As a non-fiction book about a topic that is so prevalent today, this book was very readable as it was written by a journalist who ensured that it would be consumable to all. The only wish I had was that there was some partnership with a medical professional, especially if there was an emphasis that so many people do not have access to treatment of EDs, to give more concrete advice firsthand or medical information.

I love books about food and books about body image so this was definitely something I was interested in. I found this book specifically to be really interesting. The history of food and how we view it is absolutely fascinating in general but the way this Author framed it only added to the experience. A solid book.

What’s Eating Us is part memoir and part examination of eating disorders and the harmful effects of diet culture on women. The book’s chapters are broken down into different areas that fall under the umbrella of the subtitle - “women, food, and the epidemic of body anxiety.” Each chapter begins with a personal story that relates to the topic and follows with statistics from research and quotes from interviews with professionals in the field. It was clear how impassioned the author, Cole Kazdin, is about this topic and her personal anecdotes help the reader connect beyond the plethora of statistics that are provided. Furthermore, she absolutely slams the diet industry, stating that the term “healthy lifestyle” has just replaced the word “diet.” (On a complete side note - I see NOOM advertised everywhere. I’ve never tried it, but she reports that it’s just a calorie counting app that actually triggers people who are in recovery from anorexia to start restricting calories again - but it’s healthy! *sarcasm*) What resonated the most with me, is the idea that you don't have to be diagnosed with an eating disorder to have disordered eating. Read that again. Disordered eating results from the subliminal messaging in every facet of society and it’s nearly impossible to block out the damaging rhetoric. Have you every wondered how many calories were in that slice of birthday cake? Have you ever thought or said the phrase “I need to work off that meal I just ate?” Or what about the fear of stepping on the scale after the holidays? Spoiler, you should get rid of the scale. While all these unintentional thoughts alter the way we perceive food, what is even more damaging is the way we perceive body weight. Kazdin explores how medical professionals, and the health care system in general, focus on a single number to sum up the health of an individual: BMI. That’s Body Mass Index and it’s a number that is attached to you based on your height and your weight. It does not take in consideration things like bone density, muscle density, or other totally normal things that would contribute to a higher weight. She expresses how this singular number does more damage than good, and provides several other alternatives that would be more beneficial to track when it comes to overall health. My disclaimer with this review is that most of this information was new to me. I have not done any extensive reading or research on the topic, so if you’re someone that already has a firm grasp on the topics at hand - this may not be for you. I know I was getting more personal narrative, quality investigative journalism, and a palatable take on a new topic, rather than straight from a professional in the field. However, this is a great place to start if you’re a newb like me.

Thank you to NetGalley for this arc. I have so much to say about this one! I should preface that I work in the eating disorder field, which is the main focus of this book, so I might be coming in with a more informed and, thus, critical eye. I’ve been in the field for years and there were still details I didn’t know such as it’s ok on a federal level to fire someone for their body size. That’s crazy! A lot of the information, especially about the diagnoses, treatment, impacts I did know but I applaud the author for including stats and/or definitions for almost every eating disorder diagnosis out there. Moreover, I want to give a standing ovation for the details about the BIPOC community who struggle with eating. There’s a dirth of research and it’s not talked about much even within the field and the author very aptly outlined some of the additional barriers these folks face while also acknowledging her own places of privilege. Admittedly, she did not delve much into the trans of lgbtq community barriers but one book can’t cover all of the topics! And truthfully, there’s a good amount more info about that out there so either it was too meaty to include or available enough that one could follow up for more, which is not the case for BIPOC. I like the title but I wish the subtitle specifically mentioned eating disorders because that was what this was about; not just body anxiety or how it’s hard to feed and care for a female body in American culture with our unique stressors.
My biggest pet peeve was a rather large chunk of the last quarter or so of the book running off into the topic of infertility. While I appreciate that it’s part of the authors journey, this was not entirely a memoir. And while there were some threads that tied weight and access to fertility treatments, it was both unnecessary as well as not fully covered. Basically, I don’t think it added to the book and may have actually taken away from it as there’s no warning that’s included when you pick the book up expecting to read about eating patterns. And if it felt essential to include, there were huge parts of that conversation that were entirely omitted like how the meds bloat you to incomprehensible size and how that contributes to body dissatisfaction or how you feel your body fails you in that process.
Finally, because I listened to this as an audiobook, it feels important to comment on the narration. Overall I liked the congeniality of the readers voice. However, it took her a while to warm up and deliver the quips at the ends of the chapters adequately. And the chapters having title names instead of numbers made the audio all flow together. Sometimes the ending of one chapter and the start of another were one giant pot of soup and other times they were abrupt and dissonant.
Yes, I’m aware that there are too many food metaphors. Talking about eating disorders can do that to you! I will bring the content back to my team at work and share some of my takeaways with other colleagues. She really gets diet culture right! And does an excellent job talking about some treatment red flags, with which I’d totally concur. I’m now looking forward to reading some of the books mentioned within the book to get additional perspective.

Wonderful book. I usually do not pick up self help books, but this one captivated me. It was like talking to a friend. It would bring up serious and sometimes painful topics but very gently. Recommended

This is a must-have resource. It is full of great information and advice. This is one I'll return to. Many thanks to the author, publisher, and NetGalley for the advanced copy of the book.

Thank you to NetGalley and the publisher for allowing me to read a copy of this book early! I would definitely suggest that you read this book with caution. This is a non fiction book about the treatment of eating disorders in our country and how broken the system is in regards to equality among races, gender, etc. Some of the factual stuff was SO interesting; I feel like I learned alot. But also interspersed among the facts are Cole's personal story of her struggle with an eating disorder and you very much get the message that she is still working on recovery. For people in the midst of an eating disorder or on the verge, this may trigger you and give you ideas of how to be disordered as opposed to motivating you to come out of it.

DNF

I would rather read a book by someone with clinical practice and training; not a journalist. That said, the memoir narrative was honest and relatable and I would have happily read just her memoir without her trying to “teach me”

I also feel this is a bit too “introductory” for a book on ED

A huge thank you to NetGalley and MacMillan Publishers for an ARC audiobook version of this book.

Let me start off by saying Cole Kazdin is NOT a doctor. Which is ultimately what made this book so much more readable. The title is daunting and seems like it would be a boring dive into what we already know...women and body anxiety is so prevalent in society today. However, the Emmy Award-winning journalist ties together her personal story and investigative journalism to create a compelling, moving narrative about the topic.

By tying in her personal experience with disordered eating throughout her life, Kazdin manages to create a book that is both informative and personal. Using her voice to respond to facts and research truly proves just how much is still unknown about eating disorders and how to treat them. Not only that, but the way she speaks sounds like having a conversation with a friend- she doesn't preach but instead, talks directly to you in a tone that emphasizes caring and understanding. The book also reaches across so many aspects of women's lives, from infertility to white privilege.

These are not usually my types of books but Kazdin's mix of personal and professional resources had me compelled to continue listening, no matter how close to home the words hit.

Things I learned from this book:
- disordered eating is so much more common than people believe.
- eating disorders do not necessarily have to be labeled as anorexia, bulimia or other commonly named disorders- they can be considered eating disorders not otherwise specified (or EDNOS).
- BIPOC are far more likely to suffer from eating disorders and disordered eating but are far LESS likely to be diagnosed.

This book should be recommended reading for any female. Well done, Cole Kazdin!

I enjoyed this audiobook. It definitely gives listeners a lot to think about and consider. Some of the facts and studies referenced are surprising and made me think back to my own ideas and perspectives when it comes to food, body image and dieting. I had to laugh when they got to the section on Noom, a diet plan I am currently following. It made me look at things from multiple perspectives and while I'm not planning on abandoning the app and subscription right away, it reminded me that if in the end of my journey I don't lose the weight I am hoping to it doesn't mean there is something wrong with me. The author makes tons of really great points and I definitely took a lot out of my experiencing listening to this book. Thanks to NetGalley and the publisher for giving me the chance to listen to and review this book.

Cole Kazdin explores her own and our relationship with food and subsequently weight. How consciously and unconsciously we measure what we eat and guilt we might feel for something. The diets like keto and weight watchers damage the way we should feel about food.

She also talks about how doctors mistreat obesity and eating disorders. What’s stunning is that eating disorders is one of chronic conditions in this country, there is no policy to deal with this issue because diet is a billion dollar business. So without even knowing we are not only diet industry harm us, we are harming ourselves by judging each other on how we look.

What's Eating Us. Women, Food, and the Epidemic of Body Anxiety by Cole Kazdin. Also narrated by Cole Kazdin.
5 stars! I have the ebook, which I’m grateful for. There’s so many resources and things I want to read again. But I listened to this and the author was amazing. I understood her well and I was right there with her on every issue.
Being from California I felt so much pressure about my body. I briefly had an eating disorder, and my mom was and probably still is bulimic.
This book was liberating and uncomfortable. It scared me because I realized I’m always going to not like the way I look. How unfair is that? I learned so much and I’m hopeful because I’m going to try to see things in a new way.
I recommend this if you are looking for info on eating disorders.
The author did such a good job sharing her journey and I loved it.
Thanks Macmillan Audio and St. Martin’s Press via NetGalley.

This is a fantastic new piece of non fiction that leads together facts with a personal memoir. I appreciated the acknowledgement of white privilege within the discussion of ED treatment. Likewise, I appreciated the intersection between disordered eating and infertility. This was a very personal story that really hit home for me. I would recommend this to anyone who has experienced disordered eating or looking to support someone suffering from an ED.

Disclaimer I received a copy of this book from the publisher.

This book is mostly a re-hashing of information that I’d already encountered elsewhere with some memoir vignettes from more or less the same perspective we usually get on this topic. I don’t think it added much that’s new and that was disappointing, but people who don’t read widely in this genre may find it useful. I think it was especially hampered by the self-help/diet book format which seemed to me a confusing choice given the stated values of the author.

Thanks to NetGalley for the eARC!

Thanks to Macmillan Audio and NetGalley for the advanced audiobook.

This book is a great introduction to eating disorders, disordered eating, and diet culture. Cole Kazdin discusses how bleak treatment options are and how lacking research is on these topics. There are moments when this book feels like a memoir. I am glad Kazdin narrates her own book. I find that when the author is their own narrator, they are able to articulate their jokes/sarcasm so much better. A great book to start with if you are looking to learn more about this topic.

This is a great introduction about the ongoing issues of diet culture and how its presence in our society has been negatively impacting the way we look and feel about ourselves.

As a woman of color, I really appreciate the author going into depth of how terribly under-researched eating disorders and disordered eating is in BIPOC communities. The studies are significantly lacking and typically what we see are how it primarily affects white women. We need more studies on these communities.

I think this was a way for the author to share her experience. However, readers must keep in mind that she is a journalist and not a scientific researcher. Although, she had a ton of really good points, there were also moments where I felt like she was projecting and generalizing it for everyone. It started to feel like the lines between toxic diet culture and the actual health benefits of dieting were starting to blur and made me wonder, "Well, where is that boundary line when it becomes an issue? At least, mentally? Is my way of diet and exercise considered an eating disorder or disordered eating? Am I on that path towards self-harm?" The author's experience is not the same as my experience or any other reader's experience.

It is astounding for me to learn about how many "professionals" and "researchers" are actually involved with specific diet programs who profiting off of people who truly need help and advising them in ways that are more harmful than helpful. I think it's so important that if you are one of the many who suffer from eating disorders to have the support of friends and family and to ensure you have the right professional help.

Overall, this is a great intro read and recommend.

Thank you Netgalley and publisher for providing me the audiobook in exchange for an honest review.

This book was a great read. For someone who has suffered from disordered eating and a continuous battle with my body, I felt connected to these words and the story. All awhile nodding my head about the society we live in and what is driving this obsession with women's bodies.

I thought the audio narration was great!

Kazdin offers a great starting point for anyone interested in eating disorder recovery, body positivity, and diet culture. She succinctly explains why so many of us struggle with food and weight and that it’s the fault of diet culture, not something inherently wrong with us. She’s realistic and honest about how hard recovery from disordered eating is, that it is a long process and that a good standard of care that works for everyone just doesn’t exist. But the book also offers hope and encouragement toward gaining a positive relationship with food and your body.
Having researched the topics before, I didn’t learn much new information but would definitely share this book with people just getting started on the topic. She covers a lot without it feeling overwhelming, mixes good research with personal stories from herself and others, and has a wonderful sense of humor throughout.

I enjoyed listening to the author read her own work in the audio version. I listened at 1.75 speed and was engaged enough to listen to it all in one day. I’ll be following this author in future.

The audiobook of What's Eating Us
What's Eating Us is a great book about eating disorders, and how so many areas of modern life affect and may create the conditions for an eating disorder to form. My one critique is the longer chapter on fertility; while I appreciate the difficulty child-bearing can be because of having an eating disorder, I felt it went too far into IVF and struggles there, without always linking it back to the ED. I think this book would be a great resource for anyone who has an issue with food, body image, or has or is in recovery from an eating disorder. It didn't get too bogged down in science, but was well-researched and thorough.

Thank you to NetGalley and St. Martins Essentials for an eARC and advanced access to the audiobook of What's Eating Us: Women, Food, and the Epidemic of Body Anxiety by Cole Kazdin in exchange for an honest review.

CW: graphic depictions of disordered eating, re-traumatizing therapies, body shaming, body dysmorphia, fatphobia, medical content, medical trauma, vomit, addiction, self-harm, infertility. Watch for growing list of content warnings on StoryGraph as early reviews continue to roll in.

Publication Date: March 7, 2023

DISCLAIMER: This review is written by someone who is in active recovery from disordered eating. In addition, I am a licensed mental health therapist who specializes in the treatment of eating disorders. My personal experiences may lead me to be more critical of this book than the average reader. As with all reviews, what I write here is a reflection of my own thoughts, opinions, and knowledge up to this point. Please take what I say here with a grain of salt and feel encouraged to read the book yourself and form your opinion, as I DO believe it is a worthwhile read.

Part-memoir, part scathing exposé of the systemic issues inherent in the treatment of eating disorders, journalist Cole Kazdin analyzes the pervasiveness of disordered eating, diet culture, and normative discontent.

I want to emphasize two things right off the bat as overarching critiques of this book:

1. If this is your first time picking up a book about eating disorders, it is a great introduction to the topic! BUT, crucially, it is an introduction. There are lots of other books about eating disorders and disordered eating that are written from different perspectives (like those of therapists, dietitians, and other people in recovery) that can provide additional information to deepen your understanding of this topic.

2. Cole Kazdin is a journalist. She is not a therapist, a dietitian, doctor, or any other professional involved in the treatment of eating disorders (other than her own; she clearly has put so much emotional work and physical effort into her own recovery). Her experience with eating disorders is limited to the personal and her extensive research of the topic. There are several overarching, inaccurate statements that she makes about eating disorder treatment professionals that paint therapists, dietitians, and doctors as greedy and clueless about how to help people heal from their EDs. Kazdin's statements are not true of every professional's beliefs and perspectives on EDs. Each clinician comes to the table with their own theories and reasoning about what treatment interventions they use and why. Every eating disorder professional is highly trained and continues to seek out educational opportunities to stay up to date on ethical treatment. If you are seeking a clinician (in any field) to work with you on your eating disorder, feel empowered to interview that person to determine whether they feel like a good fit for you. If something about their theory, disposition, or education feels off to you, it is okay to walk away and find someone who will be a better fit for you. Please ask your professionals questions and challenge us to show up for you in the ways that you need. Any good clinician will appreciate that.

THE PROS:
1. Kazdin presents her research in a way that is clear and concise. She outlines evidence based practices for the treatment of EDs and emphasizes the pros and cons of each type of treatment she discusses. She spends the majority of her book discussing CBT and DBT treatment interventions, as these were the therapeutic treatments that she personally engaged with, but she also briefly mentioned family-based therapy as a particular evidence based practice for working with teens and children presenting with EDs. It is important to note, however, that other treatments such as person-centered and narrative therapies can be just as efficacious as the tried-and-true "evidence based" practices. This is not me dissing CBT or DBT, as these are well documented, evidence-based practices that lead to positive treatment outcomes. It is important to note that CBT and DBT are more likely to be cited as evidence-based therapies because more research has been conducted on them. CBT in particular was developed out of a research model, so there is naturally more evidence to support its efficacy. There are other treatment options out there that can and do work just as effectively to help clients achieve their goals. The anecdotal/qualitative evidence for person-centered therapy is just as strong as the quantitative evidence for CBT. Furthermore, Kazdin herself ends up finding a therapist who does not use an "evidence-based" theory, but she nevertheless found the best healing on her long journey with this particular therapist. Please take the term "evidence-based" with a grain of salt. Healing can be found even in spaces where CBT and DBT are not the preferred practices.

2. Kazdin eviscerates SYSTEMS. She systematically breaks down each of the factors at play that are responsible for increasing our societal propensity toward disordered eating and staying sick. Diet culture. Weight loss companies (I'm looking at you Noom. WW. Optavia). Fatphobia. Weight-centric medical bias. Capitalism. Racism. Sexism. Gender essentialism. Normative discontent. Economic barriers to care. Inequity of care. High need and limited trained professionals. The list goes on and on. This is one of the primary benefits of reading this book. If you've never examined all the ways in which we are set up to fail in this society, allow this book to rip the curtains open. You are not alone and not responsible for what you are struggling with (whether disordered eating or other physical or mental health conditions). It is unfortunate that each of us faces a mountain of barriers to recovery and must fight tooth and nail to regain our health. Despite it all, recovery IS possible. Each one of us who fights for daily health are warriors who have achieved miracles. Kazdin's exploration of all these detrimental systems fosters compassion and righteous anger for those who are fighting their EDs.

3. Kazdin utilizes humor and sarcasm to make the narrative extremely relatable to the American woman. Who hasn't been directly effected by ridiculous diet culture ads? Who hasn't experienced undue comments about their body? And worse, by MEN?! Her occasional verbal eye rolling is amusing and ensures that the reader does not feel alone.

4. Near the end of the book, Kazdin encourages people in recovery to find community that will help them to recover. No one heals in a vacuum. We are all continuously bombarded by obstacles that can and do resist change and drag us back into maladaptive habits. It helps so much to have accountability to others when trying to achieve therapeutic goals. Kazdin discusses several body-positive and body-neutral spaces where people recovering from EDs can find support. Notably, she touches on the double-edged sword of Overeaters Anonymous (OA). OA works off the 12-step model of recovery popularized by Alcoholics Anonymous (AA). While there are some ED professionals who will draw a parallel between addiction and EDs because of the obsession-compulsion cycle present in each presenting issue, there are others, including myself, who find it difficult to equate the two. It is possible to recover from addiction using the total abstinence model used in AA, but the same cannot be said for eating disorders. Having attended OA meetings myself, I personally found them to be triggering and not conducive to my own recovery journey. Diet culture messaging and fatphobia can easily find their way into OA meetings. IF you find OA to be helpful in your recovery journey, that's fantastic! But it's also okay if it's not a helpful resource for you. I wish you all the best as you seek out communities to support your recovery.

THE CONS:
1. Kazdin does not explicitly explain or even outline the principles of HAES (Health at Every Size) or Intuitive Eating (IE), which are the essential frameworks used by many therapists, dietitians, and doctors who are well versed in the treatment of eating disorders. (If you would like to learn more about these two frameworks, please read Health at Every Size by Lindo Bacon and Intuitive Eating by Evelyn Tribole and Elyse Resch). In fact, Kazdin outright rejects Intuitive Eating as a helpful tool in the first third of her book! While her point here is that Intuitive Eating is difficult to follow for those like herself who have been stuck in disordered eating for so long that they have lost their hunger and fullness cues, she eventually works her way into practicing Intuitive Eating by the end of the book. Whether she refers to her new body-neutral and nourishing practices as Intuitive Eating or not, she is following the ten principles for eating intuitively by the end of her personal narrative. What she fails to incorporate when she is first introduced to IE is that mechanical eating (i.e. eating on a schedule, every 3-4 hours) will, over time, help those recovering from disordered eating regain their biological hunger and fullness cues. After cues are regained, the recoveree can begin a practice of more mindful eating that more closely follows IE. It was just frustrating to me that she would outright reject something as helpful as IE and then never come around to realizing that she IS in fact practicing IE.

2. I found Kazdin's resistance to the therapeutic process draining. I know that this is a reality for many people struggling with eating disorders of this severity. The cognitive dissonance that Kazdin demonstrates in her internal monologue is maddening. She purports to want to get better, that's why she sought out therapy to begin with. Her reluctance to change, especially at the beginning of the process, is understandable, especially given that she has established how many systems were stacked against her recovery. I'm reluctant myself to write about this particular point as a con of this book. I was irritated by her attitude, but I know that it is the very nature of this disease.

3. Kazdin neglected to include two key pieces of information that I feel are SO ESSENTIAL to understanding the systemic problems with medical treatment of EDs:
a. Nutritionists and dietitians are NOT the same thing. Dietitians have earned Masters degrees in nutrition and dietetics and are overseen by a regulatory body (i.e. they have to pass a licensing test, meet standards of care set by their board, and meet continuing education requirements to maintain their credentials). In other words, they know what they're talking about, and most utilize HAES and IE frameworks to help clients achieve their goals and maintain their nutritional needs no matter the size of their body. Nutritionists are NOT REGULATED. Yes, you read that right. Anyone can call themselves a nutritionist. They don't have to have the proper training, credentials, or knowledge. They can (and often do) spread false, uniformed nutrition information that can do more harm than good. Vet your sources before taking nutritional guidance from nutritionists and dietitians to ensure that you are getting the best care.
b. Doctors only get ONE TO TWO classes in nutrition and dietetics during their education. They are not experts in nutrition. Doctors are often weight-centric and prescribe weight loss, which is not only detrimental to health, but is also lazy doctoring. If you are struggling with disordered eating, know your rights in the doctor's office. You do not have to be weighed, you do not have to accept a doctor's guidance to lose weight, and you can always ask for a differential diagnosis. Vet your doctors and keep them accountable to providing equitable and weight inclusive care.

4. Kazdin has an awful experience with her first eating disorder therapist (who exclusively practices CBT). This therapist is not at all person-centered or trauma informed. Objectively, she is not a good therapist, as further evidenced by Kazdin's later discovery of this therapist's affiliation with Noom. Unfortunately, Kazdin's experience with this poor therapist colors her writing about all therapists. She is understandably jaded toward the sub-par therapeutic care that she received, but this leads her to make assumptions and sweeping statements about all therapists and therapeutic systems.

Overall, I would recommend this book. It is important, and it does a great job of lifting the veil on the dark parts of ED recovery. The mix of nonfiction critique and memoir makes the narrative accessible and enjoyable. Read with an open mind and be willing to exercise your critical thinking muscles. Thank you Cole Kazdin for all the work that you put into this book and the vulnerability that you showed in sharing parts of your own story. I truly believe that people will find healing and comfort for having read your book.

Wow, that was a lot. If you've made it this far, thank you for reading. I hope you learned something about the world of eating disorder treatment and recovery. I wish you all the best as you seek out the best care for yourself and endeavor to learn more about eating disorders for yourself and/or the people in your life.