Every time she stepped on a scale, every time she looked in a mirror, Jennifer Youssef was horrified by the morbidly obese person she saw.

It didn't matter that this 300 pound person didn't exist -- for her, the image was overwhelming.

"I said I should be perfect. I want to just be perfect," said Youssef.

The way toward perfection was to starve herself. But the problem with anorexia is that no matter how thin a person is in reality, the brain sees itself differently.

"It was never good enough, my weight was never low enough. I just wanted to keep losing and losing and losing."

At one point she weighed 95 pounds, but in her brain she was fat and ugly.

"I was not eating. I was exercising. I was abusing laxatives, I was abusing fat burners," said Youssef.

Anorexia Nervosa is not just an eating disorder, but a mental illness that affects tens of thousands of women in Quebec.

It's also one of the most deadly mental illnesses, with up to 10 percent of those affected dying of the disorder.


In a country where more than half of adults are obese or overweight,. it's evident that most people find eating food is easy.

In Montreal, at the Douglas Institute, doctors are researching new ways to treat those for whom eating is an ordeal.

Dr. Howard Steiger says that some people may be prone to anorexia because of their genetic background.

"When somebody gets an eating disorder it's because they carry a susceptibility that is real and physical," said Dr. Steiger.

That's why he says therapies that try to force anorexics to eat are doomed to fail.

"Instead of pointing fingers at people as being manipulative, superficial or obstinate, like people used to do when people had eating disorders, or pointing at the family saying it's a bad family or an overprotective mother. we understand now that those ideas are not at all supportable," said Dr. Steiger.

Perhaps perversely, one of the environmental triggers for anorexia may be going on a diet.


Doctors at the Douglas work on a number of therapies to get people with anorexia to change their relationship with food.

Neuromodulation stimulates the brain while people eat, controlling obsessive or compulsive behaviours in an attempt to provide relief from troublesome thoughts.

"Neuromodulation offers the promise of being able to turn up or turn down brain activation in a controlled, safe way," said Dr. Steiger.

Psychotherapists like Shiri Freiwald start with the assumption that eating food is difficult, and works with patients

"When they're at their home environment, they don't have a chance to talk about how hard it is. It's just assumed that eating is easy. Here we assume that eating is hard," said Freiwald.

For Youssef tackling her illness has been hard, making her determined to share her triumphs with those who are unable to talk about how they feel.

"I think the best thing I could have done for myself was to get help, and I think the best thing anyone can do for themself is to talk," said Youssef.

Because anorexia is not about food, or being skinny, or controlling what they eat.

"People who have an eating disorder are gripped by something that is bigger than them and is beyond their conscious control," said Dr. Steiger.

At 35, with two children, Youssef refuses to be ashamed of her mental illness, and believes in a better future where she is no longer controlled by it.

"I have a lot of hope, and I know that I can overcome this. I can. I will."