Differential diagnosis

• chronic debilitating physical disease such as cancer, pituitary failure, Addison's disease, TB, or AIDS

• psychiatric illness: depression, schizophrenia, and obsessive-compulsive disorder

• hypothalamic lesions.

Investigations will sometimes be necessary to rule out these other conditions; however, there is an important clinical pointer in that there will be no body image disturbance: only in anorexia will the patient, in actual fact seriously underweight, have an inappropriate belief of being overweight.

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