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Problem: At age 16, Sarah suddenly became self-conscious about her body when her peers teased her about being overweight. She began exercising to an aerobics video for an hour each day and found that she had success in losing weight; this was the beginning of her obsession to be thin. Next, Sarah turned to eating less food to lose even more weight and began eliminating certain foods from her diet, such as candy and meat. She increased her water and vegetable intake and chewed sugarless gum to curb her appetite. Once she began dieting, it was impossible for her to stop. She enjoyed having a high degree of self-control over her body. Still, Sarah was literally obsessed with food, even staring at others while they were eating a meal. She occasionally cooked large meals and then refused to eat all but a few bites. By the time Sarah was 19 years old and 5 feet 6 inches tall, her weight had dropped from 150 to 105 pounds. Her family was concerned about her weight status, demanding that she go to a physician for an evaluation. Sarah was not happy about this idea because she worried the doctors would force her to eat and gain back unwanted weight, but she believed that her family would stop pestering her if she went. Sarah did not think she had a problem; she thought she was still grotesquely overweight. She did notice, however, that she always felt cold and was concerned that she had not menstruated in a year.
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