ABSTRACT
Emma is 17½ years old with anorexia nervosa, binge-purge subtype.
I first noticed changes in Emma three years ago, when she was 14. We had the vegetarian thing. She was a chubby adolescent and didn't want to be that way. She cried every night. I tried to help by suggesting going for walks and cutting back certain foods. She went to dance classes with two skinny friends and that's when she decided to lose weight. Six months later she weighed 45 kg.
She began avoiding us, became isolated, eating in the lounge room. She would make excuses that she had eaten before dinner or up at the shops with friends in the afternoon and was full. Her mood became incredibly black, many anorexic wishes, and schedules for herself: how many calories; how many kilograms. She was sleeping on her bedroom floor, not in her bed. She went on anorexic websites and had an anorexic pen pal.
Emma's mother