s well-documented, and in most cases of anorexia, menstruation tends to stop well before actual starvation or malnutrition has set in. Anorexia often begins when life changes are requiring the development of new skills or attitudes, or when people feel that they are under enormous stress as a result of external life situations and conditions (DSMIII-R, 1989). Not infrequently, the disorder begins when a young woman starts a ritual of normal dieting; what distinguishes the normal dieter from others who will become anorexics remains a mystery. The victims of anorexia quite literally engage in a protracted program of self-dest
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