Ruth'sfamily is typical of those reported by women with bulimia. She was the second child of four, with an older brother, a younger sister, and a younger brother. Her father was a civil engineer and her mother was a homemaker. From the time she was little she remembers that the assumption was that she would go to college. Her brothers were both involved in athletic competition, and Ruth competed on the swim team. Strong competition existed, especially between her and her older brother, to excel in school work.