Perfectionistic, unattainable goals are cited as an explanation for the increasing rates of plastic surgery and anorexia nervosa. Anorexia is one of the most prevalent eating disorders in Western countries "affecting an estimated 2.5 million people in the United States alone." Of this number, more than 90 percent of anorexics are girls and young women. They suffer from a "serious mental health disease that involves compulsive dieting and drastic weight loss". This weight loss is the result of deliberate self-starvation to achieve a thinner appearance, and it is frequently associated with the disorder bulimia. Anorexia's deep psychological roots make it difficult to treat and often extend the recovery process into a life-long journey.