Last weekend, we visited an old friend. She looked awful. She could barely walk. She’d lost a lot of weight, and her arms and face had many scabs on them. I snooped in her kitchen and discovered that she was on a liquid diet again. The last time she was on a liquid diet, she only consumed 1/4 to a 1/3 of the packets of whatever that stuff is that are recommended/prescribed per day. That makes her calorie consumption lower than 1000 cal/day. The scabs are from self-mutilation (aka cutting). She does not have medical insurance.

Did I confront her? No, I’m not up to it. And I don’t believe it would change things. I believe that, aside from the cutting, she thinks that she is being healthy by not eating. She’s overweight, but that wouldn’t matter. Someone who is 66 inches tall and weighs 80 pounds thinks she needs to lose weight if she’s got an eating disorder. It will take some serious intervention and considerable therapy to change things for her, if, and it’s a big if, she wants to change things.