Four adolescent girls were referred for psychiatric assessment because of suspected anorexia nervosa. Although all of them had lost at least 15% of their body weight, investigation showed that they did not meet the criteria for anorexia nervosa. In all cases, refusal to eat resulted from fear of vomiting following a viral illness and not from a desire to lose weight. Their family configurations and personal histories showed many similarities, including constricted range of affect and a notable lack of anger. With counseling and, in one case, psychotropic medication, the patients recovered promptly.
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GarfinkelP.E., KaplanA.S., GarnerD.M.The differentiation of vomiting/weight loss as a conversion disorder from anorexia nervosa.Am J Psychiatry1983; 140: 1019–1022.
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GarfinkelP.E., GarnerD.M., KaplanA.S.Differential diagnosis of emotional disorders that cause weight loss.Can Med Assoc J1983; 129: 939–945.
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SteinhauerP.D., Rae-GrantQ.Psychological problems of the child in the family, second edition.New York: Basic Books, Inc.,1983: 230–257.
