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PAULA ZAHN NOW
Walking the Thin Line
Aired May 29, 2006 - 20:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
PAULA ZAHN, HOST: Good evening. Glad to have you with us. Tonight, we're focusing on something that affects some 10 million people in the United States, mostly young women. But I was surprised to learn just how many older women and men also struggle with eating disorders. A special hour is straight ahead.
ZAHN (voice-over): Beauty, success, sex appeal -- when being thin means everything.
JAMIE-LYNN SIGLER: ACTRESS: In order to be accepted in this industry, do I have to have an eating disorder?
ZAHN: A deadly obsession...
SIGLER: I seriously contemplated suicide.
ZAHN: ... that punishes bodies -- starvation, extreme exercise, from kindergarten to middle age.
SHANE SELLERS, JOCKEY: I knew I was awful skinny.
ZAHN: A lifelong battle.
JANE FONDA, ACTRESS: And it becomes a -- a real addiction.
ZAHN: From Hollywood to your hometown -- is someone you love dying to be thin?
Tonight, the struggle and the solutions: a PAULA ZAHN NOW special, "Walking the Thin Line."
ZAHN: The pressure to be thin is everywhere, especially now, when many of us are thinking about summer vacations and the beach. And just look at all the celebrities, like Nicole Richie, who just revealed she's seeking help to put on weight. Well, no young actress understands that pressure better than Jamie-Lynn Sigler. Seh was just a teenager when she found herself starring in an Emmy-winning drama on HBO as the unforgettable Meadow Soprano.
(BEGIN VIDEOTAPE) (BEGIN VIDEO CLIP, "THE SOPRANOS")
SIGLER: On the lookout for ducks, dad?
(END VIDEO CLIP)
ZAHN (voice-over): It would be the role of a lifetime for then 16-year-old Jamie-Lynn Sigler, who started acting when she was 7, and always dreamed of being a star. But, behind the scenes, Jamie-Lynn was in a desperate fight for her life.
(on camera): How seriously did you consider suicide?
SIGLER: Pretty seriously.
ZAHN (voice-over): It was a shocking turnaround for this New York teen who seemed to have it all. Jamie-Lynn succeeded at everything she did, until her first boyfriend, her first love, broke up with her in the fall of 1997.
SIGLER: You know, was I not good enough? Was I not pretty enough? Was I not skinny enough? And it was at the time where a lot of my friends started talking about dieting, calories, exercise, something that was never discussed, never a concern of mine or any of us. And it ended up becoming an obsession. Within four months, I might -- probably dropped almost 40 pounds.
(on camera): That is an amazing amount of weight.
SIGLER: Oh, yes.
ZAHN: What did you do?
SIGLER: It started off, kind of, pretty innocently, I guess I can say, because I started, you know, maybe just doing like 20 minutes on the treadmill before school and then deciding I wasn't going to have any dessert anymore.
And then, when I saw the scale start to go down, well, then I thought, well, what happens now if maybe I exercise an hour before school and don't eat bread.
And that snowballed into exercising four and a half hours before school every morning and basically eating next to nothing.
ZAHN (on camera): What time were you getting up in the morning?
SIGLER: 3:00 a.m.
ZAHN (voice over): Jamie-Lynn's eating disorder is called exercise bulimia. Exercise bulimics work out to purge what they have eaten in much the same way bulimics vomit after eating.
Chronic, obsessive exercise is accompanied by vigilant, nearly compulsive focus on calories. And Jamie-Lynn counted every last one using a calculator to make sure she always burned every last calorie she consumed and more.
On some days, that could be as few as 400. All it would take was the outside of a bagel, a fat-free yogurt and a diet frozen dinner.
ZAHN (on camera): What else would you eat the rest of the day?
SIGLER: Lots of diet soda. Lots of diet soda.
ZAHN: I don't count that as food. I count that as drink.
SIGLER: I would constantly make excuses that I ate already or I wasn't hungry or I was rushing here or there.
ZAHN (voice over): Jamie-Lynn kept on losing weight. She would exercise whenever and wherever she could. For extra exercise, fidgeting in school. When she had to do laundry, taking her laundry down to the basement, one item at a time so she had to take extra trips.
SIGLER: I was completely, physically, and mentally addicted to the exercise, and the restricting of calories. I was wearing, you know, basically children's clothes.
I mean, I was a teenager and back to children's sizes. It was hard to find clothes that would fit. And it was like every week I'd see my reflection of my back and see more bones coming out, more ribs, more hip bones and it was awful.
UNIDENTIFIED MALE: Look at me. This is no joke.
ZAHN: During this low point in her life came what should have been a high point in her career. In November of 1997, HBO announced that "The Sopranos" was being picked up for five seasons.
It should have been a dream come true for Jamie-Lynn. But under the spell of her eating disorder, nothing else mattered.
SIGLER: I truly lost a will to live. I seriously contemplated suicide because I felt that no one in this world would ever understand the constant battle I had in my head every day.
ZAHN: Jamie-Lynn's rock bottom moment came soon after on a drive with her parents into New York to go roller blading. Because they left the house more than 45 minutes late, Jamie-Lynn's strict exercise and eating schedule was completely disrupted. A disaster for an exercise bulimic.
SIGLER: I was shaking and crying in the back of the car. And my parents were crying because they didn't know what to do, and it's where it just all became too much and I blurted out, I have an eating disorder. I want help.
And my parents pulled the car over in the FDR and I remember we hugged and we cried. And the next day I was, you know, with a therapist, nutritionist. I was on Prozac. ZAHN: Jamie-Lynn cut down on the exercise, started eating more and explored with a therapist the underlying causes of her eating disorder.
The anti-depressant Prozac which is used to help treat a majority of eating disorders, helped Jamie-Lynn deal with the major mood swings associated with her bulimia.
In a few months, Jamie-Lynn gained five pounds. When it was time to go back to the set of "The Sopranos" in June of 1998, she was still 35 pounds thinner than when she had filmed the pilot less than a year before.
ZAHN (on camera): The producers brought your mother into a room. They were really concerned about the way you looked and they weren't sure you were going to have the stamina to do the job.
Were you also aware that those same producers who were reasonably honest with your mother were conducting auditions behind the scenes to replace you?
SIGLER: I was filming the second episode. I mean, I was shocked. But, almost empowered in a way like I wasn't going to lose it.
UNIDENTIFIED MALE: Dad, how do you stay so hip?
ZAHN (voice over): It took more than eight months for Jamie-Lynn to get back to her normal weight. By the time she started shooting the second season of "The Sopranos" in June of 1999, she was healthier. Her transformation from season one to season two was dramatic. Everyone noticed.
SIGLER: I thought that people were going to say, wow, she looks so healthy. She's not sick anymore, good for her. And instead it was, wow, can you believe how fat she got, and they went on from there.
And it was horrible. I was terrified of just now all of a sudden feeling like, well, what does this mean? In order to be accepted in this industry, do I have to have an eating disorder? But I'm so happy now. I don't want to go back there. But what do I do?
But, fortunately, because of what I had been through, I wasn't afraid to talk about it.
ZAHN: So Jamie-Lynn came out about her eating disorder on an HBO fan web site and in a candid autobiography.
SIGLER: Once I did come out about it, I started getting letters, and fan mail from young girls. And that's when I really realized how important it could be.
ZAHN: Today, Jamie-Lynn has stabilized herself at that healthy weight by exercising moderately and eating normally. But she doesn't consider herself cured. Instead, she will always be recovering from the disease that almost cost her life and her career.
(on camera): Is it true to this day, now that you are at a healthy weight, that you still carry with you in your purse a picture of yourself when you hit about 80 pounds?
ZAHN: Why do you carry that around? And what do you see?
SIGLER: It's awful. For me, the reason why I carry it with me is just because of a constant reminder of what I've been through.
I thought that was my life. I was set. This was the way I was going to have to live my life. And knowing that I was able to overcome it and be healthy and happy again, is amazing.
ZAHN: What a brave young woman. Jamie-Lynn Sigler just celebrated her 25th birthday and her sixth season on "The Sopranos." She's also serving as an ambassador for the National Eating Disorders Association.
Now, when we talk about eating disorders, we automatically think it's a female problem, but it's not just women and girls. It's men, too. And even top athletes.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: I was right at 2, 3 percent body fat, and doctors told me what that was doing to my organs; it was cannibalizing your organs. And when doctors starting looking into this, it scared me. It scared me very much.
(END VIDEO CLIP)
ZAHN: When our special continues, how did a star jockey starve himself for 20 years?
ZAHN: Welcome back to our special, "Walking the Thin Line."
Now, when most of us think about eating disorders, we usually think of women and girls. But as many as one million men in America struggle with anorexia and bulimia, and most experts think that number is increasing.
You're about to meet one of those men, a world-class athlete who risked his life to stay on top.
SHANE SELLERS, RETIRED JOCKEY: This is the area that I dreaded the most.
ZAHN (voice-over): A trip to the racetrack for retired jockey Shane Sellers is now a walk through hell.
S. SELLERS: This is what I -- I call a jail, you know? It's -- it wasn't a -- it wasn't a happy -- I don't have a lot of happy memories about this place.
ZAHN: But it didn't start that way. Sellers fell in love with horses and racing when he was just 11. That passion blossomed into a 26-year career, winning more than 4,000 races, earning purses worth more than $130 million. Shane Sellers is one of the nation's winningest jockeys.
S. SELLERS: It's such a rush. You know, when you pull out and that horse accelerates and you win, it's just -- it's -- it's addicting.
ZAHN: While hooked on horse racing, Sellers learned early about what he called the dark side of the sport. Every track sets weight requirements for each race, depending on the horse's age, sex and skill level, and the race's distance.
Including seven pounds of gear, a horse can generally carry about 112 to 126 pounds. That means Sellers would have to weigh between 110 and 112 pounds to make weight. Despite being 5'3'', Sellers' natural weight is closer to 150 pounds. The only way he thought he could make jockey weight was to go to extremes.
S. SELLERS: In the morning, I would get up and take a -- a diet pill. I drank a cup of coffee, and then head out to the racetrack and...
ZAHN (on camera): With no food in your stomach at all?
S. SELLERS: No food in my stomach, no.
And, you know, you go in and see the trainers and work your horses in the morning that you have to work. By 10:00, you are finished. I would -- I would go...
ZAHN: Are your hungry at this point?
S. SELLERS: Oh, I was starving. You know, I mean, I went to bed with nothing in my stomach either, maybe just a -- you know, just a piece of ham or, you know, just grab something to put in my stomach before I went to bed and -- and head to the -- to the track and maybe lay down for an hour, and then head to the hot box with -- for -- for a couple hours and pulled four or five pounds of water.
ZAHN (voice-over): The hot box is a sauna, a fixture in almost every jockey locker room.
S. SELLERS: The hot box, the sweat box.
ZAHN: Sellers would often spend two hours inside, pulling or sweating off extra pounds.
(on camera): And are you miserable the whole time you are in there?
S. SELLERS: Oh. It's -- it's horrible.
ZAHN: You have to be very weak.
S. SELLERS: Weak. You have nothing. You are -- you are already dehydrated, you know?
ZAHN: So, for more than 20 years, you went through this process of basically not eating anything during the day, sitting in the sauna a couple hours a day, sweating two or three pounds off, getting back on your horses, training and maybe -- maybe -- having a piece of ham. And that's all you had to sustain you.
S. SELLERS: Right. If I did eat anything, sometimes, when I was at my worse, I was heaving three or -- five to six, seven times a day. I was heaving.
ZAHN (voice-over): Jockeys call it heaving or flipping. Most doctors would call it bulimia. Overcome by hunger pains, Sellers would eat massive amounts of food and then throw it up to make weight.
He says a tour of the jockey locker room shows you just how easy and accepted it was.
S. SELLERS: These are regular toilets. And this is what they call a heaving. This is where they heave. You know, it's a -- it's a much different type of commode. I don't know. It's not -- I don't know if it was especially made to -- for that purpose. But it's -- it's sure not the same as the other. And that's what we used it for.
ZAHN: Is it true that some of you got so efficient at flipping that you could actually do it without putting your finger down your throat?
S. SELLERS: I was one.
ZAHN: Aside from his daily starvation diet, binging, purging and sweating in the box, Sellers says he took Lasix, a prescription diuretic that would cause him to lose more water weight. When not on the racetrack, he also ran for hours in layers of heavy sweat suits.
When he finished, he would have his wife, Kelli, wrap him in blankets to make sure he lost even more weight.
KELLI SELLERS, WIFE OF SHANE SELLERS: I was in fear of him having a heart attack. You know, I mean, it's like in -- I would try to peel the clothing off of him. And he's like, wait, no, leave it a little longer.
You know, and I would cry, like, what do you mean? You know, what are you doing, you know, and try to cool him off and, you know, help him in any way possible, and just crying. You know, I just -- I hated it, you know, because I felt like, in a way, I was almost helping him to -- to -- to kill himself.
ZAHN: Sellers was dangerously weak, a frail 112-pound man who had to control a 1,000-pound horse.
(on camera): Do you remember being dizzy?
S. SELLERS: Oh, yes, absolutely.
ZAHN: On the horse...
S. SELLERS: Yes. And when...
ZAHN: ... as you were racing?
S. SELLERS: And when I had to really ride one hard down the stretch, I would see spots, you know, until, sometimes, I couldn't pull up the horse. I had to let the outrider pull me up. I was so weak, you know?
ZAHN: Do you think it's a miracle you didn't kill yourself, because you were that weak on a horse?
S. SELLERS: Sure.
ZAHN (voice-over): And Sellers looked weak. This was Shane Sellers at the height of his career. This is Shane Sellers now. The 40-pound weight difference is startling.
S. SELLERS: I didn't know what it was like to -- to look any different. I knew I was -- I knew I was awful skinny.
ZAHN (on camera): Was it worth the cost to your body and your health?
S. SELLERS: I would say yes, only because I -- I -- what would I have done if I didn't ride?
ZAHN (voice-over): According to research, Sellers isn't alone. In a 1995 study by the Chicago Rehabilitation Institute, 69 percent of all jockeys said they skipped meals. Thirty-four percent used diuretics. Sixty-seven percent sweated off pounds in the sauna. Thirty percent flipped. And 14 percent took laxatives.
S. SELLERS: I was riding at 2, 3 percent body fat. And doctors told me what that was doing to my organs. It was cannibalizing your organs. And when doctors started looking into this, it -- it scared me. It scared me very much.
ZAHN: That fear, coupled with a devastating knee injury just last year, took Sellers out of the sport he loved so much. Deeply depressed, he began seeing a therapist, who prescribed antidepressants. Shane Sellers learned to eat again.
(on camera): Do you think that depression is a result of all the years that you went hungry and dizzy? S. SELLERS: Well, it was a part of it, absolutely. I mean, doctors will tell you that, you know? I'm not saying anything that I -- that doctors didn't tell me.
ZAHN: How is your relationship with food today? Can you eat normally?
S. SELLERS: Oh, absolutely.
No. Girl, I taught you how to cook. You couldn't...
At first, when I first quit, I would eat too much. When you heave, you eat until you until you -- and drink until you can't -- you know? And so that was -- maybe I had a problem with that, you know, and, until, like, right now, I started working out and stuff like that. And I weigh 150 pounds. And I feel good.
S. SELLERS (singing): Hallelujah, Dixieland.
ZAHN (voice-over): Now retired at a healthy weight, Sellers has found his next passion, country music.
S. SELLERS: Yes. How do you like that?
S. SELLERS: What's that, girl?
ZAHN: He still spends his days around horses, but now as an owner and trainer. He's also become passionate about his family, forever mindful of the time he lost when he was struggling to make weight. Now he can focus on his wife and children, making sure his young girls don't get caught up in what took so many years from his life.
S. SELLERS: People need to keep an eye out, their eyes open to this, because, when it -- it gets out of hand, you can't get it back.
UNIDENTIFIED FEMALE: Amen.
S. SELLERS: Amen.
ZAHN: Shane Sellers wants to make sure that what happened to him doesn't happen to other jockeys. He now lobbies tracks, trainers and owners to raise limits, so jockeys can ride at a healthier, more realistic weight.
S. SELLERS: I don't want to be remembered for what I did on the racetrack. I got -- I -- I was able to ride good horses that I just pointed them in the direction and they were going to win. It wasn't me. I was no better than the next guy. I want to be remembered for somebody that made a change in this industry, for the better, for riders.
(END VIDEOTAPE) ZAHN: Now, while some tracks have raised weights and others agree that something needs to be done, many are resistant, claiming the extra pounds will harm the horses. Many say if jockeys can't naturally make the weight, they shouldn't be riding at all. Well, Sellers believes that few jockeys can naturally keep a competitive weight, and he says he will continue to fight what he believes are unrealistic and unnatural requirements.
Well, Jane Fonda has lived her life in front of a bunch of cameras, but did you know that she battled bulimia for decades?
(BEGIN VIDEO CLIP)
JANE FONDA, ACTRESS: And it becomes a real addiction, and until you realize, which I did late in life, that the hunger is not hunger for food, it's hunger for spirit.
(END VIDEO CLIP)
ZAHN: Coming up next, how did Jane Fonda reach the road to recovery?
ZAHN: Welcome back to our special, "Walking the Thin Line." Jane Fonda's autobiography is about a year old, but remains a best- seller even now. Perhaps because it still has the power to startle readers with a secret she kept for decades, that she began binging and purging as a teenager and continued that destructive behavior well into adulthood.
ZAHN (voice-over): In her 60-plus years in the public eye, Jane Fonda has become almost as well known for her buff, toned, sexy body as for her Oscar-winning roles.
But, for more than three decades, this daughter of Hollywood royalty was hiding a painful secret.
JANE FONDA, ACTRESS: You try to fill the hole with something. Some people fill it with alcohol and drugs or sex or gambling or whatever. And many girls, including me, filled it with food.
ZAHN: Jane Fonda struggled with anorexia and bulimia.
FONDA: I was made to feel that I wasn't good enough, not by mean people, but just -- I had to be perfect in order to be loved. And, if I wasn't perfect, I would be -- I would end up alone.
ZAHN (on camera): Who expected you to be perfect?
FONDA: I think my father did. And I don't think that he meant to or realized or -- you know, I just think that, down through the generations of Fonda men, there was a tendency to not like women who weren't really thin. ZAHN: It was that simple?
FONDA: It was -- it was that simple. And I -- I didn't know that before, but I talked to a lot of the Fonda girls. And, apparently, two of his wives suffered from bulimia, as I did for 30 years, striving to be perfect.
ZAHN (voice-over): Fonda's battle with bulimia began, as it does for millions of girls, in adolescence.
She discovered that her famous father thought she was fat and thought that the only way to be loved by him was to be perfect, to be thin. In prep school, she learned how to do that. Fonda tells of her first time binging and purging in her no-holds-barred autobiography, "My Life So Far."
FONDA: We would only binge and purge before school dances or just before we were going home for the holidays. And then we would manage to ferret away all the chocolate brownies and ice cream we could get and gobble them up, until our stomachs were swollen as though we were five months pregnant. Then we would put our fingers down our throat and make ourselves throw it all up.
ZAHN: It became Fonda's ritual, binging and purging, all the while believing that she wasn't damaging her body.
FONDA: And it becomes a -- a real addiction. And until you realize, which I did late in life, that the hunger is not hunger for food -- it's hunger for spirit. It's hunger for wholeness.
ZAHN: And, in college, Jane discovered a tool to kill that hunger. While cramming for exams, she became addicted to stimulant Dexedrine, which kept her awake. It also suppressed her hunger, an addiction she didn't understand until years later.
FONDA: What an illusion that there were no consequences to be paid. It was years before I allowed myself to acknowledge the addictive, damaging nature of what I was doing. Like alcoholism, anorexia and bulimia are diseases of denial. You fool yourself into believing you are on top of it and can stop any time you want.
Even when I discovered I couldn't stop, I still didn't think of it as an addiction. Rather, it was proof that I was weak and worthless.
ZAHN: Fonda alternated between long stretches of anorexic starvation and frequent bouts of bulimia, some days, eating just an apple core or a hard-boiled egg, on other days, binging and then purging as many as eight times a day.
Like millions of others, Fonda's eating disorders continued into adulthood, through two marriages, two children, 20-plus movies.
(BEGIN VIDEO CLIP)
ANNOUNCER: Meet the most beautiful creature of the future. (END VIDEO CLIP)
ZAHN (on camera): When you look at pictures of yourself in "Barbarella" today, what do you think?
FONDA: As bulimics usually are, you know, you are -- you are thinner one day than you are the next. And I could usually see what kind of period of time it was.
It was -- it was -- it was not altogether fun. It was a difficult film to make.
ZAHN: I find it absolutely staggering that you have fought bulimia for almost 30 years.
FONDA: And then a point came in my -- in my 40s. I now had -- I was in my second marriage. And I had two children. And I had an amazing life.
A lot of people and projects depended on me. And I suddenly realized that I was either going to die, I mean, maybe not physically die, because it was never as severe as it is for people who -- girls who are hospitalized, but spiritually die, sort of fall into darkness. Or -- or I had to opt for life and light. And I opted for life and light. And I went cold turkey. It was very hard.
ZAHN: Was that the impetus for your fitness empire?
FONDA: Yes. In a way, it was.
(BEGIN VIDEO CLIP)
FONDA: Walk your feet together.
(END VIDEO CLIP)
FONDA: It replaced the -- the control that you feel binging and purging with compulsive exercise.
And it was compulsive in the beginning, until I started to make peace with myself and my body. And, you know, we're not supposed to be perfect.
ZAHN: There's such an irony that you, as a woman who struggled with bulimia for some 30 years, would launch a fitness empire.
FONDA: You teach what you need to learn.
March out and in.
ZAHN (voice-over): Despite overcoming her eating disorders and launching a successful fitness empire, the woman underneath those tight leotards and signature leg warmers was still dealing with self- doubts and a need to please.
FONDA: You know, I was fit and I was successful and I was all these things. I still had a lot of self-doubts inside.
ZAHN: To this day, Jane Fonda credits her third husband, billionaire Ted Turner, for helping her to finally overcome these lifelong issues and accept herself, imperfections and all.
At 67, through healthy eating and nonobsessive exercise, Jane Fonda's bulimia is under control. She is stunning, fit, and recovering.
(on camera): It is stunning to me that this is the first time in your life that you really feel whole.
ZAHN: Is this a good time of your life?
FONDA: It's the best. Isn't that nice?
ZAHN: Good to hear that. No one is sure how many older women have eating disorders, but many experts say more women over the age of 30 are now seeking treatment.
Just ahead, a girl who was just 5 years old when she started starving herself, by eating paper instead of food.
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: We didn't even realize at that point why she was doing it, or that she really knew herself why she was doing it.
(END VIDEO CLIP)
ZAHN: A mother's search for answers when we come back.
ZAHN: Welcome back to our special, "Walking the Thin Line." You have seen how teens and adults can become fixated on being impossibly thin. But what about children? Well, you're about to meet a young girl whose story shocked me. She stopped eating when she was just 5 years old.
JUSTINE GALLAGHER, ANOREXIC 5-YEAR-OLD: This is the story about how I used to have a really bad eating disorder.
ZAHN (voice-over): Justine Gallagher began starving herself when she was just 5-years-old.
J. GALLAGHER: I can't eat, I can't eat, I can't eat.
ZAHN: What could possibly make such a young girl stop eating? J. GALLAGHER: A lot of boys in my class said that I was fat and stuff.
ZAHN: Justine's weight was healthy, but in her baby pictures, she thought she looked chubby. The teasing and the pictures made her self conscious. Plus her mother, like millions of others, struggled with her weight and talked about it, about feeling fat and about dieting.
Yvonne didn't realize that her 5-year-old daughter Justine was listening.
YVONNE GALLAGHER, MOTHER OF 5-YEAR-OLD ANOREXIC: I was in the house saying, oh I'm fat. I have to lose a few pounds. I can't eat this, I can't eat that. I have to watch myself. She internalized that she was also heavy.
ZAHN (on camera): But it's so unusual for a kid that age because so much of the world is ego centric. It's all about themselves.
Y. GALLAGHER: I think it depends upon the child, too. There are some who are ultra sensitive and feed off other people's feelings in the household, too.
ZAHN (voice-over): Hard to believe, but this adorable, healthy, normal weight child stopped eating altogether. When the hunger pains got too bad, the only way she could deal with them was to find a food substitute.
J. GALLAGHER: I know I don't look fat now, but I used to eat paper instead of food.
ZAHN: Yes, Justine ate paper. Her schoolwork, anything she could get her hands on.
Y. GALLAGHER: We didn't even realize at that point why she was doing it. Or did she really know herself why she was doing it?
ZAHN: By the age of 6, Justine weighed just 32 pounds, the size of a 3-year-old. Her concerned mother took her to three different pediatricians.
Y. GALLAGHER: They told me it was a phase. They told me she was doing it for attention. They told me if she's hungry, she'll eat. The problem was, she didn't. She was getting thinner. She would be next to her cousin who was a toddler, and my niece's arms were bigger than Justine's.
ZAHN: Her frail body started to break down. This once healthy child developed bronchitis.
Desperate, Yvonne turned to her boss, a psychologist, who recommended this man, Ira Sacker, an eating disorder specialist and author of "Dying to be Thin."
DR. IRA SACKER, AUTHOR: I had never seen a case like Justine's in all the work that I've done with eating disorders. She was headed right down this cascading road, and Justine would have died.
ZAHN: His treatment plan started traditionally with therapy and a nutritionist. But given Justine's novel case, the Dr. Sacker decided to try something very different: photo video therapy.
He introduced Justine to photographer Ellen Fisher Turk. Turk photographs or videotapes patients and then has them write diaries about what they see.
ELLEN FISHER TURK, PHOTOGRAPHER: Image is potent for shifting how we see ourselves. We think we are one way, and when we are reflected back we see something else.
ZAHN: In Justine's case, Turk made a documentary in which Justine spoke of her eating disorder in her own words.
J. GALLAGHER: The top of my blanket in my room. It's chewed.
ZAHN: Even re-enacting some of her destructive behavior.
J. GALLAGHER: I used to bite pencil erasers off and I used to eat them.
ZAHN: For the first time, this child and her family saw how skinny, how frail, how sick she really was.
SACKER: Timing is really important because early on, if I take a picture of somebody who has lost all this weight and they look at that and they look at skin and bones, oftentimes that doesn't empower them into anything other than, wow, I'm really skinny. I'm feeling really good about it. But at the right moment of time, once they see that, it makes treatment, OK, much more effective at that moment.
ZAHN: For Justine, it was at the right moment.
This is Justine today. She learned through a combination of therapies how to accept food and accept herself. Growing stronger and reaching a more normal weight.
J. GALLAGHER: I'm a normal teenager that -- basically happy. I think that I'm a pretty good weight now.
ZAHN (on camera): How scary was it for you to see this videotape of yourself when you were so painfully fragile and thin?
J. GALLAGHER: It just sometimes it makes me sick to my stomach to see how thin I was. And sometimes I'll look at the parts of it sometimes and when I'm feeling down on myself and like feeling like I don't want to eat, I'll look at that and be like, never mind. I don't want to fall back to that again.
ZAHN: Now 13-years-old, Justine has just started high school, with its pressure to be popular and pretty.
J. GALLAGHER: I used to think I had the answers to everything...
ZAHN: But this young woman seems armed with knowledge and strength far beyond her years.
J. GALLAGHER: There's always going to be a part of you that seems like it's attached to the eating disorder. Like it's kind of like having a twin the anorexia is your twin and you have to -- like you need your space. And like it's something like that's a part of you.
ZAHN (on camera): But that twin hasn't been hanging around you lately, has she?
J. GALLAGHER: No.
ZAHN: Well, Justine certainly seems to be on the right track now, and Dr. Sacker and Ellen Fisher Turk say photo video therapy must be done along with other medically supervised therapies. A patient should work with the doctor to find the right photographer, and make sure it's done at the right time during treatment.
Now, when someone with an eating disorder seeks treatment, what exactly happens? Next, a rare look inside a special clinic for young women. Can they overcome the desire to starve themselves?
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: It's really hard to stop. It's just going to (inaudible), and it's just like anything, with alcoholism and drug addictions, it's just so addictive.
(END VIDEO CLIP)
ZAHN: Daily weigh-ins, group therapy and fighting the urge not to eat. When we come back.
ZAHN: During our special on eating disorders, I've shown you some remarkable stories, from movie stars and athletes battling anorexia and bulimia, to a little girl who began starving herself when she was just 5 years old. Well, now, I want to take you somewhere that you probably haven't been before -- inside an eating disorders clinic. About 100,000 people every year enter these kinds of clinics, hoping for help, and what you're about to see is a very private and intimate look at what they struggle with every day.
BRIANA, BULIMIA/ANOREXIA PATIENT: I just wanted to lose weight.
ZAHN (voice-over): That's the way it starts for so many young women. A diet, frenetic workouts, the turn into a potentially deadly obsession.
BRIANA: Living in Hawaii, it's really hard for, you know, a girl to be confident in her body because all my friends, they wear bikinis all the time and I always felt like I was the fattest, I was the shortest.
ZAHN: In just a few months, 18-year-old Briana's dieting turned her into an anorexic, eating just an apple and a salad a day and obsessively exercising for more than three hours.
BRIANA: After I graduated, I just wanted to lose more and more weight. And that was after I found out that I wasn't going to go to the college I wanted. And I had that thought, I guess, well, if I can't go to the college, and might as well just keep doing this to myself. I have nothing else to look forward to.
ZAHN: With her self-confidence at an all-time low, Briana continued to starve herself. When the hunger pains overwhelmed her, she'd binge on food and then throw up. She knew she had a problem, but despite seeing a therapist, she couldn't stop, until her fixation landed her in the emergency room.
BRIANA: I actually almost collapsed onto my grandpa and my chest started hurting really bad and I had to go lay down. And it hurt to even move.
ZAHN: Seriously below her healthy weight, Briana checks into the Renfrew Center, an eating disorders clinic in the lush Pennsylvania countryside.
BRIANA: I have a snack and then --
ZAHN: Here she'll be closely watched and follow a strict program every waking minute. The treatment begins with three meals a day and a couple of snacks in a tightly supervised dining room, all to make sure the women here who obsess over every morsel, every calorie, eat their food.
BRIANA: It's just putting trust into what goes into my meals and what I have to eat and just certain foods that I don't agree with.
ZAHN: Mary Hopper is Briana's therapist.
MARY HOPPER, THERAPIST: Recovery from an eating disorder is about tolerating increasing amounts of discomfort with food.
ZAHN: And tolerating the added pounds. Briana's progress is measured daily with a 5:30 a.m. weigh-in.
BRIANA: It's hard when you know you are gaining weight and you just have to tell yourself that it's for the best.
As Briana eats more and puts on weight, she gains strength and starts confronting the often painful and complex causes underlying her disorder. She has to face the low self-esteem that contributed to her destructive behavior. It will be a long, painful and uncertain journey of self-discovery.
HOPPER: Eating disorders really aren't about food. They are about your feelings. They are about relationships. They are about fears that people have. And she is getting it. BRIANA: I'm hoping to be, just more confident, body wise and mind wise and to just not be so obsessed with food, my meals, exercise. Be normal again. You know, like eat a meal without feeling that guilt that you feel afterwards.
ZAHN: Every day from 9:00 a.m. until early evening, Briana starts to tackle those feelings in individual and group therapy.
BRIANA: I feel for me, I need to work on my body image.
ZAHN: These classes help her and the other patients admit to and learn how to say no to their destructive behavior.
UNIDENTIFIED FEMALE: What does it mean to you to be in shape or to be fit?
ZAHN: Like this one, where patients talk about how they abused exercise.
UNIDENTIFIED FEMALE: Sneak out of the house in the middle of the night and go running.
ZAHN: Or, soul drama class, where they act the deep and complicated emotions tied up in their eating disorder. Here, this young woman expresses the feelings that made her starve herself.
UNIDENTIFIED FEMALE: Feeling different, feeling ugly, not thin enough, not good enough.
ZAHN: But, it's not easy. Halfway through the program, Briana wants to quit.
BRIANA: Because it's really hard to stop. It's just going to get worse and worse. It's just like anything, alcoholism, drug addictions. It's just so addicting.
ZAHN: But she decides to stick it out and by week three, the therapy sessions and supervised environment are helping. Briana starts to find a reserve of strength she never knew she had, starts to accept her body and develop a sense of self-worth. And she learns to say no to the old demons that haunted her. Too much exercise, binging and purging, even starvation.
BRIANA: I have been like craving to do those things more. I guess the more you refrain from doing something that you want to do, the more you're going to want to do it. So that little voice is just a little bigger, but it's being controlled.
ZAHN: After four weeks here, Briana isn't cured, but she is healthier. The chest pains have gone away. She has gained some much- needed weight and most importantly, she's built a foundation that she'll need when she leaves this very sheltered environment.
BRIANA: Recovery is not something that happens at one time. The four weeks I'll be here, it's not -- that's not going to be just my recovery. It's something I will have to deal with -- sorry -- for the rest of my life.
ZAHN: And we wish her the best of luck in her ongoing treatment.
We'll be right back.
ZAHN: So tonight, we have shown you how the pressure to be thin can be a life-threatening obsession, but we've also learned that there's no shame in asking for help. And that there's hope for those who walk the thin line.
Thanks so much for joining us. Good night.
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