Pile's death to be wake-up call

Some days Linda Kohles wouldn't eat at all.

Other days she'd eat just a little, then go on long runs.

Kohles, who's 28 and has suffered from anorexia nervosa for more than a decade, said she was saddened by the death of Hilary Pile, a 19-year-old college student.

The Wayne State College student, found dead Saturday in her dormitory room, had long battled an eating disorder, two friends said. Family members told KETV that her death resulted from complications from anorexia, a mental health disorder which involves self-starvation.

"It shows how dangerous it can be,'' said Kohles, who lives in Panama, Iowa, and works as a nurse in Omaha. "We have to be aware of it and get the word out."

Wayne Police Chief Lance Webster said an autopsy was performed Monday at St. Luke's Hospital in Sioux City, Iowa. A member of the Wayne County attorney's staff said the office had not received a copy of the autopsy results late Tuesday afternoon.

Webster has said there were no signs of suicide, foul play, drugs or alcohol in Pile's dormitory room. She was from Norfolk, Neb.

Deaths from complications of anorexia do occur, but there aren't specific national numbers, said Peg Miller-Evans, a psychologist and manager of the eating disorders program at Children's Hospital & Medical Center in Omaha.

The National Eating Disorders Association says the probability of death increases depending on the duration of the disorder.

One reason there aren't reliable figures is that families often don't disclose anorexia as contributing to a death because of the stigma that some people associate with the mental illness, she said.

But she said there should not be a stigma attached to it.

"There is nothing to be embarrassed about,'' she said. "Just like with diabetes or cancer, people with eating disorders should be able to ask for help and receive help."

Dr. Devin Nickol, a physician at the University of Nebraska Medical Center, said the disorder can lead to serious medical complications.

As a person becomes malnourished, organ damage can occur, he said.

Miller-Evans said that when deaths occur among those with anorexia, cardiac complications are a common cause.

Susan Feyen, clinical director at Omni Behavioral Health in Omaha, said weight loss can be dramatic. Some women and teens can drop to as little as 70 pounds.

Symptoms of anorexia can occur in children as young as 10, but are more common among people 18 to 25, she said.

An estimated 3 percent of teen-age girls and young women nationally suffer from the disorder, Miller-Evans said. The rate is about 1 percent among teen-age boys and young men.

She said the disorder is significantly under reported, which means the actual rates are probably higher.

Some teens develop symptoms when they head off to college, Feyen said. Tough classes, a change in routine and missing friends and family can lead to symptoms, she said.

Those with the disorder often are seeking a way to control an aspect of their life. They feel that limiting food is a way to do that.

Kohles said control played a big part in her disorder.

She said family and friends often asked her, "Why can't you just eat?"

Kohles said it is never that simple for people with anorexia.

Jane Wedekind, a former Norfolk resident and friend of the Pile family, said Hilary Pile had battled her disorder since about eighth grade.

Wedekind, who now lives in Utah, became friends with the family because her daughter also suffers from an eating disorder. Wedekind said her daughter and Pile were in the same treatment program in Omaha.

Ashley Volmer, who graduated from Norfolk Catholic High School in 2008 with Pile, described her as "loving, talented and very, very smart." Pile was good at making jewelry and acting. Volmer said Pile was "very close to God" and worked as a youth counselor during her junior and senior years in high school.

"She had a very strong faith," Volmer said.

Pile attended Creighton University in Omaha last school year; in the spring semester she was listed on the dean's honor roll.

Kohles said she began treatment two years ago after finally admitting to family and friends that she suffered from the disorder. She said she has learned to manage her anorexia, but knows she will never be completely cured.

"I feel lucky I have the strength to face my disorder and get better,'' she said.