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Jackie reveals she has bones of an '80-Year-Old' due to Anorexia-Caused Osteoporosis. After suffering from an eating disorder for seven years, Jackie is ready to make a change. In the new issue of PEOPLE, the singer, 22, opens up about her battle with anorexia and how she's working to get healthy.

While she's struggled with disordered eating since she was a teenager, the America's Got Talent alum — who placed second in 2010, at just 10 years old — knew she needed help last year, after she was hospitalized following a January 2021 car accident that broke her back in two places. "They were abnormal breaks, breaks that you see in 80-year-olds" Jackie explains. "That's how I learned that my eating problems created osteoporosis. So now I'm a 22-year-old with osteoporosis"

But the bone-disease diagnosis didn't immediately compel Jackie to address her food issues. "I had to eat [for my bones] to heal, and that really messed me up with my eating problems, because I was gaining weight to heal, Once I finally healed, my disorder said, 'OK, now you've got to be really hard on yourself to get all of that out of you . . . and then some'".

At the time, Jackie "didn't see results" she wanted, so she began eating even less and working out more. Jackie said "When I started to go days without eating, in my head I said, 'I know that this isn't normal, I felt exhausted, moody, tearful, but after a bit of time, I started to feel nothing". Despite seeking outpatient treatment at age 17, Evancho continued to struggle — and when the COVID-19 crisis hit in 2020, her eating disorder was only exacerbated.

Today, Jackie is "still fully in the throes" of her ordeal, but, now, she wants to be healthy. She sees a nutritionist and therapist and undergoes eye movement desensitization and reprocessing (EMDR), a type of psychotherapy that she hopes will help her process past trauma and get her anorexia under control.

Jackie says "I'm still struggling, but I'm fighting, which is good because a year ago I was giving in to it completely, and that's so dark and painful, I'm not healthy yet, but I have been able to implement healthy coping skills and better eating habits". "Since I was a kid I've put so much blood, sweat and tears into my career, and to see that sort of fade away because of this demon in my head? No, I'm going to fight this now because you can't take this one thing from me," says Jackie, who in September will release her ninth LP, 'Carousel of Time', a Joni Mitchell covers album that includes remakes of 'Both Sides Now' and 'A Case of You', among other classics.

Jackie has also been working on original music, having recently returned from a songwriting trip to Nashville, where she found drawing on her experiences cathartic, Jackie says: "It's opening old wounds, but painting with the blood; it wasn't healing, but it was making something beautiful out of something painful". Jackie adds: "There are still issues, but they are so much better, there are days where I feel helpless and hopeless, but I'm sick of living like this".