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Martha Revere had not seen her friend Kelly Franklin for several years, though they had kept in touch across country via telephone and e-mail. Now, Martha was going to Los Angeles for a convention and couldn't wait to see Kelly.

They made plans to meet for dinner at a trendy California restaurant whose specialty was a giant salad bar. The first thing Martha noticed about Kelly was how thin she was. She reminded herself, however, that several years had passed, and that people change.

During the meal she watched with some surprise as Kelly consumed a huge amount of salad. Kelly must have gone back to the salad bar ten times. Each time, she filled her plate high with food, finished it, and excused herself to go to the rest room. Martha didn't think much about it. She kiddingly mentioned how much Kelly ate, and then let the subject drop.

On the way back to her hotel, however, Martha thought about the dinner more carefully. What had Kelly been doing in the rest room? Could she have been throwing up her food? Isn't that bulimia?

Bulimia (bulimia nervosa) is a psychiatric illness and an eating disorder, present in some 2 million people, mostly women. It involves binge eating and then purging the eaten food by vomiting, using laxatives, or through serious fasting. The bingeing and purging are often followed by guilt and shame, and the sufferer often feels out of control, understanding that the behavior is not normal. Bulimia is very dangerous to one's health, and can also include depression. It is estimated that 5 percent of women have suffered from this condition.

Martha didn't know what to do. Hadn't Kelly's husband and son noticed Kelly's unusual behavior?

1. What should Martha do? List three things.
2. Whose responsibility is it to stop someone who is self-destructive?
3. If her family approached Kelly and asked her to stop, and she said no, could they force her into a treatment program? Why or why not?
4. Bulimia and anorexia (not eating) are eating disorders found almost exclusively in women. Why do you think this is so?