T
he list is impressive: Saints Joan of Arc, Catherine of Siena, Hedwig of Silesia, and Teresa of Avila; royals Catherine of Aragon and Mary, Queen of Scots; writers Simone Weil and Anne Sexton; entertainers Audrey Hepburn, Fiona Apple, and Karen Carpenter. A roll call of women who history has shown to be strong, independent, and accomplished. Women who confronted foreign landscapes, battlefields, restrictive religious and marital vows, and the blank page. Yet the other thing they have in common—the reason for their place on the List—is that they’re all thought to have experienced one form or another of anorexia nervosa.

And you can add my name to that list: Erin Block, anorexic.

Today it’s the disease of adolescent girls—blamed on catwalk models, airbrushed celebrities, thigh gap aspirations, and unrealistic diets. And while it’s true that women are faced with enormous pressure to look good and thin, the disease is much older than Hollywood norms. There are signs of it here and there in human history just as clear as the bulls, deers, and dogs in cave paintings. Egyptian hieroglyphs, Persian manuscripts, Roman histories, and Chinese scrolls all suggest the existence of what today we call anorexia. In 384 AD, Saint Jerome described the first recorded death by self-starvation in a letter to the mother of a twenty-two year old Roman woman named Blaesilla. The young woman—who was one of Jerome’s followers and also a saint—died for the Gnostic principles of denying one’s body and embracing one’s soul.

I only cared that I had one thing under control. That was the comfort I clung to with all the might in my twiggy arms.

It should come as no surprise that the practices related to anorexia are ancient. At their roots are basic human desires—to control, to be safe, to be loved, and to please. Yet it does surprise us. We think of the supple forms of Renaissance women, their nude flesh on a painter’s couch; we think of the class struggles of peasants and lords, of barely enough and plenty. Self-starvation in these cultural frameworks seems impossible. And yet it was there.

Historically, the practice reached a height during the Renaissance, as many strong, spirited women chose the ideals of the cloister over the expectations of marriage. “Holy anoretics,” they were called, breaking their dependence on patriarchal society, on their fathers and would-be husbands. Through food and fasting they discovered control over their own lives and desires. It was an assertion of empowerment. But they often fatally broke their bodies in the process.

“Fear of gaining weight” is one of the first symptoms listed in diagnosis resources today. For a long time this allowed me to deny my place on the List—to avoid the stigma of the term “anorexic,” which made me feel like a hysteric pubescent, a narcissistic teen. I was twenty-four and married—a relationship that was falling to pieces and had been for some time, sweeping me into a world of doubts, guilt, and feelings of failure. I felt like I was losing control—of my husband’s attention and desire, of my work and graduate studies.

I could, however, control what I ate. So while I didn’t want to be thin—I didn’t read Glamour or Vogue or idolize actresses with less fat than their unsalted rice cakes—I became a skeleton. I didn’t limit calories, I hacked them like an eight year old with scissors and long hair.

The condition manifests in the strong and intelligent, in the perfectionists; the sensitive ones and those with demanding consciences and high standards…. That’s how it starts—with traits masquerading as good, on your side, catalysts for growth and achievement.

I’m five foot-four inches tall, normally weighing around 130 pounds. But the winter of 2009, four months before filing papers for divorce, I dropped to 80 pounds. I hadn’t menstruated for a year and wouldn’t again for another two. My hips stuck out from my belly making me look like a cattle carcass drying in the sun. My breasts had evaporated. Before I learned to carry a towel with me for padding, my spine bruised when I sat in hard-backed chairs. I wore layers of clothing, scarves, hats, gloves, and a jacket on summer days, even inside. I was always cold.

My mother was the first to confront me, well before I reached my worst condition. You’re anorexic, I remember her pleading, you just can’t see it. My husband couldn’t either, or did and ignored it.

I couldn’t see it because I didn’t care about my weight, and that care—the fear of gaining weight—is what I believed anorexia to be. I only cared that I had one thing under control. One thing. That was the comfort I clung to with all the might in my twiggy arms.

Eventually I no longer felt hunger and my disease lived up to its name—“nervous absence of appetite”—coined in 1873 by Sir William Gull, Queen Victoria’s personal physician as well as a suspect in the Jack the Ripper killings.

If not for my mom I wouldn’t be alive today. She fed me as I recovered. I later learned she had been days away from driving across states to check me into a hospital, but she didn’t make me feel guilty or treat me as ill or insane. I had been months away from floating away entirely.

That’s what it feels like, floating away. Every day I felt lighter, as if outside my body, leaving it behind and moving into a state of mind above—looking down on myself and everyone else. I felt untethered and unbound. Safe, as if I were invisible to pain.

While the effects of anorexia are physical, its origins are mental, and it holds the highest death rate among psychiatric diseases. Many studies have connected the eating disorder to serotonin—one of the brain chemicals linked to depression and anxiety. Some researchers suggest it’s sometimes part of a coping mechanism. Not eating lowers serotonin levels, numbing dark thoughts and anxiety the same way that alcohol and drugs do.

Anorexia never truly leaves, like rheumatism of the frontal lobe, acting up when the situation gets stressful.

The condition manifests in the strong and intelligent, in the perfectionists; the sensitive ones and those with demanding consciences and high standards. In the creative and self-critical. In the defiant, trying to live through whatever’s in their path, independently. That’s how it starts—with traits masquerading as good, on your side, catalysts for growth and achievement.

I couldn’t tell you the moment I “got” an eating disorder, as if it were a head cold or the flu. But I can tell you when I knew I’d be okay, that I’d live. When I knew I’d gain pounds and feel the burden of my form returning. I knew when I bought a pint of chocolate gelato and slowly ate half of it in one sitting. Eight ounces of food, full of fat. It was scary, feeling full. Because starvation had become the norm of my addiction. As the sweetness melted on my tongue, I felt pleasure and welcomed it. I accepted that things had not been right in my head. Years after my mother told me, I acknowledged that I had been starving myself and that it wasn’t normal or healthy.

Now, more than four years later, I’ve fought hard and eaten my way back to 120 pounds. It’s still difficult not to go back to that place—not to want to float away. Because anorexia never truly leaves, like rheumatism of the frontal lobe, acting up when the situation gets stressful. When I get anxious—which is often—my appetite exits stage left and my desire to have one dependable thing returns.

Even as our culture moves from diet-centric limitations to a focus on healthy eating and exercise, anorexia will still be with us as it always has been; perhaps returning to its origins where food—or the absence thereof—allowed ambitious women illusory independence and false authority over things they couldn’t control. I believe we’re entering a new, yet old, paradigm—where the traits enabling women to succeed might also be the death of them.

I know they almost were for me.