HOUSTON -- In the psychiatric and medical confusion of anorexia, where someone looks in the mirror and sees someone completely different than the woman they are starving on the other side of the glass, some survivors, like Cynthia Nelson, make a startling admission.

“Nothing was ever good enough, no matter what,” she said. “I mean you could be dead, and you still weren’t skinny enough.

“I just wanted everybody to like me so I needed to be perfect,” Nelson said.

Her first thoughts of searching for that frail perfection began in fifth grade.

“My identity, my specialness came from being skinny, and the only thing I really thought about and wanted to do was to lose more weight and lose more weight,” Nelson said.

“I’ve seen an 8-year-old — the youngest recently are 10,” Dr. Albert Hergenroeder said. He is the chief of adolescent and sports medicine at Texas Children’s Hospital.

“Clearly from about, you pick it, 8 to 20, we’re getting regular referrals at all ages,” Dr. Hergenroeder said.

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He has about 100 patients, and a half-dozen are hospitalized. And a “young” anorexic isn’t that unusual anymore.

“I think we’re probably seeing a drift toward younger patients,” he said.

Media get some of the blame. Images of lean, sometimes unattainable bodies, are streamed, broadcast or printed for a younger and younger audience to see.

“Occasionally you look in my waiting room, and you think this is a pediatrician’s waiting room,” Dr. Margo Maine said. “You don’t think this is an eating disorder psychology practice.”

Leslie Goldman is an author who writes about her own anorexia battles, and she often tells the story about her mom: a preschool teacher.

“And she has 3-year-olds who refuse their juice and cookies because they’re on a diet, and they actually ask ‘do you have any carrots’—and they’re 3,” Goldman said.

They are modeling the behavior they see with their parents dieting at home.

“Its starts younger and younger,” Goldman said.

“Mom cooks hamburgers for everybody, but she eats a salad at the dinner table,” Nelson said. “I mean it’s not obvious, it’s not outspoken, but it’s subtle and it’s there.”

About half of young girls with anorexia recite a single incident or comment about their weight from a parent, a friend or a coach that made them believe not eating would solve their perceived problem.

By the time she was a high school student Cynthia Nelson was fighting to stay alive. Hospitals, treatment centers, feeding tubes, counseling.

“Honestly, it really -- it breaks my heart,” Nelson said.

What breaks her heart is that what she survived is evident in younger and younger victims.

“I think it’s never too early for parents to start thinking about ‘how am I going to help my kid have a healthy body image, a healthy relationship to food, and a healthy emotional life,” Dr. Maine said.

A life Cynthia now enjoys - while hoping her story will keep other young girls from the same dangerous dieting path.