The first time Brittany Faylor woke up with a feeding tube in her nose, she couldn't help but think it was never supposed to turn out this way. Five-foot-six and 72 pounds, the 22-year-old still couldn't see a problem with her diet or weight, but she'd been given two choices: eat a small meal or insert the feeding tube. That was easy enough, and the hose in her nostril wasn't nearly as uncomfortable as she had expected.

Brittany hadn't struggled with eating or image in high school, even while nearly half of her girlfriends purged, took laxatives or hyper-exercised. Two years ago she weighed 115 pounds and led her university swim team as a national athlete. After dropping forty-three pounds from her already-slender frame, doctors say she'll die if she doesn't gain weight. But Brittany stopped measuring her life in days at least 40 pounds and thousands of calories ago.

Brittany Faylor is just one of thousands in Arizona and millions across the U.S. battling eating disorders every day. This week, at least two million women will stick their fingers down their throats and vomit after eating. Another 750,000 will eat less than a banana and a cup of yogurt, and a staggering 37,000 of them will die from the disorder.

Even more common is the growing number of average-sized women damaging their organs, bones, teeth and reproductive abilities by purging, binging and hyper-exercising. Experts warn friends and family that eating disorders are fatal, difficult to spot and on the rise nationally.

"Eating disorders are extremely prevalent here in the Valley," says Amy Nygard of Remuda Ranch in Wickenburg, Arizona. Many consider Remuda, with one of the largest inpatient capacities in the world, the best help available for anorexics and bulimics.

Last year, Remuda opened a new facility for girls ages eight to 12 in response to hundreds of calls from parents of elementary students. Forty-eight elementary school girls have already graduated from the 60-day program. They comprise a growing number of the more than 7,000 anorexics and bulimics Remuda has treated over the past 16 years.

"It is getting younger and younger," says Sandy Richardson, a recovering anorexic who speaks about eating disorders to teens and preteens. "Every time I talk in high school classes, I have girls come up who have an eating disorder."

Inside Remuda

Brittany's ribbon-decorated feeding tube traces the comforter on her bed. Her two roommates also sleep with personalized blankets, surrounded by tables of framed pictures and cards.

Now a patient at Remuda Ranch, Brittany rides in golf carts to pet the horses or to go see her personal therapists. "Transportation," the staff calls the carts. Walking is exercise, a privilege earned by the eaters.

"They only have weeks when they get here, the sickest of the sick," one staff member says as a transportation golf cart glides by with three girls on board. Due to the severe conditions, Remuda must often turn away many of the less-serious cases, referring them instead to outpatient counselors.

On this day, the girls walking from building to building wrap themselves in green Remuda blankets, their bodies lacking the essential, basic fats to keep them warm. Many have seen fine hair grow on their bodies, a biological compensation for their ailing state.

One group of anorexic and bulimic girls looks like a direct sampling of skinny teens who could be strolling at an area mall.

Ill-Fated Blogs

Many of these girls have gained weight at other hospitals and clinics, only to lose it even faster after leaving. "We focus on the cause for the eating, not just the symptoms," Sphar says.

Psychologists say numerous motives drive eating disorders. Perhaps most revealing, Web blogs written by anorexic girls offer a unique and often guileless glimpse into the mindset of hundreds of girls afflicted with the disease.

"I love posting pictures of the Olsen twins when they were average size because I always feel like my body won't let me go past 104...but I know I can," one anorexic teen writes next to a dated picture of two healthy-looking Olsen twins.

For these girls, celebrities and models depicted as perfectly thin often provide motivation to continue their weight loss pursuits, regardless of the health risks.

"I'll get there," reads another caption under a rib- and sternum-bearing Paris Hilton.

Here, on Web forums, ANA's (anorexics) and MIA's (bulimics) from around the world encourage one another to ignore food, idolize celebrities and to exercise.

"I've probably gained like a million pounds back and it's all because of being forced to eat," writes Skeleton Goddess. "Tomorrow I AM NOT having breakfast. I will PRETEND I had lunch. If my plan gets ruined in any way, I don't know what I'm going to do."

"Good luck with your plan, girl. I hope it works out well! xx Lo," encourages another.

ANA and MIA are personified as close friends for victims of an isolating and lonely mental disorder. One post, next to a tight pelvis shot of hip bones draped in tan skin and a bikini bottom reads, "I'm starting to see ANA through another light. At first, I thought of ANA as someone with the perfect body…But now I know ANA is not only that, but so much more. She knows how u feel. She's been there and done that, failed at that and succeeded at that. She understands. She knows how bad you want this and how much you would give just to be her."

A new ANA from Phoenix writes, "I'm 14, almost into high school. I am terrified, that I just found out, that I am fat. I know it seems dumb, but I spent my whole life in denial and now it's time to fight back."

Measuring Up

Val Gustin was 16 and a fit high school basketball star when her father made a casual comment about her weight. "It turned into compulsion. Then I went 21 days without food," Gustin says. Soon she was only eating salads and throwing them up, running marathons on less than 500 calories a day.

On off days, Gustin ran 18 miles and took as many as 90 laxatives. At Remuda for a second stay, she had only weeks to live. "Unfortunately, death seemed like a good option. You get so stuck in the disease, you don't see anything else. You don't have any hope for the future or living a normal life," Gustin says. "I literally thought I was going to die. That was a good option."

Once Gustin even tried running off the property at Remuda, but her body was so weak she collapsed in an empty wash. A nurse carried her back.

Fatal Triggers

Like other girls at Remuda, Brittany Faylor isn't allowed to read her favorite celebrity or fitness magazines. She will earn the privilege of walking after she reaches her first goal weight. Worse than the isolation and restriction, Brittany has to eat. Registered dieticians plan her meal choices, but she's convinced the huge quantities of food will bloat her to enormous shapes and sizes.

Some of Remuda's patients are literally weeks from death. They were not malnourished children. They were raised on juice boxes and cafeteria lunches.

Medically, anorexia is defined as a body mass index (BMI) of 17.5 percent fat or less. Remuda specialists say the average American model flaunts a BMI of about 17 percent, while healthy, fit women measure between 18.5 and 25 percent.

According to the National Eating Disorders Association, the average American woman is 5'4" and weighs 140 pounds, while the average American model is 5'11" and weighs 117 pounds.

Early in college, Brittany's swimming teammates would remind her to cut her thin brown hair. She never seemed image-conscious to her friends, some of whom envied her outgoing personality, soft green eyes and way with boys.

Brittany's eating disorder didn't begin with feeding tubes or crying pleas from family and physicians. For Brittany, it began with a close friend's suicide and the ability to control at least one component of her life. For her roommates at Remuda, a comment from dad and a new diet experiment launched the girls into a prison of exercise and starvation.

Carrying the Message

It's Thursday morning, and Sandy Richardson, a slim mother of two teenage daughters, stands in a room of 200 dancers at Desert Vista High School. The girls and a handful of boys sit on the ground as Richardson flicks PowerPoint slides and explains her recovery from anorexia.

"The media sexualizes women," Richardson says, flipping from a humorous ad of a shirtless, fat man to a naked woman covered only by a Palm Pilot. "Men in ads are allowed to get old and gray. Women are expected to stay eternally young."

"Here's a Sports Illustrated cover with Tyra Banks in a bikini," she says. "Her torso has been stretched so she looks thinner. If you look here below her belly button, you can see."

Some girls grow incensed as Richardson explains how unrealistic the ideal body is for a healthy woman. She explains other photo doctoring tricks. "This cover to Pretty Woman is only Julia Roberts from the neck up."

Held for Ransom Richardson revisits her own eating disorder, a diet-gone-wrong when she was a mother of two young girls. "I remember waking up every morning saying, 'This is the day, I'm finally going to exercise. I'm finally going to not eat.'" All the while the five-foot-seven mother of two weighed less than 99 pounds. "I'd go to bed thinking, 'I'm such a loser. I'm going to eat right, going to exercise right.'"

Warning Signs of an eating disorder: Excessive facial/body hair Preoccupation with food Compulsive exercise Absent or irregular menstruation Sensitivity to cold Swollen salivary glands Hair loss Broken blood vessels in the eyes Abnormal weight loss Use of laxatives, diuretics, diet pills

Today she asks the girls to define their value. "What makes you who you are?" If it's only image and other people's opinions, Richardson warns, a disorder may be close. "Just like women think they should look this way, guys fall into the same trap, thinking girls should look this way."

Life or Death Food Fights

For Val Gustin and Brittany Faylor, the fiercest battles are fought at dining tables and in the privacy of their minds. Brittany finally began gaining weight at Remuda, but felt like an egg on stilts. Her personal physician, psychologist, nutritionist and therapist have worked hard to convince her otherwise.

Gustin remembers secretly exercising at Remuda. "Me and some of my housemates, we would try to hide food or even the butter for the roll. We thought there was so much fat in that."

Eventually, the food brought life back to Gustin. "When my body began getting nutrients, the difference in my energy level and how I could communicate, the fact that my brain was working at a normal pace was amazing to me. Once I started feeling that normality, I knew I didn't want to return to how I was.

"I wouldn't have any of this if I had let the eating disorder take my life. It's hard for those who haven't been in it to understand the freedom of a normal life without this thing weighing on your head, telling you, you have to do A, B, C, D to measure up to anyone's expectations."

About 40,000 women will die as the result of an eating disorder in the U.S. this year. About 2,000 men and women will die from heroin overdoses every year. About 2,200 men and women will die from cocaine overdoses every year. Anorexia is the least common eating disorder. About 37,279, or five-percent of the 745,590 female anorexics in the U.S., will eventually die from their disorder. Source: Harvard Eating Disorders Center, NIDA Research Monographs, U.S. Census Bureau, American Psychological Association Practice Guideline, Remuda Ranch.

Thousands of other stories don't have such happy endings. Half of all anorexics will live the rest of their lives imprisoned by the disease, and many of them will die.

Like drug or alcohol addiction, the battle will never be completely over for any of these women. It is lurking, waiting for a bad day, a weak moment.

February marks one year since Brittany chose the feeding tube at Remuda Ranch. Two college friends drove her there personally and left in tears.

Today Brittany is 23. She is home and healthy.

Now she swims again, though some days she questions her motivation. She still struggles with image, wanting to trim a little, but remains leery of the possible slide back into addiction. She has no idea how much she weighs. She no longer owns a scale.

www.remudaranch.com
1.800.445.1900