So she's past the point of no return now, right?
Like even if she did start eating she's still gonna die in a decade or so from complications?
Not necessarily, like all things in medicine, it's a total crap shoot. I've said this in the Ashley thread, but I've seen anorexics at her level (or at least near it) who did manage to recover and even occasionally have healthy pregnancies (well, a live birth at any rate, how they might've fucked up their children psychologically later on, I have no idea). Of course those cases weren't real long-haul anas like the ones in Deathfats (lul) but it's not unheard of to reach a similar state of equilibrium for a while if they establish those habits young. Actually if you exclude suicide, if they die before 30, from what I've seen, it's almost always related to incredible binge/purge sessions, Munchausens self-harm, refeeding syndrome following either an earnest recovery attempt or forcing themselves to eat more than they can handle to evade some kind of consequence (ironic), common viruses that dehydrate them on top of their regular chronic dehydration enough to be fatal (e.g. flu or norovirus), get an injury their body can't heal correctly and throw a clot, or drug abuse of some type (tons abuse caffeine or Adderall which doesn't usually kill them, anything that depresses heart rate may though. Rarely they consume alcohol only which does as you'd expect. Occasionally they abuse prescription meds you'd never expect like Synthroid or deliberately mess with their insulin aka "diabulimia" which is obviously very dangerous).
The relationship between drug abuse and eating disorders is complicated, so all I will say is that in most cases (but my no means all) one of those behaviors is often secondary and mostly motivated by the other. In any case, the real high-octane skelly tends to be of the type that lives their entire life in service to ED and obsessing over food/"thinspo"/other time wasters, don't socialize much, don't really like the idea of becoming intoxicated in any way that threatens their sense of control over themselves, and get too tired too fast to do much that'd put them in physical danger on its own. If you lead this kind of life it's not so hard to imagine that they can keep a fragile equilibrium for quite some time. Basically this guy's right:
I see people constantly wondering how bitches like Eugenia Cooney and Ashley Isaacs stay alive for so long, even though they appear to be on their death beds, and the answer is simple: these bitches do not do anything. They do not go anywhere. They do not have real jobs. They do not have real friends. They contribute absolutely nothing to society. Most people would not be able to survive while being this thin because most people actually have real-world obligations that require at least a small degree of physical exertion. These bitches do not. They might as well already be dead.
Though again, even the people throughout history who have been starved and forced to do hard labor in contexts of slavery, famine, or war could live quite a while, and often didn't die "of starvation" so much as they did from contaminated water, filthy conditions spreading contagious diseases, poor quality of the food they did eat, literally zero medical care except for the purposes of torture, or losing the will to live and refusing even the small amount of sustenance they could access. On the other hand, being a sweaty, gouty deathfat with a diet of modern mechanically-separated mass-produced F-grade goyslop who uses a gubmit-supplied scooter to stay under 100 steps daily is an insult to human physiology that we haven't really evolved any natural defenses against.