I've taken care of AIDS pt's....I've taken care of COPD'ers..and cancer pt's...that looked as bad as that girl.
I had a friend die of AN back in the 80s. She was literally committed to an asylum. She would do ok while she was admitted, and occasionally I'd see her at the mall "out on pass".
I guess they couldn't keep her forever...last I heard, she ultimately starved herself to death.
She was truly mentally unbalanced.