Rabia: "nothing is wrong"

The case (fictional)

Rabia is 15 and lives in Lahore. She is a top student at a private school and is preparing for her O levels. Over eight months she has lost about nine kilograms; she now weighs 38 kg and is 160 cm tall.

She eats only salad and boiled chicken, skips family meals saying she ate at school, runs on the treadmill late at night and weighs herself several times a day. Her periods stopped five months ago. She says she feels fat around her stomach and needs "to be disciplined". Her mother has noticed cold hands, hair falling out, and dizziness when Rabia stands up quickly.

A year ago, at a cousin's wedding, several relatives remarked that Rabia had "become healthy". She follows "what I eat in a day" videos online. She is a perfectionist with few close friends.

Her father thinks this is a phase and that she should simply be told to eat. Her mother arranged this appointment through the family doctor. Rabia says she has come only "to make Ammi stop crying" and that nothing is wrong. There is no known history of self-harm.