Anorexia has the highest mortality rate of any mental illness. The associated death rate in 15 to 24-year-olds women is 12 times higher than all other causes for that demographic. It is estimated that up to 20 percent of anorexics will prematurely die from complications related to their eating disorder. Though researchers are still studying the data, it appears the mortality rate for chronic bulimia is equally frightening.

Despite meeting hundreds of people on my road to recovery, I had never faced the death of a friend until this year. In the past two months, three fellow sufferers have passed away.

I knew these young women from an online eating disorder support forum. And with thousands of members coming and going, the odds were against our group. I have been part of that community since 2003, and without their honest and unwavering support, I wouldn’t have made it to treatment in 2005. Even when I wasn’t actively posting, I tried to keep an eye on all my beautiful friends struggling with this ugly disease. Some are healthy and no longer need an Internet message board to stay sane. Many are still there, six years later, fighting for recovery. Others have gone silent without an explanation. Though we hope for the best, that they got better or bored, we know the thing that brings us together could also end our lives.

Sadly we know exactly what happened to Jenn, Katrien and Jen. One of these young women was undergoing treatment for leukemia when her kidneys and liver failed. Weakened by years of bulimia, her organs could not take the stress of a blood marrow transplant. The other two took their own life.

Suicide is the leading cause of death for anorexics. For many years, doctors blamed this on frail bodies being unable to withstand even the most halfhearted attempts. But a recent study attributes the high death rate to the use of extremely lethal techniques with a low rescue potential. Hanging, taking a drug overdose and jumping in front of a train were the most popular methods. Whether you weigh 90 pounds or 290 pounds, it’s unlikely you’ll survive getting hit by a train.

Why is suicide the answer for so many? The toll that a chronic eating disorder takes on your body, and more importantly your mind, is devastating. More than a diet gone awry, eating disorders are a deadly disease with no proven cure. People struggle for years to develop a healthy relationship with their body and food, but only a third fully recover. When you see no end to the pain, the logical solution is to end it yourself. If you’ve been slowly killing yourself for years, it is much easier to take that last step on to the railroad tracks.

Farewell Jenn, Katrien and Jen. I hope you have finally found peace.