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It also ruins their organs. Anorexia is a truly evil disorder; it causes heart failure, infertility, kidney damage, and it literally shrinks the brain. And like you said, it makes girls look older and also ruins their skin and hair.
Having a thigh gap and being able to squeeze into clothes that could fit on a toddler isn't really worth being bald and wrinkly with heart palpitations before age 30. I can't help but pity anorexic girls because something REALLY wrong must have happened in their childhoods if they think starving themselves into looking like a Halloween decoration is beautiful. A lot of these girls need therapy.
And on the topic of Pukara specifically, I personally believe she was way prettier before she got super skinny, she was never even fat. Just sad.