I believe that it is the way you percieve your weight and your relationship with food. I have kept mine well hidden. If I have to eat in front of others I eat lots, but in isolation I dont eat never. At home if my husband is working I normally forget to have breakfest and lunch. I eat my evening meal if he is home to stop him worrying. I am now seeing a dietician who I havnt seen since christmas time I have put on weight and am now restricting to lose it. My psychiatrist is like you need to eat well etc,etc. At the moment I feel overweight (I am only just in the acceptable weight fo my height ) I thought I could get over this but it is hard and I probably need more help with my ED than I really want to admit.