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Dying to be Thin Narrated by Susan Sarandon Written, Produced, and Directed by Larkin McPhee Photo: Rosalie O'Connor Associate Producer Lisa Fisher Edited by. Dying words the last words spoken by famous people at death, or shortly before.

It is a dangerous. KATEY TRACEY: If they want thin, I will give them thin. I dropped more weight in two weeks than I had ever done in my life. DR. LINDA HAMILTON: Dancer thin is not like thin on the street. We're. talking about 1. If your career is on the line, if the roles are on the. NARRATOR: Starving herself for nearly a year, Katey Tracey.

The bones in her chest began to. She had developed anorexia nervosa, the deadliest of all psychiatric. KATEY TRACEY: It was going from one extreme to the next and people in. The. cause appeared to be an eating disorder.

ELEENA MELAMED: I remember always watching gymnastics and figure skating. And I would just think to myself, . Nobody talks. about it.

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NARRATOR: Eating disorders are common in the dance world but. KATEY TRACEY: Everybody wants to know the secret to being thin, because. So there's this whole myth that.

And that's very damaging. Because if then. you don't achieve this look, something is wrong with you. NARRATOR: Erin is fourteen years old. Tormented by an. irrational fear of fat, she has been starving herself for three. RENEE: Erin, what is your reaction? ERIN: Just that it's true. RENEE: Can you kind of look in the mirror, with your image kind of.

ERIN: I see somebody that is fat and ugly and a disappointment. RENEE: I know that this is hard for you. NARRATOR: Erin is beginning treatment at De. Paul- Tulane's. eating disorders unit in New Orleans. Her mother brought her to this. Texas. KARRI MEADOR: She's so into being skinny, to being slim. She thinks. she's fat.

I just think she's going to die, and she doesn't believe. I had to tell her in the hospital. NARRATOR: At 2. 0 percent below her normal weight, Erin has. DR. WALTER KAYE: This is a very deadly illness. It has the highest death. Approximately half a percent of people with. So over the course of 2.

NARRATOR: Prolonged starvation can cause a number of medical. Feeling alone and abandoned, she became obsessed with her. ERIN: I know I would be thin, and everybody would like me and you know. I wouldn't be having to worry about my weight and all that stuff. I felt like. I'd be loved more.

And that taught me a lot about how, you know. So. that actually was pretty much what I got from it, you know? I can live without. NARRATOR: After struggling for years with an eating disorder.

Karen Carpenter died of heart failure at the age of 3. At the time of her. But today it's. a different story.

Today, some eight. Young women, ages 1. And it was the compliment thing. It's OK be a little skinny.

The camera puts on 1. And the compliments people gave me, and just. And I was watching, and I was like. Look what she's doing. She's eating all that food, throwing up and.

I. didn't think there was anything wrong with it, 'cause it's on TV, and sometimes. NARRATOR: It has become a self- fulfilling prophecy. The. popular television series Friends played on anorexic chic in an ad which was. RUTH STEIGEL- MOORE: In some ways we all have distorted views of what is.

And the repeated exposure to a particular image teaches you to like. And we have become so used to seeing extremely thin. Standing five feet, six inches tall. Britain's top mini- model.

JOAN BRUMBERG: I think there are two primary things going on right. First the whole society. That we all can fix our bodies.

And then I think, among young women.. This is not about. This is about idealized beauty and perfection of a certain. NARRATOR: These plus- size models are boldly challenging.

Now a plus- size icon, Kate Dillon. KATE DILLON: I think that it happens to everybody at some point. And that your initial.. And at some point it's met with an outside.

And I was sitting at. And I was thinking I was like, . And when I got to school it was just.. I was fat. And whether it was in PE or coming home on the bus. Suddenly everyone liked me. My. plan worked, sadly and unfortunately. But it seems to be that that's the way.

You sort of, you do what they want and they'll say. And she caught the. Weighing 5. 0 pounds less than what she does today. Kate's image before the camera concealed a painful inner struggle. KATE DILLON: I looked beautiful. I mean it's not like.. I mean, I look at my face, my face.

I look so.. my eyes look like they're bulging out. And I just. look so weak. Like I remember thinking, ? Like what have I been doing the last couple. JOAN BRUMBERG: In the fourteenth century, the mystic Saint Catherine.

Sienna, starved to death at the age of 3. An extreme ascetic, her. But her pathway into that behavior is so markedly.

It's motivated by her faith. She also often gave away the food that. So in many respects she's not at all like a contemporary. They didn't want to be thin because it was sexy. They wanted to be thin.

They wanted to be thin because it. And they are using the appetite to express different things depending. And I think that has to do with. I think that development of someone from a child into an. And that the eating. NARRATOR: But, why do some girls develop eating disorders and.

RUTH STREIGEL- MOORE: There are a lot of precipitants. You know, it. could be the parents got divorced. It could be a break- up with a boyfriend.

It. could be any number of what may seem to be very small stresses to most people. But you. won't have those onsets unless the girl already is vulnerable in some way. So. simply because, you know, parents divorce doesn't mean now their daughter is.

Those events have to sort of occur in the. NARRATOR: Erin's personality made it especially difficult for. WALTER KAYE: From a biological standpoint we're actually finding.

And they are concerned about doing things right. Things have. to be done kind of with symmetry and exactness. And that they tend to be people. They don't want to do things wrong. ERIN: I just like everything to be controlled, just in control, you.

I don't know, just like traffic. I hate when people try and. And they are sitting right here.. That's just how I am. DR. WALTER KAYE: Now when we go back and we start looking at families of.

We see that roughly about seven. They don't have anorexia or bulimia, but they have some. NARRATOR: In search of a biological explanation, Dr. Kaye. peered inside the brains of recovered anorexic and bulimic patients. He. discovered unusually high levels of a brain chemical called serotonin, which is. DR. WALTER KAYE: Over- activity of the serotonin system reduces appetite. WALTER KAYE: This may explain the vicious cycle that people with.

They have too much serotonin. They starve themselves. That. drives down the serotonin. NARRATOR: But the brain quickly adapts by adding more. DR. WALTER KAYE: So even a little bit of serotonin sets off these.

So people have to keep starving themselves more and more to reduce. So they can never really. Nearly 5. 0 percent of patients will relapse within the first. But new research shows that these rates can be dramatically reduced if.

Erin reach their normal weight before leaving the. DR. WALSH: There is ample evidence that the lower the weight, the. So. I think what we ought to pay attention to in the treatment of anorexia nervosa. And if their weight. NARRATOR: But weight gain alone is not enough.

We need to address the underlying causes. And I believe as an inpatient, people (sic) need to address these. NARRATOR: Five weeks into her stay at the hospital, Erin is. She. admitted to having been sexually abused, not uncommon among these patients. ERIN: Trauma is what really hit if off.

Bringing up my trauma issues. I just I wanted to get rid of it somehow.. Flush them down the. RUTH STREIGEL- MOORE: Having been sexually abused teaches a girl a number. One is that she is powerless. It's just a horrendous experience to. And one way to cope with that sense of powerlessness is to try and.

And by managing one's weight, that. Some women will overeat quite. Others will diet as a. So there's sort of. NARRATOR: Talking about the abuse marks a significant turning.

Erin's treatment. ERIN: Secrets. You don't keep secrets, you know. And I. was keeping it a secret. And if I would have kept that, and went home with it. I would have just gotten sick again.

NARRATOR: Group and individual therapy are critical components. MEGAN: I just thought that I could live the rest of my life not eating. I don't have to eat, you know. I. mean, that's the last thing your parents want is for you to die. And so when. you sit there, and you're like, . I'm just going to slowly. You can get back at anybody.

And I guess.. I don't. I guess I need to find a way to forgive her, you know, because I'm just. And it's so stupid because you don't.

SUNNY: Losing your life isn't winning is it? How does it feel to be looking at all those feelings from back when. MEGAN: It just makes me mad. SUNNY: Mad because? MEGAN: Because I didn't tell them. SUSAN WILLARD: These are not generally kids who can scream and yell and. And they're parent pleasers.

And so they are aggressive in the sense. But they are very sweet and very kind and very quiet about the. NARRATOR: At age 2. Eleena Melamed has also paid a heavy. A gifted dancer, she was told to lose weight at age. ELEENA MELAMED: I remember having a teacher come up to me and pinch my.

Are you drinking milk? In time, she. became anorexic.

ELEENA MELAMED: . I was the happiest I had. I was getting all the good parts in our performances at. I was getting all the attention. I was not being ignored anymore. And when I was really thin. I was all of a sudden..

And the teachers loved. I was a whole new person. NARRATOR: After starving herself for over a year, Eleena lost. ELEENA MELAMED: Gaining weight was for me the worst thing. I was just so. ashamed of my body. I felt like I was the biggest failure and the weakest. Just the worst person.

I remember picking up a knife from the kitchen. I had so much pain inside of. I did that for a long time.

NARRATOR: Despite her fragile state, Eleena's talent did not. At age 1. 7, she was invited to join the prestigious American. Ballet Theatre in New York, by artistic director, Kevin Mc.

Kenzie. But her. struggles with weight would continue. And I just.. I. buckled under the pressure.