on. An ongoing lack of appetite, extreme selectivity of foods low in calories, binging and purging, heavy laxative use, excessive exercising, wearing loose, long-sleeved clothing to disguise extreme weight loss, and the denial of any problem are all indications of anorexia nervosa, which may go undiagnosed for a long period of time. Physical examination of the patient and laboratory tests are needed to rule out any differential diagnosis to explain the lack of appetite and weight loss, and to identify any nutritional disorders (Bochereau, Clervoy, Corcos & Girardon, 1999).
The precise causes of anorexia nervosa are not known, but contributing factors include an emphasis in many cultures of equating feminine beauty with slimness. Women's magazines are filled with images of ultrathin, glamorous women, and abound with diets and weight-loss regimens and gadgets. A young woman is constantly bombarded with an unrealistic image of what a female body should look like, and this leads to constant emotional stress from trying to attain this false ideal (Levine, 19
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