Abstract Let us start with a problem. We are bombarded daily by images of emaciated supermodels and other media images of thin women; unsurprisingly, weight and shape concerns, and dieting are the norm among young women. This preoccupation with appearance provides a fertile breeding ground for eating disorders, in particular for bulimia nervosa (British Medical Association 2000). The incidence of bulimia nervosa presenting to primary care has recently tripled (Turnbull et al. 1996), whereas that of anorexia nervosa has remained stable. The average general practitioner in the UK will have about two patients with anorexia nervosa and about 18 patients with bulimia nervosa on their list, but that does not mean that he or she will necessarily be aware of these cases. In primary care-based surveys of eating disorders the GP was not aware of the diagnosis in up to 50% of cases discovered by the researcher (King 1989; Whitehouse et al. 1992). Yet individuals with eating disorders consulted their general practitioner significantly more frequently over the 5 years prior to the diagnosis of the eating disorder than control subjects (Ogg et al. 1997).