When anorexia/bulimia are mixed with an exercise obsession, it can be devastating. I dated a woman who was that combination AND an alcoholic on top of it. Almost like clockwork, she would put down a TON of shots, beers, mixed drinks, you name it, and she would force herself to vomit shortly thereafter.
She ran marathons, took a spinning class almost daily, and she was an exceptionally picky eater. I figured out her “secret” when we first kissed and it tasted like a vomit-flavored sour candy.
I don't have much sympathy for this type of "illness". This woman has every advantage - a very large, beautiful home in a safe place. A husband and family and she must have one hell of a strong body to take the abuse she gives it.