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I'm one of those weirdos who was born and bred in Manhattan.

I grew up in Greenwich Village until I was nine, and then my mom moved to the Upper East Side, which I found very traumatic.

I came back to New York after college and lived in Manhattan for about a year. My salary as an assistant at Vogue was $18,000, but you got paid overtime and we were there 23 hours a day. So I got a studio apartment on West 12th Street that had next to no lighting. It was one room in the back of the building.

Nobody realized there was a foundational gap between the wall and the floor so water bugs would crawl in. That’s the only true phobia I have, and I’d come home to colonies. I can deal with rats and snakes, but I literally freeze around water bugs. I was so depressed after a year of that that a friend said, “Why don't you move to Brooklyn, and we'll live together?” So I've now lived in Brooklyn longer than I have Manhattan. I was always the person who was like, “I'm never leaving New York—I can't leave Manhattan.” I used to make fun of people for living in Brooklyn and New Jersey and be like, “I can't stand bridge and tunnel.” That was when I was about 15, going to clubs. I thought I was cooler than anything. Turns out, I'm not. Honestly, I find the pace in Manhattan to be so frenetic, and as I get older, it doesn't benefit me.

This neighborhood, Carroll Gardens, has gentrified so fast. I've never seen anything like it. But when Milk Bar moved in, I was like, "Phew, life is getting better." I have a terrible, terrible weakness, not just for sweets, but for “mouthfeel.” It’s very important to me. And their birthday cake truffle is the perfect mouthfeel, like on a scale of 1 to 10, it's a 12.

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I smoked every day from the time I was 12 until the time I was 43. A pack every day.

My addiction to sugar is pretty problematic. I smoked every day from the time I was 12 until the time I was 43. A pack every day. But one day, I was like, “I'm out” and I quit. Now I wish I could do that with sugar, but I have not and I'm deadlocked. I did stop for maybe, I don't know, six months, and it's amazing how much better you feel. I went dairy-free, gluten-free, soy-free, sugar-free, no alcohol ... and I felt fantastic. I was shooting 16 hours a day for the first and second seasons of What Not to Wear—it was excruciating. I had no social life, so I was able to be very regimented. That's the only way to really diet. It's just too hard otherwise.

I did the Today Show from 2005 to 2010, and I was with Access Hollywood from 2006 to 2012. So a typical day off from What Not to Wear could be a Friday night call to do, I don't know, Oscar red carpet predictions for the Today Show. Go shoot a Lee jeans commercial, and then shoot something for Access Hollywood that night. It was 12 years of this fear that I would never get another show. So I did as many commercials as I could. I did as many endorsement deals that I actually believed in. But I would turn down things that I felt weren't really part of my ethos.

I'll never forget because it wasn’t easy to turn down a lot of money, but one time a yogurt company wanted it to be about “lose five pounds.” I was like, “No, that's not what I talk about.” But for the most part, I tried to keep going and going out of fear that it would all come to an end. The one thing that I learned from that is that burnout is real.

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If you think The Bachelor is real, you're out of your mind.

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In some ways, I don't know that I’ve entirely recovered from that burnout yet. So many things went wrong after I left television that I didn't know were already affecting me—like psoriatic arthritis. I wasn't diagnosed until almost two years after I left What Not to Wear and I was so sick that last season but I had no idea what was wrong with me. Then I had hamstring surgery and needed spine surgery. I am convinced that even though my surgeon said my body is some sort of a physical anomaly, working that hard is really detrimental. It's taken me a lot of time to learn a work-life balance. Or harmony.

I still feel like I can hold my head up high because of the show. We really tried to change people's perspective about themselves, whereas I don't have any interest in Real Housewives and that kind of thing. It's all scripted. I mean, if you think The Bachelor is real, you're out of your mind.

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I've heard the new Queer Eye is incredible, but I think it's incredible because of the way they updated it for an audience that watches Netflix. It's not Queer Eye for the Straight Guy anymore, which was such a great catchy thing in 2003. But I think they should've had a queer woman. Because the word “queer” doesn't mean what it meant even in 2002. A queer woman of color would've been an incredible addition! But that's just me, feeling like, if you're going to evolve, evolve faster.

Somebody told me recently that the amount of images we see in one day is the amount of images that our grandparents saw in their lifetime. I think until we have chips in our brains or we can add more memory or RAM or whatever, it's going to get harder and harder. What I really fear is social media, because young women, as far as I see, don't understand the difference between social media as a tool and social media as an identity. I keep saying it's a tool, so use it like a tool. Get your message out there and do whatever you like, but that's not who you are. That kind of curated “authenticity” makes me anxious because that's not real.

I also feel like the process of discovery has just been destroyed by technology. You can google anything. You can shazam anything. Nobody's ever going to have to go to a library and look at an encyclopedia again. That's all I did. There's that sense that we don't discover things naturally and, in a way, can't be as fascinated by them. Our brains are struggling. It's a hard time, but one of the reasons I'm writing a book right now is I think this is going to be such an important historical moment for women.

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The way that women are valued, especially when they age, is so disconcerting to me.

I consider myself part of a new species that I’m calling the “evolutionary woman.” This is what my book, The Evolutionary Woman, is about. It’s not a lot of stats and research, but very much my perspective on women who are choosing not to get married, not to have children, and being able to see where we're going. Not just in terms of relationships, but everything else.

The way that women are valued, especially when they age, is so disconcerting to me. That's the one thing that we haven't been able to break through. It's such an ingrained bias that we don't talk about it. The book started because of the Refinery29 article I did about aging out of my old style. So I definitely talk a little bit about that. But it's much, much more about the fact that I don't feel 49.

Some people will say, “It's because you didn't get married and you didn't have kids.” And I'm like, “No, it's not that.” I think that all women don't necessarily feel their age as they get older. But they start to realize they're aging out of lots of things. Why is that? The first chapter of my book is called, “Nobody's getting out of here alive.”

Why is there this bias against aging? Why is every beauty product about anti-aging? Especially because now we do have friends who are so much younger than us. I don't envy my friends for their youth—they're my friends. We've got to reconcile this idea of longer lifespans and what women are going to do, let's say, between 40 and 80 when they're no longer socially biologically useful. Because we're still here. This is like an invisible percent of the population. I want to get these women back to the workforce. I think that there's a huge army of the population that could be utilized for the good of the world that are just completely ignored because they're not of a certain age anymore.

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I actually just rewrote my introduction because the other day I was watching Terms of Endearment and I had always identified with Debra Winger’s character. But Shirley MacLaine has her 50th birthday party in the movie and the doctor says, “You're actually 52,” and she gets upset. And I was like, “I am Shirley MacLaine.” All these years later, I’ve caught up to her age. I lost my shit. I was like, “Oh my god, I'm Diane Keaton in Something's Gotta Give. I'm Dolly Parton in Steel Magnolias. I'm not Julia Roberts anymore!” That was a disturbing moment. It was eye-opening.

To not feel any relationship to those women that I see as women in their 50s means that we're headed in a new direction. Age is becoming more and more irrelevant. It needs to be redefined and looked at for women specifically because we've internalized so much of a male gaze that we don't even realize that our thoughts about ourselves aren't our own thoughts.

I don't like the idea that there's an expectation that women at a certain age have to say, “You're the star now and I'm going to support you. I'll be your stage mom, your mentor, or whatever.” I want to continue to do work that is meaningful to me and meaningful to the people that find it meaningful. I shouldn’t have to step aside. I don't know where that idea came from and I don't like it. I don't like it because I have so many young friends and I feel just as vital as they do. I don't say that at all out of bitterness. I'm saying that because I really question how that came to be.

The central thesis really is about this moment in history that allows a woman like me to exist. Going forward, there will be many more like me. And if I'm right, that is going to significantly change our culture. All those traditional markers are just going to fade away. The average child-bearing age was 19, now it's 26. What happens when it's 49? How is that going to change life? It's going to be so different.

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I was never really into weed. I found that it made me really paranoid and anxious when I smoked it. I was approved for medical cannabis for my spine, but I actually don’t use it anymore because CBD is legal. A friend started Lord Jones and that's why I got so interested in it.

I had a really bad experience with surgery because I was on such an inhumane level of oxycontin. I was wearing a huge brace and terrified to leave the house because when I left the hospital, all they said was, “Don't slip, don't bump into anybody.” Taking that much oxy—I assume that's what being dead feels like. I felt like I was floating over my body. I couldn't feel anything. I didn't really talk. Everybody thought I was fine because I was just like, “Mm-hmm.” I don't remember anybody I saw. I don't even remember who came to the hospital. I didn't ask for water or food. Everybody just assumed I had eaten or had something to drink. I was just like a vegetable.

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Thank god my sister, who worked at Mount Sinai at the time, was here. When it was time to change the dressing on my wound, I got up with my walker, and we walked into the bathroom. She was like, “I’m going to change it.” All of a sudden I had this vision of her taking the bandage off and seeing my vertebra, and I got so nauseous that I fell, and just before I did I said, “I'm going to fall down.” If my sister hadn't been there, I would've broken my spine. I would've snapped it against the titanium.

So I wound up back in the hospital that night. I said to them, “You are giving me so much oxy that I can't feel or think or see. It's awful.” So they cut my dose in half. I was so angry about how much they pushed this medication that in nine days I completely transferred myself off of oxy and onto CBD.

The thing is, CBD does not take away pain completely, which is a godsend because you can't hurt yourself if you feel some pain when you try to do something. So it kept the edge off the pain but kept me alert enough not to fall down the stairs. I understand why, if you are having real emotional turmoil, you would want to feel nothing. Painkillers just deaden everything. But I hate them, so this was a revelation to me. The recuperation was so hard but I know it would’ve been much harder without it.

If CBD hadn't done what it did for me, I don’t know that I would be so enthusiastic. I would be like, “Whatever, CBD is another fad, another thing.” Even convincing my dad, who has neuropathy, that a topical wasn't going to get him high took me forever. But the fact is, it helps him. Even though he’s like, “I smell like weed”—who cares! You're not in pain.

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This interview has been edited and condensed for clarity. Stacy London photographed by Meredith Jenks at her home in Brooklyn.