AGNES H, VV HITAKER, MD norectic and bulimic symptoms may be diffi-cult to detect in the pediatric ambulatory care setting. The girl with early symptoms of anorexia nervosa usually does not regard her wish to be thin or her relentless dieting as problematic." The girl with symptoms of bulimia is likely to be ashamed and secretive about her binging and purging" For these very different reasons, neither girl is likely to volunteer descriptions of her eating behavior and may minimize the severity of any behavior elicited on interview. She may point to similar weight control practices by her peers as evidence that the behavior is normal and express more concern over menstrual irregularity and depressive symptoms, which may be the presenting complaint (s). If she is not substantially underweight and the physical exam does not reveal stigmata of chronic anorexia nervosa or bulimia,” then her symptoms may escape attention. In this situation, knowledge derived from recent