The singer, who is 22, has been fighting eating disorders from the time she was a teenager however, it was an auto

the accident that caused two "abnormal" breaks in her back prompted her to realize that she required assistance.

It was through this that I realized that my eating issues caused osteoporosis" she said to PEOPLE. "So I'm now 22 years old with osteoporosis.

What can cause the bone structure of a child to be damaged so much by the effects of an eating disorder?

Around 40% of people who suffer from eating disorders show indications of osteoporosis" claims Dr. Susan Albers,

a clinical psychologist who is specialized in eating disorders at Cleveland Clinic. "It's due to a decline in nutrition, particularly vitamin D and calcium.

she says, particularly for teens. If you're suffering from anorexia, and you're not eating enough then your

menstrual cycle will cease and your estrogen levels decrease, which is crucial to the growth of bone density

This is what makes bones less robust and more prone to break, she says by pointing out the fractures in Evancho's body due to the crash.

Albers who didn't treat Evancho says that since Evancho's eating disorder began at the age of 15, she likely played a role in the extent the bone-density problems.

"The older you are when this happens the greater the lasting impact it can have on bone density," Albers says.

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