Not Otherwise Specified

Hannah Moskowitz writes about her personal experience with eating disorders, which informed some of the experiences of the main character of her new YA novel, Not Otherwise Specified.

By Hannah Moskowitz


“I don’t think I have an eating disorder,” I told my therapist on Tuesday, after an hour of listening to the nutritibitch talk about my food issues and telling me that my way wasn’t the healthiest to lose weight.

She said, “Oh yeah?”

“I’m not thin.” I shook my head. “And I eat. I eat pizza and ice cream and rice krispies. I don’t think I have an eating disorder. I think I’m an attention whore.”

“Why does that have such a negative connotation?” my therapist said. “Wanting attention? Everyone wants attention.” She sighed. “Let’s check the book.”

She took out her DSM and searched the index, read for a minute, and said, “If I had to diagnose you, I’d say–”

And I could have mouthed the words along with her.

“Eating Disorder Not Otherwise Specified.”

She said, “Look, Hannah, you don’t do things halfway. You say you’re going to have to write a book, and you get it published. You want to be thin, and you get an eating disorder.”

I didn’t tell her that EDNOS is totally the definition of halfway.

I’m Hannah Not Otherwise Specified.

I wonder how it happened.

I started laughing in the nutritionist’s office because I forgot, for a second, that this was my life.

One thing they don’t tell you is that you have to remember every morning.

Thoughts upon waking up.


Goddamn, it’s early.

That was a weird dream.

I have an eating disorder.

The nutritibitch tried to play the guilt card. She had my mother come in and talk about how this was making her feel.

As soon as my mother left the room, I cried so hard even plastic skinny nutritibitch felt bad.

* * *

I wrote that when I was seventeen, the same age as Etta in Not Otherwise Specified. I’m almost twenty-four now, so that should probably seem like longer ago than it was.

Eating disorders are not exactly uncharted territory in YA. They’ve been done incredibly and painfully and accurately—Wintergirls—as well as every Lifetime-movie issue-of-the-month. The thing is, though, that you’d be hard-pressed to find a girl who had an eating disorder like I did, and I’m actually part of one of the most common groups of eating disordered people.

Everyone knows anorexia and bulimia, and at least some people know binge eating disorder, but EDNOS—Eating Disorder Not Otherwise Specified—rarely gets mentioned. The simplest explanation is that it’s an eating disorder that doesn’t quite fit in the extremely stringent diagnostic criteria of the named disorders. You don’t purge often enough to be bulimic, or eat enough calories at once for it to be a textbook binge, or weigh little enough that you no longer get your period (and if you’re a guy, until very recently you couldn’t get diagnosed anorexic at all, because of that whole have to stop getting your period thing).

That last one was me, and it’s Etta, and it was the scariest part of writing this book, and it’s the scariest part of its release.

I think a lot of people shy away from writing diverse books because of that fear of messing up the “other.” It’s easy to be annoyed by this, and that’s okay, but it’s also important to keep in mind that these people are trying to be respectful. But the idea of “otherness” can be very intimidating, whether you’re inside of it or out of it. If you’re a white Jewish girl, like me, writing about a black girl. If you’re a girl who couldn’t even spell plie before she started the book, like me, writing about a ballerina.

So it’s kind of funny that even before I started doing all of the research into the worlds I didn’t know, the part of this book that terrified me the most was an illness that I know more intimately than I’ve ever known a person. An illness that makes seven years feel like absolutely nothing.

I don’t talk about it with people. It’s in my past. We talk around it. We don’t mention treatment. We don’t mention self-injury. We don’t mention the time I tried to run away.

I dreamed two nights ago that my mother read the book and called me crying, saying she didn’t realize I was still in “that place.” It was the first time we’d talked about it since the nutritionist’s office, except that was real and this wasn’t.

I wrote about my eating disorder in the Dear Teen Me anthology a few years ago. We got edits back and they wanted me to add the line, verbatim: “But there is hope.” I wouldn’t do it, because that is a ridiculous sentence.

But I think in a lot of ways that’s why I wrote this book. The rest of Etta’s diverse characteristics—her race, sexuality, rich background—have been with her since the very first time I tried to put her in a book six years ago (back when I didn’t realize the girl demanded her own book, none of that split-POV nonsense). But the eating disorder aspect was something I intentionally gave her, and I wanted to show the weird kind of hope that is there.

I’m not recovered 100%, and I don’t think many eating disordered people ever are, and Etta, though she’s deep in recovery for the entire book, probably won’t be. But her life is still okay, and it will keep being okay. It’s something she’ll have to fight on a day-to-day basis, and sometimes that will feel astronomical and sometimes it will be feel like nothing. We look too often at eating disorders as catastrophic events—the bit of writing I posted above is from an essay I wrote called Notes on a Scandal—when really they’re chronic illnesses. And chronic illnesses need more visibility, perhaps mental illness most of all. And I like writing about intersectionality way, way too much to include it with a cisgendered heterosexual white girl.

So, sorry about that, Etta. I wanted to write about a character with an eating disorder and I knew you could handle it.

We’ll be okay.

hannahmoskowitzHannah Moskowitz is the author of over half-a-dozen books for young adult and middle grade readers, including BREAK, a 2010 ALA Popular Paperback for Young Adults, ZOMBIE TAG, TEETH, and GONE, GONE, GONE, a 2012 Stonewall Honor Book. She lives in New York city and tweets a lot as @hannahmosk.

Not Otherwise Specified is now available.