By Emilie Richardson
Late into the night, hours after finishing my 10th-grade classes and homework, I sat curled up in bed. In the quiet darkness, I stared at my reflection across the room — sunken, tired eyes illuminated only by the glow of my phone. The silence felt heavy, broken only by the hum of the air conditioner and the steady pounding in my head. Beneath it all was a familiar ache in my stomach, one that brought a strange sense of comfort.
As if broken from a trance, I looked down at the blank screen in my hands. My fingers hesitated above the keyboard, urging me to spill my secrets. I knew I should be sleeping — it was already too late, and I had school in the morning — but still, I wrote: “How long can I go without more than a meal in a day?”
For a moment, I felt proud. That question captured everything I craved: control, secrecy and the strange comfort of hunger.
I was 15 when I wrote those words, followed by: “Not eating just feels too good.”
Hidden in my notes, in a makeshift diary, I recorded thoughts I could never say out loud. Not to doctors, whose questions felt too calculated, or to my parents, whose concern would have been overwhelming. This was my only outlet, and it was there that I found solace. And in hunger, I found control.
From sixth grade through high school, this was my quiet routine. I wrote more words in that diary than calories I allowed myself in a day. Each entry only reinforced a sense of discipline and control, even as everything else in my life felt uncertain.
And for a long time, that illusion was enough.
But slowly, the tone of my entries began to shift. The pride I once felt began to dull, replaced by exhaustion — headaches that lingered, mornings that felt harder to wake up for, reflections that looked less like self-control and more like fragility. The questions began to change, too. Instead of asking how long I could go without eating, I found myself wondering: How long can I keep living like this?
At 15, I believed I was alone in this struggle. In reality, my experience reflects a much larger public health crisis affecting adolescents across the country.
Eating disorders are among the most serious mental health conditions affecting adolescents, particularly young girls. They are not simply dieting or phases, but complex and potentially life-threatening illnesses. Research estimates that approximately 13% of adolescents will develop an eating disorder by age 20. These conditions also carry one of the highest mortality rates of any mental health diagnoses, as adolescents with eating disorders are at an increased risk of suicide.
Alarmingly, the crisis appears to be worsening. Recent studies show an increasing prevalence of eating disorders among girls aged 15 to 19. Additionally, emergency room visits for eating disorders among girls aged 12 to 17 more than doubled during the recent COVID-19 pandemic.
Despite their severity and rising prevalence, eating disorders often go undetected, especially in early adolescence, when warning signs may be subtle or misunderstood. Changes in eating habits, preoccupation with weight or appearance, social withdrawal and unexplained physical complaints can all signal a deeper issue.
While my story is one example, biological changes during puberty, societal pressures, family history, coexisting mental health conditions, stress and bullying can all contribute to the development of eating disorders. Although these disorders disproportionately affect adolescent girls, they can impact individuals of any gender, age or background. Early recognition, therapy, nutritional support and family guidance can significantly improve recovery outcomes, though awareness and access to care remain ongoing challenges.
Understanding the scope of this crisis makes it clear that early intervention is critical, but recovery is also deeply personal.
It doesn’t happen overnight. For me, recovery was gradual and often frustrating, made up of small steps. I learned to recognize the patterns that had once controlled me, to seek support and to speak openly about feelings I had long kept hidden. Sharing my story transformed what felt like isolation into a path toward healing.
Eating disorders thrive in silence — in the thoughts we keep safe in our heads, in the pages of a diary I never thought I’d share. Awareness, honest conversations and early intervention must be prioritized so that we can interrupt eating disorders before they become life-threatening.
Schools, health care providers and communities all play a role in addressing eating disorders. Talk to your children, to your parents, to your doctors. Ask questions. Listen closely. And if you see someone struggling, reach out. Save a life before it’s too late, and break the silence on eating disorders.
Emilie Richardson is a second-year public health major.
“My Public Health Story” essays originated from an assignment on public health storytelling for a public health messaging and dissemination course led by Gaia Zori, Ph.D., M.P.H., coordinator for the social and behavioral sciences and public health practice concentrations in the Master of Public Health program.