Most eating disorders, especially bulimia, are as much about control as about body image. Usually the person is unhappy in other dimensions of their life.
Freudian theory applied to this suggests that it may be influenced by a negative relationship with the mother figure. I read a pretty convincing analysis about this and a lot of it could be condensed to the feeling of being generally not good enough or accepted.
Help is good thing though.
I believe 33girl hit the nail on the head with her analysis of the liability and the analogy with the restaraunt.
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