Qamar is a 16-year-old female presenting to your office with her mother. Her mother indicates she is very worried about Qamar as she has lost 30 pounds over the last 3 months. Qamar herself is not concerned and says her mom is too controlling and should mind her own business. Qamar reports she just wanted to "get healthy" and there is no reason to be worried. Her mother reports that Qamar has been more active lately, running on their treadmill at home for at least an hour every day. Her mother also believes that she has heard Qamar vomiting in the bathroom, but when questioned, Qamar adamantly denies this. Her mother also has noted that Qamar has dramatically cut back on her intake in terms of the amount, but also that she will avoid certain foods like chips and ice cream completely. She used to like these foods. When she does eat, Qamar only picks at her food, cutting it into small pieces and pushing it around on her plate. She has also started to become concerned about contamination of food, and states that the food is "bad". She has started washing her hands repeatedly before and after eating. Qamar does admit that she has had trouble sleeping lately, and wakes up early in the morning, but she states her mood is good. Her mother feels her mood has been irritable and that she has been withdrawing from her family and friends. Qamar's mother also reports that she has not had a menstrual period in over 4 months.