A Very Thin Line

On the surface, 17-year-old Alicia Mitchell appears to be a typical teen-ager. Alicia, who lives in Panama City, Fla., with her parents and younger brother, is a junior at Bay High School getting good grades.

But her life hasn't always been so unremarkable, reports 48 Hours Correspondent Cynthia Bowers. This is the second year Alicia has gone to school full time since she was 9 years old. For the past eight years, she has been struggling to control her anorexia and bulimia.

When she first appeared on 48 Hours two years ago, she weighed only 60 pounds, but she felt overweight. At the height of her disorder, she weighed 28 pounds.

"I am afraid that if I allow myself to eat, I will just keep gaining weight and gaining weight, and it won't stop," said Alicia.

Almost 10 million women have an eating disorder, according to an estimate.

"It's so prevalent in our society, this idea that one needs to be perfect to succeed," she said. "The perfect grades, the perfect family, why not add in the perfect body?"

Alicia's desire to be perfect almost ended her life. "One time I had a heart attack, and one time I had kidney failure," Alicia remembered. With her parents' help, she recovered.

But her recovery did not last long. Again Alicia refused to eat, and rapidly started losing weight. Her only meal was the vitamin-enriched drink Ensure.

The Mitchells tried everything and hospitalized her more than 50 times without success. Many clinics force-feed anorexics until they gain weight. But that often doesn't work once the patient gets home.

"Many parents are at a loss. Their child startd out as this straight A, overachieving child. And then they begin starving themselves and losing weight," Herrin said.

In December 1997, Alicia went to New York City for help from Dr. Ira Sacker, a pediatrician who has been treating eating disorders for 15 years at Brookdale University Hospital.

Dr. Sacker does not force-feed his patients. Instead, he works to build their self-esteem and trust so that patients will resume eating on their own.

"It is not about food at all. It is about control," he said. "By stopping food from going into the body, what they really feel is they can be in control of their body."

But three days after meeting Dr. Sacker, Alicia was purging again, making her dehydrated and dangerously weak. "They want to put an IV in me, but I don't want that," Alicia insisted. "I am not eating anything or drinking."

By the fourth day, Alicia was in intensive care. She needed an IV. But to Alicia, an IV means gaining weight. Without any nutrition, Alicia's kidneys were failing.

After only a week of treatment in the eating disorder clinic, Alicia tried to eat again. But it didn't last long, as the anorexia and bulimia overwhelm her.

"I felt full so I had to go to the bathroom," said Alicia. "I just do what feels right for the second. I am never going to get better."

In December of 1997, Alicia left her 15th eating disorder clinic.

"I think I will miss her. This is the hardest youngster I have ever treated in my life," said Dr. Sacker. "I wish I was more optimistic. There is a part of me that is frightened that I might not see her again."

Alicia never returned to Brookdale University Hospital, but neither Alicia nor her parents gave up. One month later she was admitted to Remuda Ranch, a private eating disorder clinic in Phoenix. While most patients stay about a month, Alicia stayed seven months, her longest clinic stay.

"Something hit me over the head. I just snapped back into reality," said Alicia. "I've grown, like, 4 inches in the last seven months."

Alicia also went from 60 pounds to 92 pounds. "I didn't care about living," Alicia said. "I cared about losing weight, and now I care about my friends, about my family. I care about life."

In 1999 for the first time in eight years, Alicia started eating, only a little at a time. She has completely stopped purging food. While Alicia fought the mental battle, the physical effects on her body were severe. Alicia went blind in her right eye from the stress of constantly purging and had to undergo surgery to replace her cornea.

Now she is optimistic. "I've got a life ahead of me actually now," Alicia said. "Before I had a eating disorder life, and that is not much of a life."

Her life now is a typical teen-ager's life, about girlfriends, clothes and a boyfriend. Her recovery from anorexia is far from complete, however.

"I stildon't like myself," she said. "It is still there and it is still with me. I still don't eat anything with, you know, this amount of fat. People on the outside don't get the whole thing. They think, well, it's good because she eats now, and she's maintained weight. People think I'm fine. But that's what people get wrong."

The Mitchells never stopped being supportive. But in the end it was up to Alicia.

"I have lost years, lost time; I have lost a lot of schooling," Alicia said. "I would go back and change it if I could, but I can't. For people that have it, it is a real thing. You can come from the bottom and get back up. You just have to do it little by little, not all at once."