When Ivy Silver got a call from her friend Jane telling her something wasn't right with Ivy's 16-year-old daughter, Rachel, the Wyncote, PA, mom was frightened. "One of Rachel's friends had approached Jane, an eating disorder specialist," says Ivy, 52, who owns an insurance brokerage and employee benefits consulting firm with her husband, Steven Leshner. "Her friends had noticed Rachel's eating habits were different. She wasn't eating any meals with them and was fixated on losing weight, talking about how little she was eating and how she would try to limit her calories to less than five hundred per day."

Ivy and Steven were surprised they hadn't noticed Rachel's unusual behavior. At five feet five inches, she had always been a "small" girl, but her weight was within normal limits, and she ate dinner with the family every night. Still, at a time when she should have been becoming more curvaceous, she wasn't.

Ivy, who had struggled with bulimia in the past, understood the gravity of the situation. Scared for their daughter's life, she and Steven sprang into action. In the end, they would spend two and a half years helping Rachel recover from anor-exia and bulimia. They enrolled her in therapy, took her to a nutritionist and scheduled weigh-ins at their family doctor's office, which revealed that their daughter had lost 15 percent of her prediagnosis weight. Rachel underwent inten-sive treatment on an outpatient basis, then began in-patient treatment at a psychiatric hospital. Both caused her to miss a significant portion of her senior year. "The grim reality of seeing boys with feeding tubes and women still sick in their fifties really inspired her to work through this," Ivy says. "She learned that this is not a glamorous disease."

An illness that starts young
It's estimated that up to 24 million people suffer from eating disorders, including at least 10 percent of late-adolescent girls and adult women. While the disease is also known to affect boys, parents need to keep a particular eye on their girls, especially if they are athletes or people pleasers. Early traces of the illness can be seen around age 7, when kids often start referring to themselves as "fat." Today, 95 percent of people with eating dis-orders are between the ages of 12 and 25.

What causes eating disorders? Sharon Fried Buchalter, PhD, a clinical psycholo-gist with advanced training in child and adolescent psychology, points to a variety of factors, ranging from psychological (low self-esteem) to genetic (depression, chemical imbalances) to social (super-thin celebrities on magazine covers).


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