ABC7's Healthbeat reporter Sylvia Perez took a look at different perspectives that involve not only the cause, but also the treatment.
Caroline says it only took one mean 'fat' comment from a classmate to send her down a dangerous road.
"I stopped eating because I thought I was fat, so I wanted to make myself skinnier," said Caroline.
At 9 years old she was 50 pounds. Doctor's say a healthy girl should weigh twice that. In the hospital she was hooked up to a feeding tube and told she was killing herself.
"That kind of made me break out in tears because I didn't really want to die," said Caroline.
Studies using MRI imaging of anorexic brains are turning the world of eating disorders upside down. Think all those skinny models are to blame?
"That is a myth," said Dr. Walter Kaye, psychiatrist, University of California San Diego.
Dr. Kaye says traits that contribute to developing anorexia are genetic.
"Heritability is a much more powerful influence than culture is," said Dr. Kaye.
So, what's the difference between an anorexic brain and a healthy one? In one study, participants were given a taste of sugar. In healthy people, the insula and frontal cortex areas of the brain lit up, signaling a 'wow that tastes good!' That pleasure light didn't turn on in the anorexic's brain.
Dr. Kaye says they may literally not recognize when they're hungry or when something tastes good.
These are studies helping doctors and patients see and understand a mysterious problem. So while scientist's try to determine the role genetics play, treatment in the meantime is key.
"There's no way you can recover from anorexia nervosa unless and until you've gained the weight you've lost," said Dr. Daniel Le Grange, director, Eating Disorders Clinic, University of Chicago Medical Center.
Dr. Le Grange says while science is making headway in the role of genetics, he also believes family can have a major influence on recovery. He's one of the original developers of something called the Maudsley Approach.
"Iif we can keep teens out of the hospital and in their natural environment, we will probably do better service," said Dr. Le Grange.
That means no expensive in-patient treatment facility. The Maudsley Approach involves three phases. The family focuses on working together at home to help the adolescent return to a healthy weight. The therapist acts as a coach. Once that is accomplished, they hand control of food and eating back to the teenager. And in the final phase a therapist works with the teen to deal with any issues that might prevent them from making a healthy transition into adulthood.
But it can be a slow intense recovery process. At least one parent has to monitor their child full time during the first few weeks. That can mean time off from work for the parent and time away from school for the teen.
But Dr. Le Grange says the treatment will work. "So it might mean that the parents have to sit next to adolescent and say this is what you have to eat in a very calm and supportive fashion but in a persistent way," said Dr. Le Grange. "They look back and tell us all you've done is allow us to be parents again it's parenting 101."
Daniel Le Grange, Ph.D
Professor, Department of Psychiatry and Behavioral Neuroscience
Director, Eating Disorders Clinic
5841 S. Maryland Ave., MC 3077, Rm W-409
Chicago, Illinois 60637
Dr. Walter Kaye
University of California, San Diego
San Diego, CA