Lynn Sucher

Tragedy began and ended with the tricky reflections on a mirror.

Michelle Walker recalls perfectly when she knew her 10-year-old daughter, Shae, slowly was killing herself. In a rare moment she saw her child, the one who liked to draw pictures and play with the dog, changing in front of her bedroom mirror.

The bones in her daughter’s body pushed tight against her skin, as if trying to break out.

“Don’t you see a skinny girl,” she said, crying as she pulled her daughter toward the mirror.

“No,” Shae said. “My thighs are too fat.”

Hundreds of thousands of parents across the nation like Mrs. Walker are fighting for calories, boxing up scales and mirrors, and wishing they had eyes in the back of their heads to catch every glass of milk dumped in the sink and every school lunch discarded, eating disorder specialists say.

Their children — the U.S. Health Department has said near 5 percent of young women have eating disorders — are dying because they won’t eat or they make themselves sick after they eat. They starve to attain the body of an athlete or the airbrushed figure of a magazine model, specialists say.

Though there is no state-by-state count of the number of women and girls with eating disorders, community groups say there is a local problem and that an infrastructure is being built to address it.

FINDING HELP

Tennessee’s first residential eating disorder treatment center has been built in Chattanooga and will open next week, said Lynn Sucher, a certified eating disorder specialist based in Orange County, Calif., who is consulting with the local clinic.

The Center for Eating Disorders at Focus Health will treat women age 18 and older, and officials hope to start an adolescent program, Ms. Sucher said.

“The saddest thing for me as a therapist is to watch them lose their adolescent years,” she said. “They don’t date. They don’t have fun with their friends. They don’t go out and eat with people, or they are out eating and purging in the bathroom. They lose their whole adolescence, and you don’t get that back.”

Along with the new residential clinic, the MCR Foundation, a local organization aimed at promoting awareness of eating disorders and founded in the summer of 2007, began its first family support group last week. Jenny Johnston, executive director of the MCR Foundation, said she has gotten a surprisingly large response.

The foundation fields about five calls a day from family members of sufferers or friends who have questions or are looking for resources about eating disorders, she said.

The mantra of mental and medical health professions on the causes of eating disorders has changed little over the years. Eating disorders in young women are gasps for control, experts say.

The young women’s conditions are brought on by trauma, the culture’s emphasis on thinness and beauty, family pressures and genetic predisposition, among other things, said Shelli Yoder, executive director of the Eating Disorder Coalition of Tennessee.

Mental illnesses such as anorexia and bulimia are appearing in younger girls, she said.

“We have seen an increase in calls from parents and educators requesting speakers and help,” Ms. Yoder said. “Pediatricians have seen an increase in their practices. Children at 5 or 6 years of age are struggling with behaviors.”

REASONS FOR PROBLEMS

Young girls have become more sexualized by clothing and television personalities, she said, and parents, eager for their children to earn a ticket to private high school education or college, are pushing their children toward athletic perfectionism at too early an age.

“It’s not for the art of play, being on a team, learning about teamwork,” Ms. Yoder said. “We are hungry to have that one thing our child is good at. It’s a huge amount of pressure not to be active but to be perfect. How are we going to get to college and stand out?”

Much of those pressures rang true for Shae Walker, who after several hospital stays and months of treatment at a ranch in Arizona retains only the scars of her illness.

Shae spiraled into anorexia after she quit gymnastics, a sports she had trained for 14 hours a week for three years.

“I was afraid I would gain weight,” said the 12-year-old. “I thought no one would like me. All the girls always talked about weight. They’d say, ‘She needs to lose weight or she can’t do this or that.’ It’s always in the magazines.”

Maybe her greatest fear was of being average and not exceptional, Shae said. In the end, accepting the comforts of normality was the one thing that saved her, she said.

“It doesn’t matter what size you are, because your family will always love you and God will always love you,” she said, tearfully reaching toward her mother.

Dos and Don’ts for Parents

Do

1. Examine your own beliefs and behaviors related to body image and weight and consider how your children interpret the messages they get from you.

2. Tell your child you love them and stay away from praising the way they look.

3. Make meals a positive, fun experience.

4. Allow your child to determine when he or she is full.

5. Emphasize to your child that what you see in the media is not real and that the media should not define their potential of self-worth.

Don’t

1. Label foods as “good” or “bad.”

2. Use food for rewards or punishments.

3. Diet or encourage your child to diet.

4. Allow teasing or making fun of anyone based on physical characteristics, including size.

5. Comment on weight or body types.

Source: MCR Foundation

WARNING SIGNS

1. Weighing several times a day

2. Obsessive exercising to the extreme to burn calories

3. Severely limiting food intake or hiding food

4. Frequent or often long trips to the bathroom, often with water running

5. Using laxatives, diet pills, enemas, diuretics or ipecac

6. Absence of menstrual cycles

7. Avoiding people, lying, keeping secrets, stealing, cutting or compulsive shopping

8. Reading books or visiting Web sites on eating disorders or dieting

9. Dental problems

10. Brittle nails and hair