I remember the first time I looked in the mirror and said I was fat. I didn't actually think I was fat; I had just heard an older girl at school saying it, and I thought it was something that "older" girls do. So I said it and then I said it the next day and the next day. It just became a habit. I never thought I was fat, but I wanted everyone else to think I did. Partly because I wanted them to tell me I wasn't, partly because I wanted everyone to think I was cool, but mostly because it had become a habit. I was old enough to know that there were many girls who did have eating disorders and a morphed sense of self, but I never thought what I said about myself was a big deal because I didn't actually mean it. I never once thought about how it was affecting the people around me. I didn't think and because I didn't think I almost cost someone their life.

I met Cathy on the first day of kindergarten. Her rabbit was sick and she was sure he would never get better. So when the teacher told us that we were going to have an art competition, Cathy asked me to help her. I drew her picture for her and she won the contest. Cathy wasn't the kind of girl to ever forget a favor; so from then on she decided that we were best friends, and we really were. We did everything together. She tried to protect me from everything bad, and I can honestly say that she saved my life more than once. I never dreamed that almost exactly after the 10 year anniversary of our first meeting I would be begging her to save her own life.

When I first started telling everyone that I was going on a diet, I was joking and I thought everyone else knew that. Everyone would roll their eyes, tell me I was crazy, tell me I was skinny and throughout all of this Cathy was there. She was there but she never had any reaction to any of this. In hindsight, I don't know how I missed it. When the most outspoken person you know has no opinion, there's something wrong, but I never noticed.

Over the course of the next six months things began to change in little ways. Every time Cathy ate she would cut her food into tiny little pieces and move it around her plate. She told me she had joined a swimming team and was going to lose a couple pounds for "bikini season". She started avoiding any social gatherings that involved eating. She looked in the mirror every chance she could, and was constantly asking me if I thought she looked good. Then she would say I was lying if I told her she looked good. These were the classic signs of an eating disorder, but I never noticed.

Cathy's behavior got more and more strange. She started working out two to three times a day, and she drank most of her meals. When we managed to sneak in a trip to the mall between her rigid workout schedules, she would wear weights around her ankles. For my birthday we went to my favorite restaurant, and I, being a clueless idiot, made her promise to "pig out" with me. When we got back to my house, she excused herself to go upstairs. A couple minutes later I went upstairs myself and I found her throwing up everything we had just eaten. Then I noticed.

When I first discovered Cathy's eating disorder I tried to get her to explain it to me. I kept asking her why. Why are you doing this? Why would you think you're fat? Why can't you just exercise and diet like a normal person? They were stupid questions. They were stupid because they were insensitive and they didn't make sense to her. They didn't make sense because she was starving. She hadn't digested a full meal in over 9 months. We can all agree that a starving person in the desert is not thinking at their normal capacity, but then we judge people with eating disorders? I didn't think of that. I thought of her as Cathy pre-eating disorder, and the Cathy that I was dealing with now was a completely different person.

Cathy didn't just start eating because I told her to. In fact, she thought that now that I knew I could help her. She wanted me to be her "mealtime alibi". In the beginning, I didn't take it as seriously as I should have. I wrote it off as a phase, but months passed and nothing got better. It had only gotten worse. Cathy had what looked like purple bruises under her eyes. She was losing hair by the handfuls, and she would weigh herself three to five times per day. She would stand in front of the mirror and talk about how she needed to lose weight. I could see every single one of her ribs. Her stomach wasn't flat; it was sunken in like a crater. Every time she would bend over the bones in her back protruded so much that it looked as if they were going to cut through her skin. She was always cold and her hands always shook as if she was nervous about something. She told me that her joints hurt so bad and that is was as if they were grating together. Throughout all of this she kept on promising me that if she lost a couple more pounds she would stop, but she lost 8 pounds and then 15 and then 20. She never stopped.

We would go out with our friends, and everyone would tell her how good she looked and how "fit" she was. She would look at me with this look that said "See? I'm fine". I just wanted to get her and shake her until she understood that she wasn't ok. She was going to die. I was going to lose her. She was going to lose her life. She was going to lose everything she could have been. All this in the pursuit of skinniness? Forget about being skinny. It would have been too great of a loss for the world to lose her.

When I was with her, I tried to reason and explain, but she never gave in. She always believed that she was fat and that since she was fat nothing good could ever happen. I realized that I couldn't do anything. I was only 15 and I was way over my head. I knew I had to tell someone, but it went against every fiber of my being. I was always a vicious advocate of loyalty and not "ratting out" your friend, but I knew that it wasn't about what I thought. It was about what she needed. I told her parents. I knew that I was losing her either way, but at least this way she got to keep her life.

On November 3, 2009, her parents had an intervention for her; they asked me to be there. I can never forget the look in her eyes as her parents talked to her. She looked so betrayed. Her parents left so we could talk. She walked up to me; her face was only an inch from my face, and she said “How could you?” How could I? She had been the best friend to me for 10 years, and I had stabbed her in the back when she needed me the most. That night I cried the hardest I have ever cried. I had lost her.

Cathy went to a center for teenagers with eating disorders. I visited her every Sunday and Friday. She hated that she was in there, and I hated myself for putting her in there. At first she denied that she had a problem, but after two months she admitted that she needed help. She told me that she understood and forgave what I did.

After six months of intense therapy, she came out of the center with strength and determination. Anorexia and bulimia will always be something she battles with, but she's stronger than any disorder. She keeps a log of everything she eats to make sure that she's eating a balanced diet. She works out for an hour four days a week. Cathy still looks in the mirror sometimes and thinks that she's fat, but she's able to combat that thought with the fact that she is now finally healthy.

A recent study states that 218 Americans die of eating disorders every year. I was not one of those. Cathy was not one of those, but that is not something I take for granted for one second. Only 30% of people with eating disorders recover; Cathy did, but it was too close.

218 is a big number of preventable deaths, and know this, they are preventable. Don't ever think that just because what comes out of your mouth means nothing to you that it means nothing to someone else. When you stand around and joke about how "fat" you are understand that you are calling everyone who is around the same weight as you fat as well. Don't kid yourself into thinking that that means nothing. Care enough about your friends to make sure they’re okay. Be conscious of warning signs. Never enable destructive behavior, but the most important thing that anyone can ever tell you is to never take someone you love for granted.