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Anorexia nervosa has been viewed here as a defensive biologically regressed posture pivoting around the events of puberty and reflecting primary gain. There is rarely any secondary gain - on the contrary life is miserable though still usually possible. The disorder is rooted in psychobiological mechanisms within the individual and in individual and family psychopathology concerning the meaning of body weight and fatness, evoked by the proband's adolescence and its maturational challenges. There are many identifiable 'risk factors' that can influence the evolution of the condition. Treatment requires a combined behavioural and psychotherapeutic approach involving special medical and nursing and psychotherapeutic skills.