• Psychodynamic theories view AN as a means of avoiding maturation, especially in sexual terms, or as a means of acquiring independence and/or a sense of achievement, through strict control of diet and weight. These attitudes may stem from disturbed family relationships, which are almost always evident in the established case, although they could then be the result of the condition rather than its cause.

• Cultural theories implicate the social and media pressures urging women to be slim and diet-conscious. For example, published fashion photographs are often stretched lengthwise to make the models look even thinner than they really are. Common to both these approaches is the idea that the anorexia develops, in response to family or peer influences, in a young person who lacks a secure sense of self.

• Hormonal imbalance: hypothalamic dysfunction is always present and is probably secondary to the weight loss.

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