Everybody knows someone with an eating disorder.

That’s the view of Spanish Fork resident Kristin Bahr, who has studied the issue many years. Her daughter, Makaila Bahr, has had an eating disorder since she was approximately 6. She was officially diagnosed when she was 17.

“There is no such thing as a look for an eating disorder,” Kristin said. “You can be 50 to 300 pounds.”

It is not always easily recognizable. Makaila, now 20, recounted her struggles.

“I started exhibiting symptoms when I was about 6 years old,” she said. “It wasn’t a full-blown eating disorder. I would compulsively weigh myself, run laps around the house trying to burn calories. I have had every kind of symptom.”

When she was 12 or 13, she was in an awkward stage, she said.

“I got bullied a lot through elementary and middle school,” she said.

She attributed part of that to her height.

“I was about 5 feet, 11 inches back in middle school,” she said. “I am 6 feet, 1 inch now.”

She began outpatient therapy at the Center for Change in Orem.

“I would tell them that everything was good and I was fine,” she said. “I would continue to lose weight and get weaker. When I was younger, I would do self harm.”

However, she was not deemed sick enough to continue therapy so tried to recover on her own. She even told her mother repeatedly that everything was fine. She was able to get counseling later and is working to overcome the disorder.

“I have been in solid recovery about six months and for recovery a year,” she said.

“I realized there was a real problem probably about two years before she sought help,” Kristin said. “She was really empty. Her fun personality and wit were gone. The light in her eyes was gone.”

Others around her only noticed her slender figure and many were envious. They both worked in the same retail clothing store and Kristin remembers hearing a comment.

“These people were ahead of me on the escalator,” she said. " 'I wish I had her body,’ they said about Makaila.”

Mom didn’t see things the same way.

“All I could see was bones,” she said. “I couldn’t figure out how someone would want that.”

Makaila also saw herself differently from the way others did. However, when she looked in the mirror she saw herself as healthy.

But she was far from it.

“She was dying,” Kristin said. “Her kidneys were shutting down. Her heart was weak.”

Makaila went back for help and this time was admitted to the Center for Change, where she stayed from May to August in 2014.

“My arms were so thin you could almost touch your fingers around them,” she said. “I was always cold. My hair was very brittle and falling out. I couldn’t sleep and would wake up at 3 or 4 in the morning.

“But when I looked in the mirror I wouldn’t see a fat person, but a healthy person.”

Her personality also changed and she became sneaky.

“I compared it to a drug or alcohol addiction,” she said. “I secretly felt that it was cool. I had willpower. I lost a lot of friends in the process. You're not a person, just a shell of a person.”

She has come out of that shell and learned from the experience.

“I learned that healthy is not what the world thinks it is,” she said. “It is not going to the gym two hours a day and eating salads.”

She had previously had more of the world’s view.

“Looks were huge to me,” she said. “When I had long hair I was ‘that’ girl. That was where my confidence came from. I learned that confidence is 110 percent what you think about yourself, your kindness, your empathy. It will show on the outside what you are on the inside.”

Kristin has learned a lot.

“An eating disorder is not a choice,” she said.

Looking back she realizes there were signs she could have noticed sooner.

“She never seemed genuinely happy,” Kristin said. “She would be compulsive and make split-second decisions. Now she thinks things through. She is honest. She is fun to be with. Her personality is back. I have my daughter back.”

Having gone through the process, she said it has brought a realization of strength.

“Our family can go through anything and survive,” she said.

Other family members and friends did not maintain their relationships.

“You lose a lot of friends, and family members turn their backs on you because they don’t understand,” she said. “It is the deadliest of all mental illnesses.”

That statistic was provided by the National Association of Anorexia Nervosa and Associated Disorders.

Kristin recently participated in a Mothers and Others March (MOM) on Capitol Hill in Washington, D.C. One of the efforts of the march was to raise awareness that eating disorders are legitimate illnesses. Most insurance programs do not cover treatment, she said. Treatment can cost $500 to $2,000 per day.

At the march, author and former U.S. Representative Patrick Kennedy spoke and urged help, saying the brain is part of the body and should be treated like any other part.

Kristin said that one in five people has an eating disorder, although some may yet be diagnosed. That includes 30 million people in the United States.

“For me the hardest thing was the misunderstanding and the stigma,” she said. “That needs to change. When my husband and I told people, some immediately withdrew. It was circumstances beyond our control. It would be best if people could listen and love.”

To help those determine if an eating disorder is present, the pair gave advice.

“I think when kids are dieting early or doing restrictive eating it is a sign,” Kristin said.

“Pay attention to any differences in their personality,” Makaila said. “See if they are isolating a lot more, if they take a bath or shower right after eating. Make sure they are not exercising too much.

“If you ask them if there is something wrong, don’t be too harsh about it. Stay friendly, open and non-judgmental.

“At the same time, don’t enable, but listen and set boundaries,” she said.

Daily Herald reporter Barbara Christiansen can be reached at (801) 344-2907 or bchristiansen@heraldextra.com. Twitter: @bchristiansen3.