At the peak of her eating disorder, Stephanie Covington Armstrong threw up 15 times a day. Any food in her stomach made her uncomfortable, and it was only when she vomited that "everything was right with the world," even if only five minutes until she would do it again.
It was like crack, she said. Drugs and alcohol seemed messy but binging and purging offered that same high, the kind of high that would take away the self-hatred that constantly weighed her down.
For seven years, Armstrong's bulimia was her deepest secret. And as a black woman, she said carrying the stigma of an eating disorder was even worse.
"There is that shame of not being a strong black woman," said Armstrong, a Los Angeles playwright and author of the book, "Not All Black Girls Know How to Eat."
"People would ask me, 'What, do you want to be white or something?'"
More than 10 million Americans suffer from some kind of eating disorder, and many of them are not white, young or female, according to the National Eating Disorders Association.
Dr. Wendy Oliver-Pyatt, executive director of the Oliver-Pyatt Centers in Florida, said that, at any given time, at least half of her patients are not what society typically thinks of as someone who has an eating disorder: people older than 40, mothers, men and minorities.
"Minorities, men and older people have an even more difficult time," said Oliver-Pyatt, speaking on behalf of the National Eating Disorders Association. "It's almost culturally accepted for a young white woman to have an eating disorder."
"Many black women are coming from an environment where there is such little control," Armstrong, 45, said. "Who has less control than poor minorities in this country? I've interviewed black women who have said, 'All I have is my food. You're not taking that away.'"
Armstrong's favorite uncle raped her when she was 13. Already having lived in a fatherless household, she didn't feel worthy enough to come forward with the trauma.
"He was the one male I trusted," Armstrong said. "My thoughts were, 'If he didn't think I was worthy, if he could rape me, then maybe I am not worth anything. Maybe I do lack value.'"
On the outside, Armstrong was driven and bright. She did well in school, but the self-hatred owned her.
At 17, she discovered food helped her cope with feelings of worthlessness.
"It's like gambling," she said. "You win a little something and you're on this high. But, eventually, you need it more than it needs you. It turned on me."
And for years, she continued to lose the gamble. But she chose to be silent rather than go against the symbol of an archetypal strong black woman.
After battling the disease for seven years and becoming suicidal in the process, she finally went in for treatment.
"If my whole life was going to be about throwing up and controlling food, I didn't want to live anymore," Armstrong said.
She relapsed in her late 30s,but unlike in her younger years, after a few weeks of vomiting again, she realized she needed someone to help her cope with the heaviness.
"When I recovered the second time, I had nothing to hide anymore," said Armstrong, who now has a heart murmur because of the the bulimia. "I can safely say now that I'll never throw up again. It doesn't occur to me anymore. I have no desire. It used to be in the back of my mind but it just isn't anymore."