An adolescent with low and reducing body weight and amenorrhoea

Chloe, aged 16 years, is small for her age and looks underweight. She is dressed in baggy clothes and has been brought to see you by her mother because of her weight loss. They moved to your area several weeks ago and Chloe has for the past sixmonths been under the intermittent care of a psychologist and a nutritionist specialising in eating disorders.

Her mother comes into the consultation with Chloe but says it is only to fill you in on some details. She does not know how much weight Chloe has lost but says this has been a problem for over a year, and that Chloe’s old school friends used to say she was ‘chunky’. Chloe says she is just trying to become ‘healthy’ but her mother is concerned that Chloe has been exercising more than she should for some time and that, since the move, she is deliberately not eating carbohydrates. Her mother is also concerned that Chloe’s periods ceased many months ago. Her mother then leaves the room.