“No one expects a grown woman in her 40s to have an eating disorder. That’s for teenagers, right? Well, guess what – it happened to me.”

Alexa, a 44-year-old real estate agent, was telling me about her struggle with non-purging bulimia^[1], which has come to control her life. We spoke in 2024 at a coffee shop as part of my ongoing research on eating disorders.

The names of my research subjects have been changed for...