e her body proportions. She may jog and exercise relentlessly to expend calories. Physical changes accompany the weight loss. Menstruation stops and ovulation ceases. The sin dries out, cheeks and forearms become covered with downy hair, the heart rate and blood pressure drop, and the manufacture of blood in the bone marrow is depressed. Most of the sufferers are female--some 95 percent of those treated for the problem at the George Washington University Medical Center eating disorders program have been female (Dunn, 1992, 74).
Anorexia is defined by the American Psychiatric Association as evident in a patient who weighs 15 percent less than normal body weight, has not menstruated for at least three months, and feels fat and is unwilling to gain weight. The disorder may also involve a slowed heart rate and thyroid function; lowered body temperature and blood pressure; slowed reflexes; premature bone loss; hair loss; and mood changes. Bruch (1973) identifies two major types of anorexia, primary anorexia nervosa and atypical anorexia nervosa, and the common symptoms are found in primary anorexia nervosa. Bruch says that three areas of disordered psychological function can be discerned. The first is a disturbance of delusional proportions in the body image and body concept. The second is a disturbance in the accuracy of the perception of cognitive interp
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