What Happens When You’re Bulimic, But Not Thin Enough for Anyone to Notice?

Millions of people who need treatment for eating disorders go undiagnosed. One young woman’s infuriating story should serve as a wake-up call for the medical community.

Illustration by Camily Tsai

Eighteen-year-old Alexa Giardino sat with her legs dangling from an examination table. She swung them gingerly, nervously waiting for her lifelong physician to walk through the heavy wooden door. She was only there for a routine check-up, but her palms were sweating. She kept trying to wipe her hands on her tissue paper gown but they would just stick. The door suddenly creaked open. Clipboard in hand, her physician entered with a smile. “Hi Alexa,” she said. “Let’s get you weighed and measured.” Giardino leapt down from the table and padded over to the scale. Her weight was the current focal point of her entire existence. She knew she was exactly 129 pounds. She knew she was thirty pounds lighter than at her last appointment the previous year. But most importantly, she knew that she owed her weight loss to countless post-meal purges.