Veran í moldinni (The creature in the dirt), by Lára Kristín Pedersen, chronicles the struggles of a professional Icelandic football player to name, understand, and overcome her food addiction. A memoir, the book starts in 2006 when the then-twelve year old Lára Kristín began experiencing obsessive thoughts around food. As the story progresses, we witness how her obsessive behavior towards food develops into a severe addiction that affects every aspect of her life, including her career and personal relationships. Lára Kristín openly discusses the challenges she faced, including misdiagnoses and the isolation caused by her addiction. It is a compelling and honest account of her experiences.

Much of the text concerns coming to terms with food addiction, a malady that is largely overlooked by the medical profession. As the memoir unfolds, Lára Kristín seeks help from doctors and psychologists and receives varied diagnoses, including eating disorders, depression and anxiety. Throughout her encounters with the medical profession, Lára Kristín struggles to reconcile her formal diagnoses with her own experience, finding that existing medical practice offers little understanding and no help in resolving her relationship with food. As the memoir unfolds, and her medical diagnoses yield little in the way of results, her addiction leads her to isolate, binge on food, and avoid leaving her apartment for days, neglecting her football practice and ignoring calls from concerned family members. Her life became consumed by the constant pursuit of her next “fix” where she would seek out food that was heavy in fat and sugar and eat until she felt numb. She describes her concerns with people seeing how much she was eating, going out of her way to obtain food discretely, sometimes even stealing it, and always eating alone. It is from this experience of extreme isolation and shame that the book takes its title, a moment in which the author felt alone and underground—in the dirt.

Two themes recur in the author’s description of isolation, addiction, and alienation from the medical establishment. First, the diagnoses that Lára Kristín receives from the medical establishment confine her to categories and treatments that ultimately exacerbate her suffering. Second, and significantly, is the confusion (on the part of the author, but also in family, friends, and medical professionals) that can arise when one has an unhealthy relationship to a substance that, unlike drugs or alcohol, is necessary to survival. In this, the food addiction described by Lára Kristín seems unique from other, well-documented forms of addiction.

The turning point in Lára Kristín’s story comes when her mother sets up a meeting for her with a consultant at the Icelandic food addiction center where she is finally diagnosed with food addiction. There she begins a novel therapy program that has been designed to specifically treat that diagnosis. Her diagnosis offers both clarity and reprieve, leading to a realization that forms the core argument of the book. Following her diagnosis, Lára Kristín contends that food addiction is distinct from eating disorders like bulimia and anorexia and is better understood and treated as a substance addiction. Lára Kristín argues that food addiction ought to be approached similarly to alcoholism.

This comparison is not just descriptive, but prescriptive:  after her diagnosis, Lára Kristín’s treatment takes the form of a 12 step program. Her diagnosis and treatment mark a turning point in her life and in the text: she moves from isolation and confusion to a clearer understanding and, given her treatment program, a social network that provides explanation, reassurance, and comfort. Her experience in the 12 step program is thus as much social as it is medical, providing a community of fellow addicts that share a history of frustrating and tragic experiences as well as a common aspiration.

If one central goal of the book is to put a name to food addiction and categorize it as a substance use disorder, a second mission is to destigmatize food addiction and bring the concept greater public recognition. Lára Kristín explains that there is a lack of understanding and knowledge of this illness in society, which makes it complicated to seek information and help for both the people suffering from this illness and their relatives. Lára Kristín describes a stigma surrounding food addiction similar to the stigma that has been surrounding alcoholism. Much like alcohol abuse, food addition is seen as an overindulgence. People are seen as lacking willpower and willfully engaging in bad behavior. People that have not dealt with addiction and do not understand the loss of control are tempted to think that food addicts need to simply stop their bad behavior.

With this book Lára Kristín explains her personal journey but at the same time attempts to raise awareness of an illness that is surrounded by the sorts of stigma and stereotypes common to those who suffer from addictions of all kinds. She wants to see food addiction acknowledged in the health care system so that the afflicted can have better access to resources and experience more understanding and less shame. The book is well written and effectively engages readers, allowing them to empathize with Lára Kristín’s struggle and gain a deeper understanding of food addiction.