B.Intense fear of gaining weight or becoming fat, .

             even though underweight. .

             C.Disturbance in the way in which one' body weight .

             or shape is experienced, undue influence of body .

             weight or shape on self-evaluation, or denial of the .

             seriousness of the current low body weight. .

             D.In postmenarcheal females, amenorrhea, i.e., the .

             absence of at least three consecutive menstrual cycles.

             (Johnson 1996).

             A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration (Johnson 1996).

             During the current episode of anorexia nervosa, the individual has regularly engaged in binge-eating or purging behavior, i.e., self-induced vomiting or the misuse of laxatives, diuretics or enemas (Johnson 1996). Individuals with anorexia nervosa have a disturbed perception of their own weight and body- shape (Johnson 1996). Some individuals perceive themselves as overweight even though they are emaciated, while other perceive only certain parts of their body as fat (Johnson 1996). .

             Although anorexia nervosa typically develops during adolescence, late-onset disease may emerge in adulthood after successful pregnancies and child rearing (Tinker 1989). When a patient's weight falls below 70 percent of ideal body weight, hospitalization and use of a nasogastric tube and hyperalimentation may be necessary (Tinker 1989). Many adults who have anorexia nervosa resist an impatient psychiatric admission, however they can be managed on an outpatient basis by a team consisting of the family physician, a psychotherapist and a nutritionist (Tinker 1989). With careful attention to fundamental concepts of care, interventional skills and positive attitudes toward patient care and recovery, most patients with eating disorders can be expected to do well, however the expectation that every patient will develop entirely 'normal' behaviors and interpersonal relationships may be unrealistic (Tinker 1989).