Polycystic ovarian disease (PCOD) is common endocrine disorder. Majority of young females are affected. Insulin resistance along with dysfunction of hypothalamopituitoryadrenal axis is a key etiological factor in development of all manifestations of PCOD. They present with irregular menses, infertility, obesity,

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Anorexia nervosa is characterised by disturbances of eating behaviour. It has refusal to maintain a minimally normal body weight. Young women are commonly involved who become overly concerned with body shape and weight and are underweight. Its binge eating disorder characterised by repeated episodes of binge eating and self induced vomiting. Aetiology is unknown but combinations of psychological biological and cultural risk factors are involved. Sexual or physical abuse mood disturbances are in anorexia nervosa. Numerous physiologic disturbances in variety of neurotransmitter systems causing neurochemical, metabolic and hormonal changes may play role in de velopment anorexia nervosa. C/f anorexia nervosa typically begins in mid to late adolescence early puberty stressful life event may be associated. Despite being under weight patients with anorexia nervosa are irrationally afraid of weight gain and have distortion of body image. They are binge eating and socially withdrawn and engaged busy in work or study and exercise. Physical-they complain of cold intolerance constipation. They have bradycardia, hypotension and mild hypothermia. Self downy hair growth (lanugo) present. Salivary gland enlargement so face appears surprisingly full in contrast to generalised wasting. Lab abnormalities-mild normochronic normocytic anaemia. Dehydration may cause raised BUN and serum creatinine. Elevated liver enzymes. Bsl often low. Hypokalemia, hyponitremia is common. Endocrine abnormalities-low oestrogen and testosterone Low LH and FSH, Low thyroxine, Normal TSH, CORTOSOL increases. CVS-reduces cardiac output,bradycardia, non specific ST-T changes. Prolonged QT may develop into arrhythmias Diagnosis-American psychiatric association DSM-5 criteria. 2. Case report A 19 year old male patient came to the OPD with H/O vomiting, Excessive eating for last 3years. Now patient p/w swelling all over the body, generalised weakness breathlessness and constipation for last 6 months. HOPI-Pt was apparently alright 3 years back when he c/o increased appetite and over-eating which was followed by abdominal discomfort and feeling of overweight.To seek relief he induced vomiting by inserting fingers in his mouth and assumption that by doing this losing the weight. He had h/o staying away from home and family for education before the onset of symptoms. H/O Edema H/O weight loss (~20kg) H/O Constipation since last 6months.