The cheerful drawings depicted carrots, broccoli, and other vegetables, and the childish scrawl over them read, "Good Foods!" When 9-year-old Lily showed them to her mother, Maria Adams, one spring afternoon, Adams did what any health-conscious mom might: She grinned with pride. "Lily and her friend had started 'The Healthy Eating Club,' and this was their information packet," says Adams, of Columbia, South Carolina. "I was big on natural foods, smart fats, that sort of thing. I thought, 'How cute that she's taking after me.'"
Even more impressive was Lily's follow-through. Later that day, Adams served the girls a snack of ice cream. As her playmate gobbled it up, Lily primly pushed the bowl away. "It's a bad food, Mom," she said. Over the next few weeks, Lily started refusing all treats, and at mealtime, she moved more food around her plate than she put in her mouth. "I'm not hungry" or "I just want to eat healthy," she'd say, when her parents pressed her. After a few months passed and her pickiness persisted, Adams talked to Lily's pediatrician, who connected the family with a psychologist and a dietitian. The dietitian calculated that Lily was eating only 700 calories a day -- less than a third of what she needed. Adams supervised mealtime more closely, but when she managed to force her daughter to eat more than a few bites of vegetables or bread, Lily would ramp up her activity, racing her bike up and down their street, or sneaking in extra laps after swim practice. "It was like Lily suddenly had an uncontrollable urge to move," says Adams, who requested that we not use her or her daughter's real name for this story.
Within a year, Lily had grown 3 inches, but had not gained a single pound. She dropped from the 80th percentile to the 40th percentile on the growth chart. Previously a muscular little girl, she now had a jutting collarbone, prominent ribs, and a new layer of fine hair on her arms -- lanugo, which the body grows as a way to help regulate its temperature. Barely out of third grade, she was diagnosed as having anorexia.