She stands 5 feet, 5 inches tall and weighs barely one hundred pounds, soaking wet. Her shape is slightly more ”womanly” than most of the peers her age, though she’s not fat by any means. But, for much of her early years, she thought she was–even when her weight fell well below a healthy percentage. At one point she stepped on the scale and watched the needle stop at 85, full of self-loathing. Needless to say, she became frighteningly underweight. But when she looked in the mirror, her stick then legs appeared as tree-trunks, despite her rib cage being shockingly visible through her waistline, reflecting back at her were fat rolls and excess flesh.

Anorexia, as defined by the National Institute of Mental Health (NIMH), is an illness in which people starve themselves intentionally. Typically beginning around puberty, the behavior involves extreme weight loss. Even at 15 percent and more below healthy body weight and emaciated in appearance, people who suffer from anorexia are convinced they are overweight.

Eating disorders don’t discriminate by age or gender. Men who battle these disorders are often athletes who feel pressured to maintain low body weight/fat to improve performance. When instructed by those in charge to lose weight for a sport, they can become preoccupied with food and obsessed with lowering body weight. Boys and men who develop body dysmorphia also may suffer.

Women, however, comprise the majority of the eating disorders. Women who suffer from this tend to be perfectionists, according to the American Psychiatric Association. In general, they may be critical of themselves or specific aspects of their physical make-up.

Michele Ford, LCSW, ACSW a specialist in eating disorders says this often begins when young people are passing from childhood into adolescence, becoming terrified of the new phase. There have been cases reported of kids as young as eight years old (and even younger) suffering from anorexia. But, adolescences are not the only ones at risk for eating disorders. Therapists treat eating disorders patients of all ages.

Control is a term frequently associated with eating disorders, as well. For some, food and their weight feel like the only things they can control. Researchers are finding eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors.

Most experts agree on society placing too much value and importance on being thin. Trying to change these societal attitudes can be challenging with the pervasive messages sent to young girls to be thin.

“We need to say, OK, we are not going to buy into this,” Barabara Cubic, MD and associate professor of psychiatry and behavioral sciences at EVMS, says. “We need to be active in trying to change the primary importance society puts on body weight.”

Eating disorders are progressive. Left untreated, they can result in severe health impairments or even death.

For those who suffer from anorexia, low body weight often leads to loss of menstrual cycles, this, in turn, can weaken bones. Other symptoms include low blood pressure, slowed breathing and pulse, brain damage, multi-organ failure, infertility, brittle hair and nails, gastrointestinal bloating and severe constipation, stomach weakening, and damage to the structure and function of the heart. Cubic says the literature shows that one out of five may die if left untreated.

Getting professional help offers the best chance for recovery. Comprehensive treatment is the key to success, according to the American College Health Association (ACHA). Just returning to a “normal” weight won’t solve the deep-rooted emotional issues. Self-esteem, positive body image, and self-confidence, as well as healthy eating habits, are all necessary for real and lasting recovery.  Treatment and therapies often include individual and/or family psychotherapy, medical care and monitoring, nutritional counseling and medications.

Having her hip bones poke out, shoulder blades visible, and a thigh gap was all a sign her plan was working. Only, it still wasn’t enough. Even then. She believed there was still too much of her. What started as a game of calorie counting morphed into self-loathing and body dysmorphia.

When recovering, the whole family needs to be involved in understanding better what their loved one is experiencing. The key is to catch it early and treat it and prevention is the key. Warning signs of a developing eating disorder could be taken seriously. According to NIMH, they include:

• an excessive focus on body size and appearance and relentless pursuit of thinness
• counting fat grams and calories, extremely restricted eating
• exercising excessively
• depression and isolation
• bathroom use after meals
• weight changes, distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or denial of the seriousness of low body weight.

She wrestled with this on and off through her teens, twenties, and even now if she isn’t careful, it shows it’s ugly head in unexpected ways. The healing is a process that can last a lifetime.

What would I want that teenage girl to know who began the dangerous dance of restricting calories all those years ago?

Someday those legs will proudly walk you across a stage to receive your college diploma and down the aisle to get married; your body will experience pure joy training to run marathons and long distance triathlons; you will learn your body’s magnificence when you carry to term and give natural birth to two beautiful children; you will discover your body’s true strength fighting and beating cancer. You will discover your body was not designed to be hated. Instead, it is a gift from God. And the day will come when you will learn to honor it, be grateful for it, and treat it with grace and love.

More stories like this in my new book!