Shira Gusfield doesn't like anything about herself. Most of all, she explains, fidgeting and biting her lip, she hates her body.

“It kills me. It kills me,” she says, shaking her head as she explains how hard it is to have gained so much weight; the 70 pounds that she lost over a four-year period, and then some. “I hate it.” The 21-year-old is sharp and matter-of-fact. She has no illusions about the miracle of therapy, and believes she’s never known what normal eating looks like.

Right now, she is in “partial recovery.” And things are indeed a bit better than they were three years ago, though she was thinner then (never thin, though, certainly never too thin). She speaks as though years of therapy have rewired her somewhat, remembering her childhood self fondly. As a quiet and dreamy 7-year-old, Shira remembers, she’d scooter around her cul-de-sac for hours, babbling made-up languages as she pretended to embody little girls from faraway lands.

Still, there's doom even in this happy memory, a foreshadowing of sorts.

“I guess I see it now as a sort of coping mechanism for the craziness that was going on around me,” she says. “An escape.”

And who could blame her for wanting one? Two years before, when she was five, there was the ballet class that marked the pivot point to her relationship with her body. Then her sister’s comments, her mom’s hints, her days in solitude amidst a crowd of other seventh-graders. Nearly 10 years later, Shira feels so alone in her symptoms she’s not sure what she can tell me. Halfway through her biography, she stumbles; her sentences, already padded with circuitous “likes” and “you knows,” falter and fail.