Anorexia nervosa is characterised by a disordered body image, obsessive fear of obesity, and food avoidance, leading to weight loss that can be fatal (Fig. 13.25). Even after weight regain occurs, onset of menses and pubertal development may not occur for years. While uncomplicated weight loss can certainly lead to arrested puberty, amenorrhoea may occur even before the weight loss is severe in this condition, due to psychological factors inherent in anorexia nervosa. Psychological stress in other situations is also implicated in irregular menstruation.
