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Does the person have a history of repeated dieting
that may alternate with periods of bingeing and/or periods of fasting?
When you express concern that she is already thin, does she respond with
"I just need to lose five more pounds" and then continue to diet and
change her goal weight as she reaches each new mark? Does she exhibit
a fear of gaining weight and becoming fat?
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Is she able to view her body size objectively
when you tell her she is not overweight, or does she respond that she is
fat (she may actually see herself that way) even when everyone around her
tells her that she has gotten too thin or that she is of normal weight?
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Does she frequently refuse to eat meals with
family or friends with the explanation that she ate somewhere else or at
another time? Is there food missing that no one in the family can
explain? Does she eat in secret during the night or when no one is
home?
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Does she seem to eat a great deal of food at
mealtimes without gaining weight? Does she excuse herself from the
table immediately following meals and go into the bathroom? Do you
hear a lot of water running during these trips to the bathroom or find
tell-tale signs of vomiting?
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Have you found empty boxes or bottles of laxatives,
diuretics, diet pills, or syrup of ipecac? Are there frequent complaints
of stomachaches, constipation and/or other gastrointestinal disturbances?
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Does she profess to exercise in order to stay
fit, but spend several hours a day doing aerobics, running, calisthenics
and other forms of exercise to the exclusion of other activities?
Does she panic when she cannot fit her exercise routine into her daily
schedule?
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Have you noticed frequent mood swings, irritability,
emotional instability or depression? Has she expressed a desire
to die or kill herself?
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Have there been menstrual irregularities or a
cessation of her menses? Does she complain of shortness of breath,
muscle cramps, frequent sore throats or rapid heartbeat? Does she
seem to be having more frequent colds and infections? Have you noticed
swelling in her parotid glands (salivary glands, just below and in front
of each ear)?
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Is she experiencing more frequent dental problems,
such as an increase in cavities, periodontal problems or an erosion of
her dental enamel?
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Does she always feel cold and wear many layers
of clothes to cover up her body shape? Have you noticed a fine downy
hair beginning to grow on her body?
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Is she a perfectionist and a high achiever who
never seems to feel good about herself or her achievements? Is she
experiencing difficulty in maintaining concentration and making decisions?
Is she frequently complaining of not being able to sleep and feeling tired
and lethargic?
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Is she experiencing problems with her interpersonal
relationships and beginning to withdraw from social activities and friends?
These warning signs associated with eating
disorders are only meant to make you aware of the more typical symptoms
and behaviors. If you suspect that someone you know may have an eating
disorder, it is important that you address the topic with her in
a caring, non-judgmental manner, then recommend a thorough psychological
and medical assessment by professionals who have had training and experience
in working with these potentially life-threatening problems.
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