Simran’s story began in an unusual place: at the family dinner table, when she was still a child. “My family had a lot of hang-ups about food, therefore I don’t think I’ve ever had a normal relationship with food.” In an environment that emphasized control, food as a reward, and unhealthy fixations on fad diets, Simran’s eating habits rapidly became an eating disorder. “I went on my first diet when I was nine years old, and by the time I was in the 8th grade I was experiencing liver and muscle problems because of my low weight.”

Her first round of treatment for the eating disorder came early. “I was 69 pounds and in liver failure when my English teacher forced me into treatment at the end of eighth grade.” However, the treatment program ended up doing more harm than good, and Simran’s condition continued to worsen. “I was so consumed by my eating disorder. It was all I did.”

Despite this, Simran was an honors student and an accomplished violinist. The summer after her senior year of high school, she was accepted into a summer Shakespeare program at Harvard. “I planned to forgo food all together, but I quickly realized that that would not be feasible. I found myself eating three square meals a day, not because I was hungry, not because I wanted to, but because I had to; my brain wouldn’t work otherwise. I really, genuinely, truly thought I’d recovered from my eating disorder.”

After the program, Simran left for London to begin her undergraduate degree. The experience was not at all what she thought it would be; alone in a foreign country and feeling disconnected, Simran’s eating disorder once again began to surge. “I was bored, and in lieu of an academic challenge, I lost forty-something pounds in under six months.” While her psychiatrist at home was immediately concerned, Simran’s family was less so. And while her psychiatrist recommended Simran make an appointment with a cardiologist and admit herself into the hospital, she decided to forgo any of that in order to return to the UK to continue with her education.

“I had been having chest pains and palpitations when I was home for Easter, but I didn’t really register how serious it was.” Back in the UK, while attending a Shakespeare symposium at Cambridge, Simran suffered a heart attack brought on by an electrolyte imbalance. She collapsed on the steps outside of the school, and was rushed to the hospital.

A few weeks later, Simran “Staggered into the Cardiology Clinic at 74.7 pounds. My heart rate yoyo-ed between a terrifying 30 bpm and an equally appalling 140; they couldn’t get a blood pressure reading because the cuffs kept slipping off my arms.” Simran was only 19 years old when she had her heart attack. But it was the start of getting real help, and meaningful treatment.

Simran is currently being treated by several doctors, including a cardiologist, therapist, nutritionist, and a psychiatrist. “It’s weird recovering from a heart attack brought on by an eating disorder, because the programs are at odds with each other.” For instance, recovery from a heart attack often includes exercise, but because those suffering from eating disorders tend to abuse exercise (as in, they exercise an extreme amount to lose weight), exercise tends to be forbidden in a recovery program for an eating disorder. Just the same, the diet prescribed for heart attack recovery is at odds with the diet prescribed for an eating disorder, as one focuses on losing weight while the other focuses on gaining.

Beyond this, many medical professionals are still unsure how to treat heart disease brought on by an eating disorder. “I am fortunate to have excellent doctors who communicate well with each other. My cardiologist admitted she didn’t know very much about heart disease brought on by eating disorders, but she’s been learning as much as she can in order to give me the best treatment possible.” Simran’s doctors agree that she needs to gain weight in order to save her heart, but how quickly she should gain the weight is often in question. “But they do agree that my heart will recover as my weight improves.”

Simran is continuing to work on both her weight, and her mental health, in order to fully recover from her eating disorder. She wears a cardiac monitor because as her doctor puts it, “her heart is still not used to food yet.” But she is well on her way. “It took me a while, but I finally decided to recover. I withdrew from university, and committed to the nutritionist-prescribed meal plan. I have gained 30 pounds since May 2016 (10 to go until I’m weight restored!), and I am about to graduate from cardiac rehab.” As a part of that recovery, she blogs regularly about her experience, a process she says is “cathartic.”

Simran’s story highlights a common misconception about heart disease: that only older, overweight people are at risk. But there are many contributing factors, and the more awareness we can raise, the more likely it is that someone’s life will be saved.

To learn more about Simran and to follow her journey in recovery, you can read her blog Cupcakes and Cardiology here.

If you or a loved one are struggling with an eating disorder, please visit the National Eating Disorder Association here.