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As a high school student, Jan received many academic and extracurricular awards and graduated third in a class of 150. While in high school, she was active as an actress and enjoyed participating on the debate team. Until Jan got into junior high school, she was overweight. At that time, she weighed 170 pounds and stood 5'6" tall. She went on a very restrictive diet and in one year lost 62 pounds which brought her down to her present 108 pounds. Two years after the weight loss, at age 16, she started the binging and vomiting routine. She binges on sweets, ice cream, cookies, peanut butter, and candy as often asfour times a day. She says that she has no feelings involved with the binging and does it as naturally as someone else might wash their hands. She has been binging and purging now for 4 years, vomiting after every meal. In the first interview, Jan expressed concern about the bulimia, about a feeling she had regarding problems in maintaining intimate relationships, and about being stuck in making progress in school work. She said she doesn't know who she is, she is working too hard to try to anticipate the needs of others, and she loses herself in the process.