"By January 2018, knowing her daughter was critically unwell and in need of urgent help, Rita persuaded her to visit a public centre for eating disorders. By then, Dalila, who is five feet three inches tall, weighed just 31kg (68 pounds). The specialised centre in Fermo, about an hour's drive away, had initially directed Rita to services closer to the family's home when she contacted them. 「They didn't want to take her case. I was sitting here in the living room, and I told them, 'Either I die, or she dies. You figure out what to do,'」 Rita remembers telling them in desperation."

"When they told us it was anorexia nervosa, I thought: this is an illness, not a whim. That meant there was a cure."

"「When I got up, the first thing I did was light the fireplace because she was always cold. Despite all the sweaters she wore, she was still freezing. Then I'd prepare a hot water bottle for her,」 Rita murmurs, giving her daughter a small smile. Dalila would spend hours under the hot water trying to warm herself, but Rita never said anything about the high gas bills. Dalila lights a cigarette. 「My body had disappeared,」 she recalls. 「She became so thin it hurt even to sit on a chair,」 Rita adds. 「I had to put cushions on the chairs so she wouldn't feel pain.」"

"Anorexia nervosa remains undertreated across Europe, with institutional capacity concentrated in urban centres."

"Rita's initial rejection by the Fermo centre — and the 60-kilometre distance between her village and the nearest specialised service — reflects a structural reality: eating disorder treatment in Italy, like much of Europe, exists in pockets rather than as a distributed network."

"Family-based treatment has emerged as the gold standard for adolescent-onset eating disorders, yet it places the entire burden of execution on unpaid caregivers."

"Dalila's weight of 31 kilograms placed her in the critical range where organ failure becomes imminent."

"Dalila's withdrawal from social life, her evasiveness, her refusal to eat with family — these are diagnostic markers of anorexia, but they read to untrained observers as behavioural problems or family conflict."

"Rita describes the family's initial state as one of confusion and anger, not recognition. 「We didn't understand what was happening,」 she says."