By Sarah Foster Special to Published Nov 13, 2010 at 11:09 AM

Most of us look in the mirror and can immediately find a couple things we don't like about our appearance. Maybe it's our chin, breast size or a couple wrinkles that weren't there a few years ago. For some, we just lament the fact that we were born this way, spending money on expensive creams and move on grudgingly.

But what happens to those whose brain gets caught in a compulsive cycle with potentially fatal results?

Numerous studies have found that, in the United States, as many as 10 million females and a million males are fighting a life and death battle with eating disorders like anorexia or bulimia. Millions more are struggling with binge eating disorder.

Eating disorders are rarely about just looks. Like many addictive behaviors there are underlying issues making their way to the surface as an obsession with eating and weight. Anorexia is often thought of as associated with a very controlling, strict lifestyle or family dynamic. Bulimia is thought to be the opposite. Like the chaotic cycle of binging and purging, the lifestyle and surrounding environment of the individual is usually very chaotic and irregular.

Two new television series recently put eating disorders in the spotlight. E!'s series "What's Eating You?: Fear, Food and Obsession," and "Obsessed," an A&E series about obsessive-compulsive disorders (this show covers many OCDs, not just those involving food and weight). Both look into the lives of individuals suffering from obsessive compulsive disorders involving body image.

I recently had the opportunity to reconnect with a high school friend who has struggled with eating disorders for a decade. She agreed to talk to me about her struggle and recovery in the hope that it may help others fighting the same demons. For reasons of personal and medical privacy, the names in this article have been changed.

"Jessica" was always a fit, tomboy type until she hit puberty and was the first girl in her grade to develop breasts, an awkward nuisance that made playing sports with the boys a constant reminder that her body was changing. Other than the frustration, she didn't pay so much attention to her changing physique and instead, like many young girls, spent far more time dissecting each and every aspect of her face that made her feel less than the girls on the cover of Teen Cosmo. When did your general teenage discomfort with your body turn into something that might be considered an obsession or a disorder?

"Jessica:" I played high school basketball my freshman and sophomore years and was in good shape. We had two-a –day practices so my metabolism was really high. Other than the fact that I had boobs and high school boys seem intrigued by those no matter what they look like or who they're attached to, I didn't think much about my body or weight. Then in my junior year of high school, a boy I knew said to me, 'You look good. Last year you were getting a little chubby.' From that moment I realized other people were conscious, not just of how my looks stacked up against other girls, but whether or not I had gained or lost weight. That was a new and freaky feeling.

Later that year I broke up with my high school sweetheart and it was devastating. I wasn't eating much anyway out of being so upset, but one day, I can remember it like it was yesterday, I ate a cracker. Just one cracker and before I could swallow it, for some reason I just leaned over the sink and spit it out. I have absolutely no idea what caused me to do this, but that was the moment that everything changed.

OMC: When did things really start to register with you that this was more than a phase or you just being upset about your relationship ending?

J: When I went away to college, it felt like a disaster. I was away from home, drinking all the time, eating all the time and everything felt like it was out of my control. I was trying so hard to fill the voids and fears I had and I didn't know that I should or, I guess, I didn't really want to reach out for help. The following summer things got really bad. I was purging everything. My skin was grey, I could barely stay awake, my throat burned all day long, and it just kept getting worse. Nothing felt good. Eating and binging both made me feel like a failure. They both felt horrible and yet, I did them both every day, much of the day.

OMC: Did you share with any friends or family what you were going through? Did you ever get the help you needed so badly?

J: I didn't really want to share any of this with anyone. It was embarrassing and hard to live with day in and day out. I think most people around me knew something was very wrong but didn't know how to help me or approach me. I'm sure I looked like a ticking time bomb. I did see a therapist for a while after my parents found out what I was doing and immediately sent me to my doctor. I'm sure it helped immensely to talk to someone about everything that had been going on, but I think I needed more help than anyone knew. Imagine being bent over the toilet with snot, throw up and perhaps even blood running down your face. Imagine throwing up 'til you thought your insides were going to burst into flame. There is no way you can put your body and your brain through that for month after month and be thinking clearly. I was off in another realm all together and I needed very intense help. I never felt I got that.

OMC: Were there moments that you would describe as 'whoa moments' in which you realized how dangerous your behavior was becoming?

J: I had a few eye-opening moments but when you're that messed up it's hard to see them for what they really are. I had been taking Ipecac (Ipecac is used to induce vomiting in cases of accidental ingestion of a foreign or harmful object or substance.) to throw up rather than cramming my fingers down my throat. My parents found out and I thought my dad might actually kill me. He knew how dangerous it was for me to be doing this and the look on his face convinced me never to use it again, but it didn't stop me from purging on my own.

OMC: Are you noticing side effects from your years of dealing with your eating disorder?

J: I've always prided myself on having great teeth. Everyone tells me I have great teeth and a great smile and I love that. I never had braces and never had a cavity until late in college. My dentist has told me that the acid damage to my teeth is causing sensitivity and decay. For awhile I had really severe acid reflux problems, my mouth was also really sensitive due to the continuous exposure to stomach acid. I worry that I haven't seen the worst of the damage. I hope that I got things under control before I did too much permanent damage but I fear that I won't know until things start going wrong.

OMC: Do you feel like you've recovered from your eating disorder?

J: I don't think I'll ever be one hundred percent 'recovered' from it. I think it's always going to be a work in progress and that every week, month and year that I can say I haven't participated in my obsessive compulsive behavior is a good thing. But I can't tell you that I don't think about it all the time. I do. Every day and meal and glance in the mirror is a struggle. Some days are better than others, and again, I feel like each day, I'm further from the person I once was, being totally controlled by this disorder, but I don't think that feeling of fear of losing control over the disorder will ever go away completely.

OMC: What was it that helped you begin that recovery process?

J: What helped me the most was having a support structure. When you have people surrounding you that don't care if you're thin, don't care what you weigh and you feel like you can only be yourself around them, you can start to snap out of that cycle of self hate. I have to work on it constantly, but I did manage to slowly break free from those obsessions.

Sarah Foster Special to

No, the sex columnist's real name is not Sarah Foster. (Foster is the model/actress that played an ex-lover of Vincent Chase in the first season of "Entourage.") In reality, our sex columnist is a Wisconsin native with a degree in journalism and a knack for getting people to talk to her.

Sarah never considered herself an "above average" listener. Others, however, seem to think differently. Perhaps she has a sympathetic tone or expression that compels people to share their lives and secrets with her despite how little they know her. Everyone from the girl that does her hair to people in line at the grocery store routinely spill the details of their lives and relationships to Sarah, unprompted but typically not unwanted. It’s strange to her that people would do this, but she doesn’t mind. Sarah likes that she can give advice even if it is to complete strangers.

So why the pseudonym? Simple. People tell Sarah these things because for some reason they trust her. They believe she cares and therefore will keep their secrets in a locked vault the same way a best friend or therapist would. Sarah won't name names, but that vault is now unlocked.