Welcome to the Mad in America podcast. My name is Brooke Siem, and I am the author of the award-winning memoir on antidepressant withdrawal, May Cause Side Effects.

Today, I am excited to be with Kelsey Osgood. Kelsey is the author of How to Disappear Completely: on Modern Anorexia, which was chosen for the Barnes and Noble Discover Great Writers New Program, and her new book is, Godstruck: Seven Women’s Unexpected Journeys to Religious Conversion, which came out in March 2025. Her work has appeared online and in print at The Atlantic, The New York Times, Harper’s and The New Yorker, among other outlets.

The transcript below has been edited for length and clarity. Listen to the audio of the interview here.

Brooke Siem: Kelsey, I am so excited to be with you today because when Bob Whitaker said that you had written a book on anorexia and then another one on religious conversion, I was immediately interested to interview you because I also have a very similar story about eating disorders and anorexia in the early 2000s.

So much of what you wrote there, I just thought I could have written myself, and I have also, in the past year, started reading the Bible. I didn’t grow up with any sort of organized religion but I just realized I had a lot of opinions about something I hadn’t actually spent any time with. So I’m just so excited to talk and thank you for being here.

Kelsey Osgood: Thank you so much for having me.

Siem: You are also one of the best writers I have encountered in years. I am incredibly impressed by the quality of your work and the way you’re able to combine history with your own story. I highly recommend that any readers pick up the book, but because this is a podcast about mental health and social justice, I am going to start by reading a quote from page 60 of Godstruck in which you compare the world of psychiatry and psychology to religion.

So you say, “One could argue that psychotherapy and its medical enablers have just become a kind of replacement religion, one with its own oddities and obligations. Both can involve confession to an intermediary, ideally on a regular ritualized basis, offer psychic tools for human improvement and sort humans and their experiences into categories. For example, sin or symptom, Jew or schizophrenic. Both purport to help a person move from some negative state, damnable or anxious, despairing or depressive, to a good one, optimized, pure, mentally healthy, enlightened. Both are jargon-heavy. Both have origin stories that look ridiculous prima facie.

People love to say how crazy it is to believe that Joseph Smith discovered lost portions of the Bible on buried golden tablets. But isn’t it also laughable to think that all women secretly want penises just because some man sat in his little study and wrote that down? Both deal heavily in narrative, encouraging adherents to locate a familiar, inevitable trajectory within the minutiae of their lives. That old Augustinian arc is still there in the analysis cum trauma memoirist who was born into dysfunction, descends into despair, has an epiphany, meets a chymotherapist, receives a satisfying diagnosis, calibrates their meds, and ultimately achieves stasis.”

I’m going to start there and just let you go a little bit because you have these two books and this incredible life experience that I know our audience is going to want to hear about. So tell us a little bit about your story and how we went from anorexia to God.

Osgood: So I was born in the mid-1980s in the suburbs of New York. I’m from Southern Connecticut, which is the stereotypical preppy American suburb. I had no particular reason to feel out of place in this environment, meaning my family fit the description of the other families. But for some reason that I’ll never really know for sure, I was just born a sort of existentially uncomfortable person.

I spent a lot of time thinking about things like the nature of consciousness. How do I know that what I think and experience of the world is the same thing as what my friend on the school bus sees and experiences? I thought about morality a lot. How do we know what’s good? Do we know what’s good because we decide what’s good? Or do we know what’s good because there is an intractable definition of what’s good?

When I was a preteen, 11 or 12, this kind of personality bent of mind was a poor match for adolescence, I think. I also started to have pretty normal concerns about my identity. Who am I? Who am I in my school environment? Who am I in the world? I felt that I didn’t have a clear passion or a clear path. I wasn’t a super good athlete. I was neither super popular nor super unpopular. There was a part of me that felt pretty conscious about the fact that I was casting around looking for a way to feel happy and comfortable in myself, and also feel like I had a vocation, a job in the world or something to do or be.

I was also very smart, but I wasn’t a very motivated student. I just wasn’t sure what I was going to do, and this felt like a newly urgent question. This feels very embarrassing to say at the age of almost 42 but one of my biggest problems in this stage of my life was I looked very young for my age. When I was 12, I passed for maybe eight or nine.

I was acutely aware of the fact that my peers were entering this new stage of life where they were having crushes on each other, and girls were experimenting with makeup. I felt emotionally and internally on the same page as everybody else. But I was also very ashamed. I felt that it was embarrassing to admit that because how could somebody who looked the way that I did have a crush on a boy? Wasn’t that deeply humiliating to admit this? So I came up with this idea really very consciously. I know what I’m going to do, I’m going to become an anorexic. This felt like it solved a lot of problems in my life.

First of all, there is an identity, and now any woman who experienced the late ’90s to early 2000s probably also remembers some of the media landscape that existed at the time. There was a lot of after-school specials, Oprah episodes and memoirs. There was a big umbrella genre of sad girl lit, which could include Prozac Nation or even older things like I Never Promised You a Rose Garden.

And then there’s the subgenre underneath that of eating disorders content. So, The Best Little Girl in the World, Maria Hornbacker’s book Wasted, this trove of content that people say the idea is, is to provide education and awareness. Parents can see what the warning signs are, and kids can see that, actually, this thing is dangerous.

But I think that what happened to other women of our generation and me is that it kept these ideas, anorexia, self-harm and bulimia in what the medical historian Edward Shorter calls the symptom pool. It presented this option: if you’re sad and you’re struggling and you’re not sure how to get those problems addressed. Here’s how you do it, and this is a clear way to make sure that those around you know that you’re struggling. It makes your struggle legible. It makes people understand it.

Then there was this other layer on top of it, of I want all of the things that Oprah and Maria Hornbacher have told me are true of anorexics. They’re perfectionists, they’re people pleasers and they’re really smart. I didn’t really think these things about myself, but I thought I could back my car into the driveway if I made myself into this person who was very disciplined and very conscientious.

What happened was I fumbled around awkwardly for a few years trying to diet, but not doing it very well, taking a lot of laxatives, exercising fitfully, binging fitfully, not eating enough fitfully. I was sent to therapy and to a nutritionist. I then played the role of the patient, the role that I had educated myself on.

I knew what that was supposed to look like because I’d read these books, and I had high hopes for what was going to happen in the therapeutic relationship. In a lot of these books, the therapist is this preternaturally wise individual. I’m going to get in there, and they’re going to see inside of me, and they’re going to tell me how to live, how to make sense of being a human on the earth.

But it wasn’t like that. It turned out that a therapist is just a regular person, and they don’t have any special insight. I had those hopes for a little while, and then over time they started to diminish. I realized, actually, we’re all just people who aren’t really sure exactly why we’re here. Some of us might fixate on that a little more than others. So this situation lasted on and off for approximately seven years. After that initial period of time where I was trying to successfully be anorexic, I entered a phase where I ended up actually becoming successfully anorexic.

So I restricted my eating enough, I dropped to a low enough weight, and I was hospitalized. I was very sad that I was disappointing my family. But on the other hand, I thought this is the role that I was born to play. I’m doing the thing that I set out to do, and I thought that I was going to have a satisfaction akin to like a near-death experience.

I came out. I was like, okay, I’m better. Went back to school, got a boyfriend, had a sort of normal end of high school experience. I went to college, and I then started to think again. I’m around all these people who seem to know what they want to do. I don’t really know what I want to do. Of course, now looking back on it, nobody really knows what they’re doing freshman year, but that’s that was what I thought.

Then I relapsed and experienced the whole thing over again. I was hospitalized again twice in that period of time. By that time and by the end of my experience with anorexia, I felt a lot more that it had become a habit that was very difficult to break and a lot less of this sort of romantic idea of what it meant to be an anorexic, which is what I really felt when I was 13. I write in Godstruck that I’m not sure that I would draw a direct line between becoming religious and recovering from anorexia, but the timing does more or less add up.

Siem: I want to go back a little bit where you mentioned that you chose to become anorexic because I also remember a similar choice. You use the word real a lot, and I think about that, too, and especially if we really want to expand that even further past just eating disorders, which I think are perhaps one of the more obvious paths to go down because there is a physical component that can be measured, whereas we don’t have that with other psychiatric diagnoses.

Osgood: So when it comes to something like eating disorders, where there’s a physical component that has to be addressed, I’m not naïve. I don’t think that somebody who’s underweight and not eating well, we could just talk to them about the theory behind this, even though I do think for me at a certain age that would have actually been meaningful.

I think that for me, the choice felt very clear, very deliberate, and that was part of the early shame. Once I was put into therapy, and once I was in the hospital and really all throughout. I don’t remember at what point I came out of the choice closet or if I even did so in a very real way at any point. But I remember thinking that’s the deeper secret. The eating disorder is not really a secret. The deeper secret is that I wanted that. Then that, in a twisted way, became its own means of self-flagellation.

What kind of person would want that? You have to be a really bad person to want that and to put your family and your friends through it. And also, I think we see versions of this throughout psychiatry and mental health.

So I think for conditions where there aren’t these measurable components, or there are, but they’re so squishy as to be basically meaningless. DSM checklists or questionnaires and stuff like that, do you feel sad three times a week or four times a week or whatever? I think the choice comes with the ways that we think about and describe ourselves, right?

Maybe a lot of listeners are familiar with Gary Greenberg’s work, his book, Manufacturing Depression, I really love. And at the end of it, he talks about this kind of plea to the reader of like, maybe you’re sad, maybe you’re not sad, but you have a choice. You can choose to say that you have a brain disease. You can choose to tell yourself this story about yourself, or you can tell yourself the other story, which is actually the story that we have way more evidence for, which is that life is hard. People are different and complicated. There are all sorts of ways to conceive of why you might be struggling at any given point in your life.

Siem: The order of operations for me was my dad died, and that sort of spurred the eating disorder, and then the eating disorder led to the child psychologist. I actually admitted it to the child psychologist, and she told me verbatim—I’ve never forgotten this, it’s in my book too—after I told her what I was doing, and she said, “Well, I have another client who only eats white things, that’s a real eating disorder.” And I think back on that moment, later on, she would say, “I can’t help your daughter; go see a psychiatrist.” And that’s what actually led to all the medications.

I hear this, too, with Abigail Shrier’s book, Bad Therapy. She talks about how so many of these psychiatric diagnoses are introduced to youths and adolescents by the therapist or the school, and that’s exactly what happened to me. So my question for you is, what do you think might have happened if your parents did not put you in therapy?

Osgood: Actually, I had this conversation with my mom in the last two years. I wrote her an email and I was like, “I just want to let you know that I’m sorry that this happened” because my mom was actually really not on board with a lot of this and she expressed that in ways both subtle and less subtle. She didn’t explain at length why she thought it was a problem, but I knew that she didn’t really want me to be in therapy or in any of this treatment. At the time, I was able to write her off as a sort of avatar of a repressed past where everything has to be perfect.

I told her in the last year or two that I’m sorry, that must’ve been a really difficult position for you. I think that there was a lot of pressure for her to do it from teachers, from the school and from therapists. If your child isn’t well, if your child is sick, this is what it looks like to love and care for them, right? I think the pressure to do that is probably a thousand times worse now because people just draw a direct line between therapy and psychiatric care and love and kindness and good parenting. You always do that.

I’m not sure that it would have just gotten better on its own. I do think probably a viable alternative, and this is one that is used often now, which is what’s called family-based therapy. Back when I was young, it was called the Maudsley method. And it’s sort of where the parent serves as the treatment facility, meaning that the parent supervises all the meals. I think that if that had happened in my family, I would have crumbled in a second because I was terrified of my mom, and I would have just done it.

I definitely think that that would have been more successful than putting me into these hospital environments where I was around a lot of other people. We all competed with each other. We all learned from each other. I don’t want to be overly cynical. They were all nice, we were all nice people. It was just a challenging situation.

I didn’t feel that I was able to be honest with the therapist. And part of that is because I think that I just didn’t have the vocabulary. I didn’t have actual words for what was really bothering me underneath everything. These are things that you can see reflected in history, in literature, in theater, in theology, stretching all the way back to the Bible, and so I think that if somebody had been able to like walk me through that a little bit, you know, of course my adult self feels like that would have been amazing, but it would have been so hard in those circumstances.

Siem: One of the most profound things you wrote, and I believe this was in How to Disappear Completely, was the idea of trying to self-create a near-death experience because the underlying assumption is that there’s clarity on the other side. I have never heard anybody articulate this before, and I think there’s really something to it. I think typically there’s a sensitivity there where folks are trying to feel things very deeply and are trying to make sense of the depth of suffering, the existential crisis.

Osgood: I think I meant that pretty literally at that age. I actually did want to have a near-death experience. And I thought that that would, first of all, satisfy me on an anorexic front. I would feel that I had accomplished something. And also, as you said, that I would have this clarity, in a way, it’s a little bit like a religious conversion, or at least one of the models of religious conversion.

You are like, once I was in the depths of despair, I was in the pit. If you read Psalms, there’s a lot of being in the pit and then how should the God recognizes the sufferer and rescues him and brings him up. I think that in some ways it would be nice if life worked that way.

Part of what is interesting about an observant Jewish life is that it’s an embodied religion; there’s a lot of like acknowledgement of being here. The minutia of daily life is prescribed in ways that sometimes can actually be really taxing for a variety of reasons, because there are really rules and regulations around everything that you do. But I view it differently from that. I view it as being very realistic and sort of trying to think about how we bring a sense of importance to our lives here on earth. As opposed to in other faith traditions, where the focus is really on what happens after these road-to-Damascus moments.

Siem: I want to come back to the religion a little bit towards the end of this interview, but I want to make sure we touch on something first. The one thing that you’ve mentioned in private that doesn’t really get mentioned too much in the books is the use of psychiatric drugs and how those impacted your experience and withdrawal journey as well.

Osgood: So I was prescribed medication briefly in my teens, which was like, sort of how you describe, the first line of treatment. You go see a therapist and a nutritionist. Then if that’s not working, maybe they tack on a group therapy. And if that’s not working, then you go see a psychiatrist. Like we’re going to just throw spaghetti at the wall and see what sticks, right?

When I was 18, and I was in my freshman year of college, that’s when the real psychiatric portion of the story starts. I was restricting very heavily, and my therapist at the time wasn’t seeing any positive movement in any direction. So she’s like, okay, now you’re going to go see a psychiatrist.

I remember the first one I went to see was a guy. He worked out of a hospital in downtown Manhattan. I had that maybe familiar feeling that people will recognize from their own lives, like this combination of a lot of hope, oh, this guy’s going to know what to do to fix my life. And also of dread. I was never against psychiatric medication, but I didn’t like it as much as I liked the other narrative around my suffering, which was that it was very poetic, and it meant that I was this very smart and deep soul.

I talked to him about what was going on in my life, and he said, “I think you’re too malnourished. I don’t understand what your static brain chemistry is because this isn’t you, right? So in order for me to feel good about prescribing you something, you’d need to come back when you were a little more stable.” At the time, I remember being disappointed that he wasn’t going to fix me on the spot and also a little complimented, like, I’m so malnourished that he can’t even prescribe me medication.

So then, fast forward to later on in the year, and I was still in the same relapse. I had been hospitalized and had come out, but nothing had really changed. She sent me to another psychiatrist, and this one pretty much immediately gave me Prozac and some other things. I think she gave me Xanax in case I was nervous when I was eating. Prozac became the drug that I took most regularly from the age of 18 until I was 31. Right after I was prescribed Prozac, I went into the hospital again, gained weight, was in a better place, came out, and my mood was better. Then I was going to see the psychiatrist, I believe it was once a week at that point. So that was in addition to seeing my nutritionist and my therapist.

I had this sense of every other week kind of going in and being like, well, I have to have something to say. Not that I was making things up exactly, but this is a transactional relationship. What am I bringing to the table here if I just go in and say everything’s fine, you know? So I would go in every two weeks, and I would kind of notice all my moods dipping or I wanted to hurt myself or something like that. Whenever that would happen, then she would raise the dose. And after a certain amount of time, I ended up on a hundred milligrams of Prozac. Then, because I was deemed at that point stable, I saw her less frequently.

So for the next four years, that was my dose. I rarely saw her. I would just call her and say, I’m out of my medication and then it would be at the pharmacy, and I would pick it up and take it and go on my way. Then, right after my senior year of college, I studied abroad for a semester in Paris, and I was filling my medication at a pharmacy. The pharmacist stepped out from behind the counter and was like, is this correct, in Europe, we would not prescribe this dosage. This is not a normal dosage. I remember for the first time about medication, I had this moment of, “That’s not what I want.”

At that point, I’m 23. I’d been in psychiatric institutions four times. I’ve seen what it looks like when people have a more tenuous grip on reality, and I know that that’s not me. So I’m starting to think that doesn’t make a lot of sense, right? When I went back to the US, and I went back into treatment, that’s when I started to get into a lot of not-so-nice conversations with my therapist and sort of be asking her questions like, “How do you know that this is necessary? Explain to me why this is necessary, because when I look back over the last few years, I see my mood start to noticeably go up when I’m hospitalized. So when I’m eating, and when my weight goes up, how do you know that you can’t trace a mood rise to that instead of to the medication?

I got a lot of answers that will probably sound familiar to a lot of people who listen to the podcast, right?

My least favorite of all time was “we know you need the medication because it works for you.” Which makes no sense. Or, “if you had diabetes, would you be ashamed to take insulin? It’s the same thing. You have serotonin depletion.” It was not equivocal at all.

All of my requests for greater elucidation on this matter were basically dismissed in a way that I think, looking back, actually makes me very angry. The overarching message that I got was the reason that you question this and the reason that you have concern about taking medication, it’s part of your personal desire to be an aesthetic. You don’t want to have this need. Why can’t you just have a need and have it met? That’s your pathology, you know?

And then to find out years later that actually, no, I wasn’t exhibiting problematic thought patterns by asking these questions. These are totally legitimate questions to ask about taking medication. I am sympathetic about when somebody is in front of you, and they’re really struggling and you feel like you have a limited number of options, I get that. But it beggars belief that a healthy young person would then be resigned to a lifetime of medication. I felt that my distress over that was really not taken seriously. That’s how I felt.

So essentially, through my twenties up until when I was 31, I think once or twice I tried to go off. Once, I went off cold turkey, and it was not great. I lucked out in many respects on the side effects front. I didn’t have certain somatic side effects that people describe. I just felt very sad and tired and very physically heavy.

Then another time I tried to go off in a more methodical way, not really any better of a result there. Then, finally, when I was 31, I was starting to think about wanting to have a kid, went back to my original doctor, and she conceded that we shouldn’t keep you on this dosage, so you can start to taper off. But if you feel bad, you should call me because we don’t want you feeling bad.

I remember that line sticking in my head so much because I had really thought that the point of all this therapy was that I shouldn’t actually have to be afraid of how I felt. So you feel bad. So what? I’m an adult. I’m not going to do it; people feel bad sometimes. Why should that be? Why should we be afraid of that? Shouldn’t you be telling me you can get through that?

So I ended up successfully going off. And I think what really saved me was that I got pregnant really quickly after I went off. I got a lot of like nice early pregnancy hormones that are coursing through your body, making you feel happy about the world and about new life. And also from a psychological perspective, I had a project. I had something that I was doing and that I was focused on. I think that’s really what helped. And now I haven’t been on medication for more than 10 years.

Siem: Last question. I want to just talk about what converting to Orthodox Judaism has done for your life in a way that has helped. How has it made meaning for your early experiences in psychiatry and psychology, and how do you think that it could benefit others?

Osgood: I do feel that a lot of younger and older people who find a lot of meaning in seeing their life and the world through a therapeutic lens, whether using ideas from therapy or from psychiatry, using identifying markers from those disciplines. I feel that it’s a result of a crisis of meaning in our culture. I think that, in addition, there’s also a crisis in the way that many people live. I think that people feel that they are lonely and that they’re disconnected from other people around them. There’s this idea of community, you hear this a lot, there’s no village anymore. Where’s the village? I need a village.

There’s this idea that in the past, we had these sorts of civic and social structures that kept us bound to one another. I think when I was in my twenties and even like around the time of my conversion, there was this idea, well, good riddance. We don’t really need those anymore. We don’t need churches because they have all these archaic rules, and they make people hate themselves. And we don’t need small towns because we’re sophisticated and we can move, and we live in a globalized world.

I think right now we’re seeing a reevaluation of a lot of that stuff and a thought of, well, maybe I do need to know my neighbors and maybe it is useful to be part of a network of people. Maybe I do need a system by which I can step away from my phone, my computer and social media. These things that were these great promises of like, it’s going to bring us together and help us, but really have not gone the way that we wanted them to, you know?

I think that religion really provides a lot of this stuff. This structure is there, and it’s different from the faith tradition. I’ll speak specifically here about being Orthodox. There’s a way in which I feel that in my environment we talk about meaning and we talk about our faith tradition and we talk about God a lot. But there’s also this way in which we don’t compare to what people might think. If somebody just swooped down into my life, they might be surprised at how they would have maybe expected God to come up a lot more than he does.

But what they would see is the fact that I see all of my neighbors with great frequency. I see them at synagogue. I see them when someone in our community dies. I see them when babies are born. We have these rituals that connect us very tightly to one another. I think that is a lot of what people are missing. I think that there’s a lot of sadness and frustration at modern life that people interpret as something that’s happening specifically inside their own minds, not happening as a result of structural problems.

I must have midlife ADHD. No, that must be because your computer is eating away at your attention span, and also because we haven’t prepared people for the natural progression of what it means to be a human moving through life and reaching a stage where your brain is not going to feel the way that it did when it was 20. Or I feel anxious about the state of the world. I have an anxiety disorder. Maybe it’s because your brain is not supposed to be processing news from all over the globe every single second of the day. I do think that religion puts a lot of guardrails around these things and really can hold the human being.

I think that there’s a lot of discussion about what is something else that could do that? Does it have to be a religion? I participated in a lot of these discussions because, since the book came out, there was a lot of data that showed that maybe religion was reentering the public square in a way that people weren’t anticipating.

If I can go back to what I said before about Gary Greenberg’s narrative. When he says to pick a story and pick the right one or pick the hopeful one, right? To me, picking religion felt like the more hopeful belief, and I know that that sounds probably a little crazy to people for a lot of reasons. But I saw in religion’s conception of what the human being is, which is like endlessly downtrodden but also endlessly resilient and able to repent and be better and try harder. That looked so much more hopeful to me than what I had been told about my brain as this broken machine. I felt that if I’m going to pick between these two stories, I’m going to pick the one that’s like thousands of years of trying harder and getting up in the morning and doing better. That to me just felt like the no-brainer choice.

Siem: I would really encourage anybody who has even a passing curiosity about getting a little bit more involved with religion beyond just spirituality to read Godstruck. You outline seven different women’s journeys to religious conversion, and at the same time, you give a history of seven different religions. I felt so enriched just to learn more about Quakerism, Islam and the Amish.

So, thank you so much, Kelsey. Just in the last couple of minutes, can you tell us where we can find you and if there’s anything you’d like to ask or leave with the audience?

Osgood: I’m Googleable and I have a website. I don’t have any social media. If the spirit moves you, so to speak, you can email me through my website. In terms of leaving something with the audience, I don’t know. I think that those of us who have been questioning these paradigms for a long time, I think it can feel easy to feel discouraged. I know I feel discouraged a lot because I feel that it’s really the default mode for understanding a lot of our lives these days. But I do think that things are shifting, and there’s room to reevaluate, and we should stay hopeful in that respect.

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