I didn't really realize til it was pretty far along.you wouldn't believe the stuff you tell yourself. Like that everyone is conspiring to make you fat, etc.  And even then I still thought I looked ok until I saw a really bad picture where I have the anorexic "horse teeth" because your mouth/teeth look weirdly huge and protruding. Then it kinda was like an oh shit moment.  But it didn't help for long.