Expert: Robert M. Kalman - 4/30/2004

Question
Over a year ago one of my good friends decided to lose weight becasue she wanted to be a model. Now she is extrememly skinny and i cant help her. She is about 180cm tall, 14 year old girl and last i heard she was about 40 kilos. She has her parents thinking that she is fine, saying she eats her lunch and is never hungry at dinner time (she throws her lunch away everyday). If she is forced to eat dinner she just throws it up. Her thighs instead of going out from the knee up, they get skinnier, her skin is a blotchy unnatural colour and her hair is not as shiny and healthy as it used to be. She has taken laxatives and has been in tears saying she wants to die. The most she eats a day is an eighth of an apple, but i am unsure if she even has that anymore. I have read many articles about anoerxia nervosa and she fits the description. When she was younger and in primary school she was overweight and got teased. When high school begun she was at a very healthy weight. She still thinks she is fat though. She said that she would rather die then go back to how she was. Today i was talking to a friend who is naturally very skinny and was saying she wants to put on some weight for a more natural look, my other friend cannot comprehend this and thinks she is crazy. She hears storys about anoerxic people and being like 30 kilos and she says she is proud of them! Me and a couple other friends have been to the school nurse and talked to her about it. We have constantly tried to talk some sense into her but she thinks she hasn't got a problem. Her parents are beginning to realise her problem and have being going to dieticians etc. but they are still in denial. She has told us the doctors have tried to to convince them to admit her into hospital but they won't sign the papers. I am terribly worried and frustrated about my friend. I dont want her to die. She needs help. Me and other friends of hers have tried over and over to help her, we have all been in tears about it too. She thinks she is fat and hasn't got a problem except being fat. Please help. If she doesnt get help soon i am afraid it will be too late.

Answer
I can sense the urgency in your letter. Unfortunatly she will probably get worse untill her parents realize that the problem will not go away without some intervention. People with this illness do not want to exist. They want to make themselves invisible so they keep unconsciously starving themselves. The idea that someone can be PERFECT is totally absurd, but the anorexic believes that the smaller they are the more perfect they look. Don't give up on her! Also, something had to happen to her to make her start to starve herself..Tell her parents your concernes.. Robert