"I cried a few times whilst reading this, because it's an upsetting story at times that reflects a cruel and stark reality. Many who have experienced mental illness across their lives can relate to Hadley Freeman describing her adolescent desperation, anger, and self-destruction. I, who has never experienced anorexia nervosa, but does experience obsessive-compulsive disorder—just as Freeman herself has across her life—related strongly to her reflections on guilt, obsessiveness, shame, and the unending quest to feel some semblance of control in a world restricted by a set of self-imposed rules.

I was surprised, even morbidly amused, when she'd occasionally describe behaviour taken straight from the scrapbook of my own life: turning taps off with your elbow so you don't need to wash your hands again, did you say? I'm a professional in this sport. When I was a child and twirling around, having to spin back the other way an equal amount of times to 'unravel' myself? Of course, after all, one has to be sure you haven't accidentally trapped yourself in an alternate time continuum! That is to say, though the behaviour was not always familiar to me, the distorted thought processes, the ugly emotions, and the inability to give yourself a break offered me some insight into Freeman's anorexic worldview. It doesn't sound like a pleasant place to be.

Structured roughly in chronological order, we follow young Hadley from the moment her mind breaks in two (I still remember my own mind altering practically overnight), through memories of her time in various hospitals over her teenage years, through to her university and later adult life, and finally her reflections on recovery and her current experience. Peppered throughout are the stories of other women she knew in hospital, some of which made me sob; interviews with professionals on current research into anorexia in terms of treatment and causes, and how this understanding developed from when Freeman was ill; alongside this, we also see the author's own insights on being a girl and now a woman, and how this uniquely relates to anorexia's expression and existence (it's perhaps the most gendered mental illness there is). Obsessive-compulsive disorder and drug addiction are also discussed.

Like most everyone else, I came into this book with certain confusion about anorexia and its causes. Was it simply an embodied reflection of our society's obsession with female thinness? Are models, and more importantly, those that hire and sell their images to us, entirely to blame? What do anorexic girls mean when they say they 'feel/look fat', when this so clearly isn't the case? Is their actual visual perception distorted, as well as their psychological interpretations? How does one recover, and if some do, why don't they all?

Though research into this area is still ongoing, and ultimately, it's not entirely understood why some recover and some do not, or even what causes eating disorders more broadly, there was still a lot of knowledge to be gained. Girls and young women with anorexia know they are incredibly underweight, Freeman tells us, but they want to look ill. Once this clicks, it becomes easier to understand the general rationale of the illness; if it's about the state of being ill itself, then it does become about difficult emotions and fears of growing up, rather than the food itself. The hyper-fixation on food, she continues, is not the most important or significant factor, but a self-destructive expression of deep-rooted unhappiness and self-loathing. Within this context, 90s skinniness, the fashion industry, and presentational aspects of gender division more generally are unhelpful, to be sure, but also can't be neatly labelled the sole instigators of female discontent (they certainly do nothing to discourage disordered eating and negative body image, however). Girls learn about their expected gendered behaviours in less visible ways, too, and an emphasis on being well-behaved and excessively deferential quickly morphs into perfectionism and self-denial. The anger, ugliness, and fears of teenage girls do not have an appropriate outlet here, and when they don't the brain may simply create a space for those feelings to go, no matter how destructive this ends up being. I learned a lot through my experience of reading this, and became more than a little angry at the trivialisation and in some cases demonisation of some of the most vulnerable girls.

Speaking of vulnerable children, I thought I would briefly address the negative—and, in my opinion, mostly unfair—reviews and criticisms that this book has received on account of a few things. Firstly, and no doubt this was anticipated by Freeman herself, there are a few who have similarly suffered with an eating disorder and are unhappy with her portrayal of anorexia nervosa. Though this is understandable—when people have suffered they want to see their experiences represented—if it is one's sole metric for measuring the merit of this book, many will be left disappointed. She is one woman, and has never claimed to speak for everyone.

She no doubt also anticipated the hoards of one-to-two-star reviews by people calling her a ‘TERF’ for a few chapters that make reference to, and compare, the experiences of girls with anorexia and girls adopting transgender identities and seeking medical treatment to become transmen (I saw one reviewer express their disbelief that Freeman would talk about dysphoria as though it’s an illness—wait until they discover that transitioning requires one to fulfil certain diagnostic criteria. Gosh, it’s almost as though you’re considered to be in psychological distress). For those who don't know, in 2009 most referrals to the UK's adolescent gender clinic on account of distress towards one's biological sex (gender dysphoria) were boys, but by 2019 the number of overall referrals had not only notably increased (77 in 2009 to 2,590 in 2019), but also had a demographic shift, with 74% of those referred being young girls. The proportion diverges from more equal numbers between boys and girls pre-puberty to skewing more heavily female during. If this sounds at all alarming to you, or at least something curious that ought to be looked into, then welcome to the ranks of women and men who are called fascists and extremists for expressing this utterly benign and reasonable view—I know, I'm similarly scratching my head and asking what the heck's going on.

For my part, I believe it’s not only reasonable, but good old-fashioned sensible to investigate why there has been an increase in the number of natal girls identifying as trans. It would be unbelievably irresponsible not to with such a striking demographic shift in those seeking to transition. The more people decry journalists, healthcare professionals, and parents for wanting to look into this issue as evil bigots, the more convinced I become of just how ideological many peoples beliefs about this topic are, and the more aware I am that they are not led by compassion and caution, despite how often they may claim to be. No diagnosis nor treatment is exempt from criticism and above careful investigation, and to argue otherwise is to argue that some young people do not deserve the same thorough and evidence-based medical care. That's all I've to say about that right now, but I felt the need to tell any who may be confused by such reviews, or wrongly convinced of the author's supposed bigotry, that this is a sensitive and loving book that is well worth your time.

Ultimately, this is a hopeful and compassionate book, and the author's journey to recovery (which took decades) is personally inspiring to me, and no doubt will be to many others who have spent time locked in tense arguments inside their mind. Nobody gets out the other side without staring down their fears, and some will never be able to fully shake them, but we are able to make the decision to live and flourish regardless. As someone who is still struggling, and potentially not quite ready to give up all of my illness just yet, it has offered me renewed confidence in my capability to chip away at my fears day after day and know I am resilient not for my ability to hold onto them, but to allow myself to let them go. Highly recommended."