It starts innocently, as these things do: You avoid soda and desserts all summer in preparation for basketball season, because you want to be faster up the court than anyone else. But the restrictions escalate, and soon there’s no oil, no butter, no mayonnaise, no sauce, no dressing, no cheese, no peanut butter, no white bread, no white pasta, nothing fried, no sweets, no snacking. You eat every four hours, and on Wednesdays you have a frozen-yogurt waffle cone. You run to the yogurt shop.


You examine yourself naked in the full-length mirror in your bedroom to mark the changes. Your knees look knobby. Little bruises dot your spine like a string of pearls. The left side of your sternum rises higher than the right, which you had never noticed before. Your thighs don’t touch. You are tall, five-eleven, and your body has new angles. You cannot, you think, be blamed for enjoying the feeling.


You’re sure nothing is wrong, but no one will believe this. The psychiatrist doesn’t believe it. She offers you a chocolate-chip cookie, looking hopeful. Your parents have paid her seventy-five dollars to advise you to “focus on the positive.”

The positive is that in six months you will be eighteen and no longer legally bound to obey your parents. The counseling will stop there. So will their marriage.


People have started offering you desserts in a way they think is casual, saying, “It’s just one bite. It won’t make a difference!” But it does. You can eat certain foods and you cannot eat others, and this is the only way you can feel OK. Losing weight is not the point.

The intensity that has always defined you — that has made you captain of the basketball team, editor-in-chief of your high-school newspaper, Ophelia in the school play — now finds you occupying the full twenty-five minutes of lunch with eating half a sandwich. You chew deliberately, tasting every bite, becoming full. You convince people you have it all under control.

You do have it all under control. Control is exactly the problem.


Research has suggested that starvation over a period of time can rewire brain chemistry, and that these changes can become hereditary. There is a biological advantage to this: if a food shortage is likely to continue over generations, descendants will have a better chance of survival if they instinctively regard food as scarce.

Forty percent of Ireland’s population died in the mid-1800s, in the Great Famine. Men stole food, either to feed their families or in the hope of going to jail, where they were guaranteed bread and porridge every day. The jail was overrun with petty thieves who all had the same idea.

Your great-great-grandfather, John Rooney, survived the famine. He came to Iowa.


The doctor, an eating-disorder specialist, says that 139 pounds, which is within the normal weight range for your height, makes you look emaciated (this is the word he chooses: emaciated).

You tell him you care about being good at basketball, but not about your weight, not about how you look.

Your body is designed to make you eat, he says, and your body usually wins.

You allow him this.

So, Kathryn, he says, tell me: Why do you care about being good at basketball?

You ask, Why do people want to be good at anything? You wish he would engage you on this point, because you have more questions like that. Instead he thinks you are being difficult and makes a note on his chart. You lift your one-liter water bottle and chug.

The good news, he says, is that your heart is fine, and your pulse and circulation. I have no reason to tell you to stop exercising. But you are thinner than most fashion models.

Thanks, you say.

No, he says, I mean, they are too thin. Can you . . . ? he trails off. When he starts again, he tells you that nearly everyone with an eating disorder will relapse. They are diseases you can never lose, just learn to manage. His words will scare you for a long time.


Your basketball coach stops calling your name in the starting lineup. Stops relying on you to make his free throws in overtime. Will not look you in the eye.


After John Rooney moved to America to escape the famine, he married a girl from Kilkenny, near his home county. If the science is to be believed, your history could look like this: their children, when they had them, found themselves compelled to consume rich foods even in the absence of hunger, as if there might not be a lunch, might not be a dinner — though of course there would be; this was Iowa, and the farmland was lush.

This fear runs through your family. Your father cannot stand to see good food go to waste. Your younger sister hoarded food as a child, stealing the Communion wafer at church each week to add to a pile under her bed. Your grandmother found joy in baking and eating during years of marital strife, and finally found herself diabetic and in a wheelchair, trapped in a body that had betrayed her.

This same grandmother pulls you aside at the holidays and tells you that you would look prettier with a little more weight on your bones. You are starting to feel trapped, too.


One night at Mark’s house, your friends corner you with questions about your eating habits. It seems clear to them: if you would gain weight, your coach would let you play. Then you would be happier — you seem kind of angry, they say. But you have the best shooting percentage on the team, regardless of your weight, and you think that should be enough.

Your friends block the door to stop you from leaving. They ask why you’re not fixing the problem. You, who have always tried to do everything perfectly, are doing all of this wrong.

There’s no point in arguing, but your entire body feels like an argument.


Your mom walks into the sunroom, where you sit so close to the heater that it almost burns your back. We don’t need the heat on in October, she says.

It’s late October, you say, and I am cold.

She is silent. Then she says, I know you are bingeing on lettuce!

You say, Hold on. Lettuce?

It’s a laxative, she says.

You tell her you’re not bingeing on anything, least of all lettuce, which sounds gross. Your mother can see that something is wrong, but she knows you are not a liar. She walks back into the kitchen. You hear her banging the dishes around.


Your friend Paul tells you your boobs look smaller.


It’s November, and basketball season is almost over. With two minutes left in a blowout game, your coach tugs the shoulder of your jersey and puts you in for the first time, a token gesture to end the season. At the buzzer you nail a three-pointer that makes no difference.

You stay in the gym until the lights go out, and then you start running around the track. You’re still wearing your basketball uniform. You breathe in the stale smell of sweat and remember what it felt like to be relied upon, to be the leading scorer, to see your stats in the paper the next day. You think about how hard you worked. But you could not have done anything differently. The compulsions you feel are inescapable.

Every pound of body weight lost equates to five pounds of pressure off the knees, so your joints are bouncy as you circle the track. It takes an hour for you to feel spent. Spring will bring track season, and you decide you will be the fastest. You will work the hardest.


Tonight your mom brought you a bowl of frozen yogurt. It seemed like a stab at reconciliation, so you ate it all while she watched. Now you’re standing over the trash can, looking at an empty ice-cream carton. She must have tricked you; your mother is not a liar either, but she has become desperate. There is only a forty-calorie discrepancy between a half cup of ice cream and a half cup of frozen yogurt, but you cannot eat ice cream. You sprint upstairs, run back down, then sprint back up (five calories burned climbing a flight of stairs, now ten) before kneeling in the bathroom and jamming your fingers against the back of your throat, awaiting the milky bile that will mark relief. But something is wrong: it is not working. You try using a toothbrush, but you do not react to it. This cannot be true: this is your escape, this is your safety net, but you do not have a gag reflex, oh my God, you do not have a gag reflex, so all that’s falling into the toilet is drool and tears, and now you are stuck with the ice cream, with the calories; you are stuck with everything you will ever decide to eat again.


Of course, your ancestors would tell you there is nothing noble in starving yourself. They would expect you to get on with living, as they did. There is work to be done, fields to be sown. You have a pantry full of nonperishables at home that you didn’t even have to can yourself. That you would not only avoid perfectly good food, but try to throw it up — the thought of it.


You are very cold, a chill that does not break. You run everywhere — across parking lots, into the movie theater, into school — because the winter air is unbearable. You wear four sweat shirts at once. Your hair hangs like damp yarn around your face. Your temples look bruised and greenish. The books say that if you get thin enough, you will get a mustache and thicker, darker hair on your arms — like fur, to keep you warm — but these have not come yet. The skin below your stomach develops a weird yellow pigment: jaundice, you guess. Your clothes fit like garbage bags.

Your body has become your metric: by its size you can judge your perfectionism. You find yourself staring into mirrors, lifting your shirt, evaluating.

You know that your behaviors have evolved, become more extreme, but you don’t want to admit this to your doctor. He is two hours late to see you this week. When he walks in, he tells you that the anorexic girl in the appointment before yours died on his exam table — she went into cardiac arrest and did not recover. He is visibly shaken. He says this could happen to you: the chambers of your heart could degenerate and surrender, just like that.

You press down on your pointer finger and watch the redness return to it, like he showed you, to check your circulation.

He draws a long breath. Still, he says — and you can see it pains him — for now you’re clear to run.

Your parents, when he tells them, are angry: How can you tell her that?

It’s remarkable, he says. He explains that many girls with your body mass index feel weak with fatigue, their futures uncertain. But on paper you present as healthy. Potassium, folate — all of it good, all impervious to what looks like starvation.

I cannot deny the risks, he says. But her body is holding up.


You stop at the park with Paul on a Sunday and sit together on the low branch of a big tree, legs dangling.

How’s it going, he says.

You want him not to worry. The doctor says my heart is very healthy, you say. I can still run track.

He nods, then pulls a Swiss Army knife out of his pocket and flips it around in his hand. Lately you never know what to expect from people. He says nothing but looks at you deeper than you thought it was possible to look at a person. Then he opens the knife and drags the blade across his forearm. Blood blooms along the line he carves. When you protest, your words are jumbled. His are clear and even.

My heart is very healthy, he says. I can still run track.


Does your parents’ divorce have anything to do with it? Your friends, the psychiatrist, the cardiologist, the school counselor — they all ask this question. You don’t know, but what difference does it make? You have lost your starting spot on the basketball team, your credibility, a number of friends, and more than fifty pounds.


By not eating, you have overridden your survival instincts, but now your body begins to push back. Cravings arise suddenly — they feel elemental, primitive. Biological imperatives do not like to be repressed, and you imagine 1.5 million withered Irish peasants crowded in the pit of your belly, torches raised.


Your friends demand to know how much you weigh. Your answer comes out haltingly. You don’t mean to lie. You are not a liar. Still, from somewhere inside, a little untruth is uncorked and rises to the surface and bursts, and you say 130. They look at you, dubious. Even your words have lost their weight.


Paul is sorry for the knife thing. That’s what he calls it: the knife thing. He tells you this while you are standing in your prom dress in front of the chocolate fountain at school. He promised to be your date and is keeping his promise. He nods seriously at people as they pass. You paid $150 for a tight red dress that makes your thinness seem fashionable, and nearly that much again for someone to strategically bobby-pin your hair, which has become stringy and flat.

Have a cream puff, Paul suggests.

I just ate, you say.

Come on.

I’m fine, thanks.

He picks one up, dunks it in chocolate, and stuffs it into his mouth, eyes still on you. He eats another, and another. The fourth one bursts when he bites it, the cream spilling over his lips. It is difficult to watch. You glance at his arm, remember the park, and wonder how in this situation you could be pegged as the unstable one.

Paul, you say.

You look like a corpse, he says.


You qualified for track regionals in the mile and the two-mile, neither of which you had ever raced before. When you asked your coach if you could try, he laughed — you were always a sprinter — but he said yes, and now you have beaten his distance stars. You have been running more since you found you don’t have a gag reflex. But you also like running, because it simultaneously requires all of your attention and none of it.

The wins, though, feel awkward and freighted. People clap unconvincingly, as if unsure whether they should applaud. A reporter asks a couple of questions but drops the story for reasons of “sensitivity.” You check your body against pictures of professional athletes, and you think you look the same — but you are not a professional athlete, and a few months ago you looked very different.


This is how it ends: Your mom has baked brownies and set them on the counter for your sisters. She has given up on your eating desserts, but tonight you are alone, and something snaps, and you think: I will have one bite.

The thick fudge coats your tongue, rolls around in your mouth, sets off sense receptors you didn’t know you still had. The chocolate tastes alive. You moan with the indulgence of it. One more bite. One more. Soon you are cramming entire brownies into your mouth, chomping so hard your jaw hurts and bits of them crumble and fall, and you pick those up off the floor and shove them in, too. You feel so much pressure against your stomach that you fear it will rip open and the brownies will spill out onto the floor. You eat all of them. Every single one.

When it’s over, you look at the mess as though someone else made it. You don’t know how you will explain this to your sisters. You will have to make another batch. It’s late and the floorboards are cold on your bare feet as you measure the flour and cocoa powder with impeccable precision. While the brownies bake, you lie on your back in the sunroom and run your hands over your swollen belly. You do sit-ups, even though the floor hurts your spine.

The timer sounds. You pull the tray out. Before the brownies are even cool, you’ve started eating again. You don’t even cut them, just dive in with a fork and demolish the apology you spent an hour creating.

This will become your life. You will watch, horrified, as your body bows to biology. For months you will rip through tubs of ice cream, boxes of cereal, entire loaves of white bread. You will run frantic midnight miles. Your body will bulge, become doughy and floppy and not-yours. When you go away to college, you will find yourself stealing your roommates’ food, sneaking away with strangers’ leftovers in restaurants, eating until it hurts to breathe. Four thousand calories a day. Five thousand. Six. You have starved yourself, and now you will eat like a person who has starved. Years will pass this way. Even after you can finally pull yourself together, your 105-pound self will berate you for every bite you take. She will keep score, remind you of how far you have fallen. She will pace around in your head, agitated, banging on the walls.