Dear Worried Friend:

I assume your friend is former Family and is struggling with issues related to life in the Family and the trauma she experienced.

Anorexia is, to an extent, a type of Self Inflicted Violence (SIV). It is a common coping mechanism that many severely traumatized survivors utilize to cope with overwhelming emotions. Other methods of SIV may include cutting, picking, beating, poking, hair pulling, stabbing with sharp objects, drug and alcohol abuse, etc. Trauma survivors do this as a form of self punishment, establishing control, overwhelming stress relief, dissociation, addiction, etc. It is symptomatic of much deeper issues and is almost always done in private and carries with it a sense of great shame and guilt.

In the case of your friend it is noticeable to all and she believes she deserves this lack of self care. Her sense of self-esteem is non-existent. All you can do is seek to enlist her family to get her the professional help that she desperately needs. Anorexia can be life threatening. Let her know that you care and that you will support her no matter what it takes. However, ultimately she has to decide (hopefully with the support of her family) to get the help she needs.