This interview should consist of open-ended questions to make Sara feel like she is able to express herself in the way she sees fit. To help a client, a clinician must be able to build a rapport with a patient and creating an open conversation that allows Sara to express herself will help her let go of the refrigerator and have someone to confide in. Additionally, this interview should include questions about how Sara feels personally, how she feels about her body image, any experiences or trauma she may have had regarding her body image and size, and her perceptions. on the importance of being “skinny”. This interview will be the final determining factor if Sara suffers from bulimia nervosa. Bulimia nervosa is linked to psychosis, so more questions should be asked to see if Sara feels mentally defective and blames others for her defects (Miotto et al., 2010). A test of Sara's DNA would also be helpful in this case. Sara states that she has always been big, in a bigger sense, but given her obsession with bingeing and purging and her possible weight which has not been revealed, a simple thyroid test could determine if weight problems may be thyroid and/or due to a poor lifestyle. habits such as overeating. Current research has been done on the link between genetics and bulimia nervosa. Lewin and Carter (2014) state that neurotrophic factors are a group of proteins that complement growth and