The first step a professional will take towards a diagnosis of anorexia is an evaluation of the child’s weight relative to the average for her age. If she consistently maintains a body weight 15% below average, whether by weight loss or failure to gain weight, a clinician will dig deeper, and try to find out if she is extremely troubled by weight gain or the prospect of being fat, even though she’s so thin. He will look for evidence of an unrealistic body image or denial of the severity of her condition. Irregular periods can also be a factor in diagnosis. The diagnosis can be of restricting type (no purging) or binge eating/purging type (she uses self-induced vomiting or misuse of diuretics, laxatives, or enemas to keep her weight down).