Anorexia and bulimia seem to be getting much more common in boys, men, and women of all ages and socioeconomic backgrounds; they are also becoming more common in racial groups previously thought to be impervious to the problem.
I guess that all figures into my approach because once I start hearing the imagination land stuff (that's my new phrase now I guess) I tend to tune out or start laughing at it like, "Haha, you guys really believe there is a heaven. "