subjective components (Bane & McAuley, 1998). The final criterion is amenorrhea in

postmenarcheal women. Amenorrhea is the absence of three or more consecutive

menstrual periods (Highet, 1989).

 There are two types of anorexia: binge-eating purging type and restricting-type.

Binge- eating purging type anorexics engage in binge eating or purging behavior during

an episode of anorexia, while restricting-type anorexics do not engage in this behavior

(APA, 1994). Purging behaviors include self-induced vomiting, fasting, and misuse of

laxatives, diuretics, and enemas.

 It is estimated that 0.2% to 1.3% of the United States population suffers from

anorexia nervosa, and 90% of the sufferers are women (APA, 1994). Caucasians are more

at risk than ethnic minorities (Cash & Henry, 1995). Also, the more affluent are at greater

risk for developing anorexia nervosa than those that are less affluent (Allaz, Bernstein,

Rouget, Archinard, & Morabia, 1998). Adolescents and young adults are also a high-risk

group (APA). Certain personality characteristics are risk factors for anorexia nervosa.

These include a need for approval, conscientiousness, high personal expectations,

perfectionism, obsessionality, insecurity, self-denial, and being deferential to others

(Garfinkle & Garner, 1982; Strober, 1986).

 Most medical complications of anorexia nervosa are a direct result of weight loss,

and these complications often return to normal with weight restoration (Costin, 1999).

Anorexics have brittle nails, thinning hair, and yellow-tinged skin due to dehydration,

nutrient deficiencies, and poor liver function (Walsh, Wheat, & Freund, 2000). They also

experience a fine downy growth of hair on the face, back, and arms, known as lanugo.

This hair aids in insulation (Rock, 1999). More serious complications of anorexia affect