Empty by Susan Burton

"The beginning of anorexia is like heroin before it wrecks you. It's a sensation akin to bliss. But the rest of anorexia is like heroin, too, in that it's a downward trajectory, and I want to shut myself in the bathroom with the fifteen-year old me and warn her of the peril: organ failure, cognitive impairment, the highest mortality rate of any psychiatric illness - is anything I'm saying getting through? I want to tell her that if she escapes that jeopardy and finds a way to be, say, a "high functioning anorexic", she will lose and waste so much. I am her living proof."

Susan Burton is a well known editor and writer. You can see view her writing work in Slate, Mother Jones, New York, The New York Times, and Harper's where she's the former Editor. Her radio documentaries have won multiple awards, including an Overseas Press Club citation. Susan graduated from Yale in 1995, and now lives in Brooklyn with her husband and their two sons. 

In her new book, titled Empty, published by Random House, Susan reveals the extent her battle with binge-eating disorder (BED) and anorexia nervosa that took control her mind and body throughout her adolescent and young adult years. 

Photo of Susan Burton by Willy Somma

Susan was anorexic first, then she started binge-eating, and later returned to anorexia. This is common in individuals with eating disorders. I, myself have cycled through various diagnoses such as Eating Disorder Not Otherwise Specified (EDNOS), bulimia, anorexia, atypical anorexia, and anorexia again. 

When Susan was actively binging, back in the 1980s, binge-eating disorder wasn't in the DSM, so wasn't actually on the "official list of things" someone could have. It wasn't recognized as an eating disorder until 2013. BED is now the most commonly diagnosed eating disorder amongst all feeding and eating disorders.

Susan states "Eating disorders are characterized by secrecy. Even after I stopped binging, I told no one about it. Not my husband, not a therapist. Not anyone. Anorexia was impossible to hide - it was a demand to be seen. But I didn't talk about anorexia either".

Other characteristics include preoccupations with weight, food, and calories, skipping meals, withdrawal from friends and activities, extreme mood swings. Some physical characteristics could be noticing fluctuations in weight (both up and down), difficulties concentrating, dizziness, fainting, feeling cold all the time, trouble sleeping, fine hair on the body (lanugo), and muscle weakness. 

Sleeping, by Kinga Cichewicz

There was some dysfunction and addiction present within Susan's family that may have contributed to her eating disorders. Her father and his unstable mood, and her mother and her own body images and unhealthy drinking habits. 

Her parents eventually divorced and Susan moved west to Boulder with her mother. She was accepted into Andover but ended up at public school, where she was happy to go, ecstatic actually, she could be like one those girls who graced the cover of Seventeen magazine. They all went to public school, right?

Just before the move to Boulder, she noticed she had lost a few pounds, and stated that "the exact sensations I craved: light, relieved, unburdened. It had never before occurred to me that I could achieve this state with an alteration to my body".

It was a feeling I personally would come to crave again and again, a repetitive cycle that started when I was 11. A few lbs, on and off again, here and there. What started as a couple of lbs grew to more and more, until I had lost more than 35% of my body weight. Chasing that high was my drug, my heroin, seeing those numbers drop lower and lower. Then I'd have to watch painfully and experience the physical discomfort as the number climbed higher and higher in treatment.

Susan talks about how weighing had always just been a check-in for her but later on it had become a gratifying experience. She began to stay on the scale for an extra second, stating "It hadn't occurred to me I could get into this range before".

For me, it also started out as a little check in. Now it's a daily habit. A ritual that must happen at least once a day, and sometimes several times a day. It's compulsive, and sometimes that means getting up in the middle of the night to check, to ease the anxiety so that I can get back to sleep. Because if I don't get up and check, then sleep does not come again. 

Right before her senior year, Susan got a job at Alfalfa's, an organic food store that smelled like wheatgrass and vitamins. She admits that working there was perhaps inevitable since she was obsessed with food and her job fed the obsession. 

Her eating was worsening around this time, and the way in which she describes her binges is completely intoxicating. Susan describes them with so much intensity that I found myself holding my breath, tensing up, having flashbacks to times that I was in the exact same position as her. 

Eventually, Susan started to make some really positive changes. Mostly for Mike, the love of her life. She wanted to be the open and generous girl he'd fallen for. Slowly, she started eating again. 

Years would pass before Susan realized that her eating disorders had not delayed her, they had defined her. In her thirties, she was asked to provide an essay for an anorexia anthology, she said "Sure, I'd love to". Her anorexia had been no secret, people had seen it. However, she felt she couldn't tell that story without telling the story about her binging, something she had locked away, and couldn't face.

For some reason, it's always been easier for me to tell the story of my anorexia (clean, disciplined, empty, controlled), than it is to tell the story of the bulimia (chaotic binging, destructive purging). I feel as Susan felt, and even then, I am just beginning to feel the strength to talk about my battles with anorexia. The binging is an entirely different monster in which I have never talked with anyone about. It comes with a whole other level of shame, and in order to understand it, I’ve always felt that the person has to have been there in order to understand, but maybe I’m wrong. Maybe for people to understand it, I just have to talk about it. I’m not sure. Sure is easier said than done. I just hope to be able to tell both sides, because without one, half of my story is missing. 

Susan came out and told her story at thirty-six, including talking about the binging for the first time. She got a job, watched her mother get sober, watched her father get stable, got married, and had kids. 

To conclude, this book was incredible, and I'm grateful to Susan for sharing her story. Her strength to share is an inspiration to me. 

I listened to both the audiobook and read the e-book. The audiobook accompanied me on my daily walks, and the e-book joined me for my evening baths at home. It was nice to hear Susan's voice as she told her story. Her writing is brilliant, captivating, and articulate. 

Empty is available in hardcover at Indigo or on Kobo. For other retailers, check out GoodReads
The paperback is available for pre-order, hitting shelves July 6th, visit Penguin Random House for more information. 


I'd like to take a moment to honour International No Diet Day which is today. It was started by Mary Evans Young in 1992, after her personal battle with anorexia. While in recovery, Young worked to help others appreciate themselves for what they are, and to appreciate the body they have.

Diet culture is all around us in the form of advertisements in magazines and social media, and the pressure to be thinner is stronger than ever right now.

I wanted to recommend some anti-diet culture books that I've found helpful. I haven't read the entirety of all of these books. 

I have read the entire F*ck It Diet (read my review here), and Sick Enough. For the others, I've taken bits and pieces, snippets of these that I've found inspiring in my own recovery journey, so I've included them here as well:
The Let Us Eat Cake is also an incredible resource that I've found extremely helpful throughout my recovery journey. Having worked with both dieticians in the past, I can't recommend them enough. They're awesome!

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