a 10:1 female-to-male ratio. 
Development and Course
Anorexia nervosa commonly begins during adolescence or young adulthood. It rarely be-
gins before puberty or after age 40, but cases of both early and late onset have been de-
scribed. The onset of this disorder is often a ssociated with a stressful life event, such as
leaving home for college. The course and outcom e of anorexia nervosa are highly variable.
Younger individuals may manifest atypical features, including denying “fear of fat.” Older