At 5'8 and a skeletal 105 pounds, Ali knows that people think she's too thin, but she says she still needs to lose another 10 to 15 pounds. Ideally, the 23-year-old says, she should be able to wrap her hands around her waist completely, but she can't because she sees pockets of fat. "I just want to be thinner," Ali says.
Diagnosed at age 10 with anorexia nervosa, Ali restricts her food intake to 700 calories a day and keeps a container in her room in which she purges five to 10 times a day.
Ali's mom, Shelly, says she checks on her daughter morning and night to make sure she's still breathing. "I want my daughter to outlive me," Shelly explains. "I don't want to bury my daughter."
Anorexia is a potentially life-threatening eating disorder characterized by a restrictive diet and extreme weight loss. People who have anorexia often equate being thin with self-worth and in Ali's case, will starve themselves to the point that they cannot help but eat, and then — fearing they will gain weight — throw up.
The exact cause of anorexia is unknown, but doctors believe it may be a combination of biological, psychological and environmental factors, according to the Mayo Clinic. Certain people may have a genetic tendency toward perfectionism, sensitivity and perseverance, all traits associated with anorexia. Others may have obsessive-compulsive personality traits that make it easier to stick to a diet. And peer pressure may also play a role.
Up to 24 million people in the United States suffer from an eating disorder. But, only one in 10 men and women with eating disorders receive treatment.
Former Miss America Kirsten Haglund is one of those people. Having battled anorexia since she was 12 years old, Kirsten spent years denying that she had an eating disorder. Her moment of realization came when she almost fainted from overexercise and too few calories. Kirsten says she realized that she wanted to get married, have children and help others. "I felt that desire so strongly, and I realized, oh my gosh, I want to live," Kirsten says. "I don't want to die from this disease."
The Doctors, Kirsten and psychologist Dr. Patricia Pitts plead with Ali to make the commitment to get help.
"I think it's what is going to kill me," Ali says, softly. "And I want to live. I just don't want to gain weight. And it's so hard because they say you have to gain weight to get better."
Anorexia red flags:
• Skipping meals
• Making excuses for not eating
• Eating only a few certain "safe" foods, usually those low in fat and calories
• Cooking elaborate meals for others but refusing to eat
• Repeated weighing of themselves
• Frequent checking in the mirror for perceived flaws
• Complaining about being fat
• Not wanting to eat in public
Health consequences of anorexia:
• Abnormally slow heart rate and low blood pressure. The risk of heart failure rises as the heat rate and blood pressure levels sink lower.
• Reduction of bone density (osteoporosis)
• Muscle loss and weakness
• Severe dehydration, which can result in kidney failure
• Fainting, fatigue and overall weakness
• Dry hair and skin, hair loss is common
• Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.
• Heart problems, such as mitral valve prolapse, abnormal heart rhythms and heart failure
• Bone loss
• In females, absence of a period. In males, decreased testosterone
• Gastrointestinal problems, such as constipation, bloating and nausea
• Electrolyte abnomalities, such as low blood potassium, sodium and chloride