If you’ve watched the show, you’ve seen her sister show up with the same emaciated body & puffy face and she has kids and isn’t into fashion, so you can see that Rachel would look like she does no matter her lifestyle.

However, like people have said, she clearly is anorexic, most telling for me is her (seemingly) throw-away comment about wishing coffee had vitamins. Who wants zero calorie drinks to contain nutrition so that they don’t have to eat? Anorexics, that’s who. Her husband Rodger needs to strap her down and force her to get help, LITERALLY!