This 20-year-old Russian girl has been making waves in the online world.
Kseniya Bubenko is perilously skinny.
She is 1.58m and weighs just 20kg, a curious mixture of skin and bones.
Photos of her recently emerged on online after she appeared on a Russian talk show, shocking netizens with her tiny frame. Her pictures have also gone viral on Facebook.
She has reportedly named her own diet "pobeda" ("victory" in Russian) and her images have appeared in many publications worldwide.
Reactions are flying in thick and fast from netizens all over the world, with many criticising the fashion world for abetting eating disorders by glamorising extreme thinness.
On Singapore's own citizen journalism website Stomp, the reactions range from disgust to admiration.
"She's beautiful..." Stomper localblood gushes while PasserBySaysBye thinks otherwise. "Her face is pretty.. but her body is not," he says.
For those who decry the notion that ultra-skinny is sexy, change is coming.
Last week, Israel became the first country to ban underweight models from catwalks and commercials.
The move is the first attempt by a government to use legislation to take on the skinny trend.
The law could become a model for other countries grappling with the spread of anorexia and bulimia, particularly among young women.
The anti-skinny law will not apply to foreign publications sold in Israel.
But otherwise, models must produce a medical report, dating back no more than three months, at every shoot that will be used in the Israeli market.
They must state that they are not malnourished by World Health Organisation standards.
The UN agency uses the body mass index - calculated by dividing weight by height - to determine malnutrition.
Any advert published for the Israeli market must also have a clearly written notice disclosing if the model used was digitally altered to make her, or him, look thinner.
This article was first published in The New Paper.
Understanding a disease of the mind
Understanding a anorexia
Also known as Golden Girl Syndrome, anorexia nervosa is characterised by voluntary maintenance of unhealthy low weight (less than 85 per cent of expected), cessation of menstrual periods for at least three cycles (amenorrhoea), and an intense fear of weight gain or becoming fat.
Those who have anorexia are very concerned about their weight and they keep it as low as possible by strictly controlling what they eat. They may also exercise very vigorously to lose weight.
The onset of anorexia is often innocuous with mild attempts at dieting initially. These frequently get of hand rapidly.
There is no single cause for anorexia nervosa - rather, it is the result of a combination of emotional, social and biological factors. However, most studies suggest that it is 10 to 20 times more common in females than in males.
Although the condition is the leading cause of death for mental health cases, with a 10 to 15 per cent risk of premature death, the disorder often causes the sufferer to become severely disabled, but stops short of killing him or her.
The disorder is alarmingly common amongst girls in Singapore, and the number of cases seems to be on the rise.
Between 1994 and 2002, there were a total of 126 cases recorded by the Child Guidance Clinic and the Eating Disorder Clinic at the Institute of Mental Health. In recent years, the number of anorexia cases has increased, with Singapore General Hospital (SGH) seeing an average of 120 new cases a year.
The cause of anorexia is not known. But it is believed that anorexics have certain personality characteristics which increase their likelihood of developing the condition.
Most anorexics have certain personality traits like difficulty handling stress, a tendency to anxiety and depression, obsessive-compulsive feelings and perfectionism.
The secret ways anorexia destroys your life
What are you risking, besides your life?
Circulation may be impaired due to slow or irregular heart beats and the blood pressure may be low, either of which can lead to dizziness. There may be swelling of the face, hands and feet, and fatigue associated with altered sleep patterns.
Untreated anorexia results in severe complications, which includes: >> Thinning of the bones; >> Electrolyte imbalance;>> Low blood sugar levels;>> Heart failure; >> Kidney failure;>> Liver damage,>> and anaemia.
Low levels of nutrition can also lead to a host of problems, such as:
>> Low potassium levels can lead to dehydration, fatigue, kidney damage, irregular heartbeats and fits.>> Low sodium levels can lead to confusion and, if severe, fits.>> Low calcium levels can lead to painful and tight muscle contractions. >> Low calcium and vitamin D levels can lead to bone damage.
There may be dental decay due to the stomach's acid acting on the teeth, caused by frequent vomiting.
Anorexic children have impaired growth and delayed puberty. Adolescent and young females may cease having periods and/or have infertility.
Anorexia in pregnancy increases the risks of miscarriage, premature birth and baby of low birth weight.
For men, there may be loss of libido and impotency in men.
Anorexia can lead to bulimia nervosa, in which there is binge eating followed by immediate attempts at vomiting and/or laxative use to get rid of the food consumed.
Serious complications secondary to bingeing are rare but can be catastrophic when they occur, eg rupture of the oesophagus or stomach.
This section was contributed Dr Milton Lum, a member of the board of Medical Defence Malaysia, in an article first published in The Star/ANN.
You don't have to go throught it alone
Warning signs to look out for
How do you tell if your friend or family member has an eating disorder? Look for these 20 behaviours, signs and symptoms:
1. Extreme preoccupation with food2. Distorted perception of their body3. Emotional state tied to eating habits4. Self loathing comments5. Becoming very secretive about food6. Moodiness, shakiness, irritability7. Obsessive rituals (such as eating only certain food at certain foods)8. Social withdrawal9. Avoidance of social situations that include food10. Loss of menstrual period11. Development of fuzzy hair on the body12. Exercises in an extreme manner13. Excessive calorie counting14. Dramatic weight loss unrelated to illness15. Gets very cold easily16. Dry and brittle hair17. Hoarding and hiding food18. Blisters on knuckles and fingers from sticking fingers down their throats19. Frequent and secretive trips to the bathroom after meals20. Consumes large amounts of food when experiencing stressful or unhappy emotions21. Eats secretively or is ashamed of the amount consumed
Source: Association of Women for Action and Research (AWARE)
Where to get help
Singapore General Hospital Eating Disorders Programme (Tel: 6321 4377)
Association of Women for Action and Research (AWARE) Eating Disorders Helpline: 1800-774-5935
Singapore Association of Mental Health (Support for Eating Disorders Singapore SEDS) Helpline: 1800 283 7019