless social life thrived but my health deteriorated further. At least once a week, I’d be invited to try out a new exercise class, where I’d meet other fitness editors with similarly intense health habits. It wasn’t uncommon to hear someone talk about two-a-day workouts, which made me feel like I wasn’t doing enough. Soon enough, I stopped considering yoga “real” exercise; on the days I did a 90-minute vinyasa after work, I’d add a morning Pilates class too.
I knew that I hadn’t fully overcome my eating disorder. But it never crossed my mind that my career might be amplifying the problem. In my field, an obsessive focus on health was nothing out of the ordinary.
“Mainstream culture doesn’t name everything out there as an eating disorder that should be,” says Julie Church, cofounder and nutrition director of Opal Food + Body Wisdom, an eating disorder treatment center in Seattle. “And it’s tricky to know yourself. Someone in the wellness industry might have a harder time knowing when something that is trendy might lead them to a disorder or relapse.”
There were moments when I’d tell myself, This needs to end. This is controlling my life. I don’t want to be like this. One such moment occurred when I was diagnosed with osteoporosis at 25. Maybe it shouldn’t have come as a surprise. Years of being underweight can halt estrogen production and in turn decrease bone density. But I sobbed when I saw the results, gutted by the thought of becoming frail, or even disabled, in my 30s. Yet my eating disorder had so much power over me: I was convinced that if I gained “too much” weight, people would reject me, from friends and coworkers to potential partners and even strangers on the subway.
At that point, none of the experts I’d seen had pushed me to gain enough weight to reach a “healthy” body mass index. I’d stopped getting help for my eating disorder before leaving for college. Then, starting in my early 20s, I received on-and-off treatment from a variety of professionals: doctors, therapists, dietitians, a nutritionist and even a homeopathic healer.
I had to step on a scale during most of my appointments, and the doctor I saw in my 20s routinely did blood work to make sure my red blood cell count was OK, but that was the extent of her involvement. Dietitians would suggest ways to adjust my diet for weight gain, but no one sat me down and spelled out the potential long-term consequences of years of malnutrition. Therapy sessions unfolded like casual conversations about my day. It seemed like we rarely addressed my anorexia, let alone connected it to other things in my life.
Because no one said otherwise, I thought the size that I’d maintained pretty much since middle school was healthy enough, even though I hadn’t gotten my period since I was 13 and was clinically quite underweight. My eating disorder convinced me that the consistently low number on the scale was just my natural set point, and that it was prohibitively difficult for me to gain a substantial amount of weight, when really, I wasn’t making a good-faith effort to do so.
About four years ago, when I was 30, my parents confronted me. I’d been unhealthy for far too long, they told me, and my job seemed to be making things worse. My mom even suggested that part of the reason I’d spent several months earlier that year interviewing for new jobs without getting any offers was because my eating disorder was obvious to anyone who met me.
Their concern didn’t go over well. Somehow, I didn’t think my job editing metabolism-boosting meal plans and crafting shedding-for-the-wedding guides had any bearing on my personal relationship with food. Nor did I see my relationship with food overall as unhealthy: I could easily say to a friend, or write in a story, “Eat what you love! Work out the way that feels best for you! Don’t make healthy the enemy of fun!” But I could never be that easy-going myself. As much as I cared and knew about health, the persona I created around it had become disingenuous. My own lifestyle habits were rigid and self-punishing, and generally made all aspects of my life unpleasurable.
In June of 2017, 20 years after developing anorexia as a middle schooler, I decided I wanted to get healthy. I felt guilty about the stress I’d put my parents through and worried that malnourishment would leave me infertile, knowing that I wouldn’t get a period if I didn’t take birth control.
With referrals from a recovered woman I knew, I found a new team of healthcare providers. My new doctor explained how my low weight affected my estrogen levels, which in turn affected both my bones and my digestive system, in addition to my menstrual cycle. He also brought up the psychological burden of the disorder, and checked in to make sure I was talking to a therapist — and actually talking about my eating disorder.
At the same time, my new therapist and I dug into my underlying feelings surrounding self-image, body size and relationships in a way I’d never done before. She helped me distinguish the eating disorder voice in my head from my own voice, and connected the dots between the ways I’d been depriving myself of both food and love. Some of the lessons sound like cliches — to accept myself and realize that I deserved love — but they were cliches I really needed to learn.
My health remains a work in progress. I’ll probably never regain all my lost bone density, but I might be able to get back to a pre-osteoporosis level, called osteopenia, and I’ve regained my natural menstrual cycle. Under my new doctor’s care, I’ve also hit my highest weight ever (though I still have thin privilege), one my physician deems a healthy goal.
I’ve talked to both my therapist and dietitian about whether I should stay in health journalism. Would it jeopardize my recovery? Could I report on research about nutrition and exercise without being a hypocrite? With their help, I decided to continue down my career path — with one important change: I don’t write about weight loss.
This has been easier to do than it might have been a decade ago, thanks to changing cultural and scientific beliefs about health and weight and their relationship to each other. A lot of magazines and content platforms in the lifestyle and health space are overhauling their weigh-loss content, and giving up, or at least cutting down on, the kinds of 1,500-calorie meal plans and diet hacks that were once a staple of nutrition reporting. Self magazine published an article in 2018 outlining its reformed approach to covering weight. Instagram just announced a policy banning content that promotes weight-loss products or cosmetic procedures to users under 18.
There’s still a lot of progress to make, but I hope the shift away from the Flat Belly Days of health journalism continues. There are much better things to do with your professional and personal time than count and recount calories.