It's always wise to rule out any medical concerns either causing the difficulty of keeping down an average sized meal or medical complications of vomiting (i.e., low potassium, acid reflex, stomach problems, tear in esophagus, etc.) In addtition, stress, anxiety and depression could make it difficult to take in much food. In individuals with anorexia, these emotions can be shut down by eating less and less. They also could make it difficult to eat. In any event, your friend needs a medical exam with blood work and psychiatric/psycholigical evaluation. There is hope. In having a clear diagnosis, treatment is available. If stress, anxiety and/or depression are part of her dynamics. Stress management tools, cognitive behavioral therapy, dialectical behavior therapy and/or medication could help. Anorexia can be life threatening. To learn more about eating disorders, visit the bella vita website. There is also a free survey to screen for an eating disorder. Best, Dr Patricia Pitts
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