Lia had a best friend named Cassie, a girl who she met when Cassie moved in across the street in second grade. The summer between their fifth and sixth grade, Cassie began dealing with bulimia to become thinner. By eighth grade, both Cassie and Lia shared a goal of being the thinnest girls in their class. Cassie and Lia had a contest to see who could be the thinnest. Lia was hospitalized to treat her eating disorder during their junior year of high school. Nine months later Cassie was found dead in a motel. The cause of death was unknown at first but an autopsy showed that she died from boerhaave syndrom. Lia, getting a message from a motel employee named Elijah, who told her to come to the motel to meet him, went to the scene of where her ex-best friend died. When she met and saw Elijah, he didn't know who she was, so she told him she was her step-sister Emma. At Cassie's wake, they meet again and finally, at Cassie's funeral, he learns the truth of her name after Lia's mom finds her. During this time, Lia's weight drops from 101 pounds to 93 pounds, though she has rigged her family's bathroom scale so that her parents believe she weighs more. After her father gets back from his trip, and tells Lia she is moving in with her mom, since she isn't working with them, she goes into the bathroom and cuts deep into her skin, from her hand all the way to her brain. Her step-mother Jennifer and step-sister Emma find her and take her to the hospital, after that, she is supposed to live with her mother, Dr. Chloe Marrigan. Dr. Marrigan feeds her and doesn't leave her side without having someone else watch her.
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