You DO make a choice; however, it's because MENTALLY you keep seeing yourself as huge, fat, obese. You can be 5' 10" and weight 100 pounds and look in the mirror and see a 300 pound slob. You'll see fat rolls hanging where bone is actually protruding. It's all in the mind. The brain still malfunctions, creating this incorrect body image. The choice to starve is DUE to the brain malfunction. And yes, they can get counseling and treatment and live normal lives, but like alcoholics, they are NOT cured. Once an alcoholic, ALWAYS an alcoholic. They can NEVER take one drink again for fear of slipping back. Anorexia is just like that.