Case Study - Eating Disorders and Nutritional Needs

Although eating disorders have been around formindlessly all day long or can be a huge meal that
as long as there have been humans, theencompasses a full day's worth of calories in a
extensive research on them has existed for onlysingle sitting. If this happens continually, the
about thirty years. It is known that there is ametabolism will slow and eventually stop working
distinct and definitive correlation between aaltogether, leading to weight gain. Because stress
diagnosis of depression in the early to late teenis a major factor for binge eating, the weight gain
years and the development of eating disorders.alone is enough to trigger another binge episode,
The three eating disorders that are mostleading to a vicious cycle of stress, binging, stress,
commonly studied and/or diagnosed are anorexiabinging, etc.
nervosa, bulimia and binge eating.Other risk factors for binge eating include:
The debate over whether or not obesity should- Stressful situations
be considered an eating disorder continues; while it- Specific upsetting thoughts
is now considered a disease in and of itself,- Feeling guilty about something one has done
obesity may also become classified as an eating- Feeling socially excluded or isolated
disorder and treated as both a psychological- Worries about problems, the future or
disorder in addition to being a physical problem. Forresponsibilities
now, it is a medical disorder, as well as a risk- Boredom
factor for a number of serious conditions, but notRecovery Possibilities
an eating disorder.After five to ten years, half of those who were
Anorexia Nervosatreated for bulimia had recovered, 30% had
Anorexia is diagnosed when a personrelapsed at least once and 20% were still
(predominantly females) refuses to allow her bodydiagnostically considered bulimic. Those who had
to be over 85% of the weight that is normal fordouble diagnoses, specifically substance abuse and
her height. Psychologically, the person who isbulimia, were the least likely to have full and
diagnosed with anorexia is obsessed with weightmeaningful recoveries.
and body image and rigidly monitors everythingThree Eating Disorders, Three Women
that goes into his or her mouth at everyElaine was diagnosed with anorexia nervosa at the
moment, even counting out the calories in theage of 20 and has been in counseling for about a
toothpaste that they might use that day. Theyear. She has slowly regained some of her
DSM-IV-TR, the diagnostic tool for the mentalweight, but has relapsed several times during this
health field, has these criteria for diagnosingtime period. Elaine has spent several months in the
anorexia nervosa:hospital to be given IV fluids and has even had a
- Unable or unwilling to keep body weight at orscare with her heart. After several months of
above 85% of the normal levelrenewed counseling efforts, she is making some
- Intense fear of gaining weight or, moreslow progress. At this point, she is eating only
importantly, of becoming fat when they aresmall meals, mostly liquids and semi-soft meals. As
obviously and dangerously underweightpart of a contract that Elaine signed with her
- Obsession with weight and body image to thecounselor, she is only allowed to exercise at a
point of detriment to the self esteemslow to moderate pace no more than fifteen
- The absence of three menstrual cycles in a rowminutes per day and must have something that
Some anorexics will spend hours exercising, evencounts as a small meal at least every two hours.
when they are exhausted and their muscles areElaine has agreed to add a liquid protein shot as
hurting. They may not be sleeping correctly andone of her mini meals, giving her 25 grams of
many of them will have heart problems as ahighly digestible protein and all of the vitamin C
result of their extreme weight loss.that she needs every day. She is pleased with the
Warning Signs:fruit-based flavors and is progressing, slowly and
- Preoccupation with food, eating or dietingcarefully.
- Compulsive or excessive exercisingEvelyn, on the other hand, was diagnosed with
- Negative self esteembulimia. Her method of choice is to binge,
- Withdrawal from friends and family, especially ifconsuming up to 5000 calories in a single sitting at
the social event will involve foodtimes, and then forcing herself to vomit. At times
- A complete loss of menstruationwhen she is unable to vomit, she consumes a
- Intolerance to cold temperaturesdouble dose of laxatives after an hour of jogging.
BulimiaShe has destroyed the enamel on her teeth from
The bulimic will eat, either a small amount or athe constant vomiting; she no longer goes to the
large amount, and then compensate for thebathroom normally because she has developed a
calories that they have consumed by eitherdependence on the laxatives. She finds herself
exercising too much, taking laxatives or makingplotting her next binge, including what she will eat
themselves vomit. The typical cycle is binge andand when. She always wakes the next day
purge, where the bulimic will eat huge amounts ofvowing not to do it again, but by mid-afternoon,
food, often more than a full day's worth ofshe is thinking of the binge that she will have next.
calories at a single sitting, and then will vomitPart of her counseling program will be to start
immediately. If vomiting becomes problematic,eating healthy meals. She will also be treated for
laxatives might be used.the health conditions that she has brought on
Diagnostic Criteriaherself, including the damage that she has done to
- Consumption of large amounts of food, or aher intestinal tract. Using the liquid protein shot will
total lack of control during the eating cyclehelp her to keep her metabolism high and keep
- Recurrent behavior of trying to compensate forfrom being hungry throughout the day. Evelyn will
the eating/overeating.also keep a diary of her trigger foods so that
- Binge eating and compensatory behaviors atwhenever she feels that she might binge, she can
least twice a week for at least a three monthfind an alternative behavior.
periodBecca is 43, newly single and a binge eater. She
- Self evaluation that is overly influenced byhas always been a little overweight, however, in
weight and body shapethe last few years she has really picked up
- Bulimic behavior that does not occur only duringweight - whenever she has had a bad day or
episodes of anorexiafeels lonely, she turns to food for comfort. The
(DSM-IV-TR)food has been increasing in amount and the binges
Like anorexia, the presence of depression tendsare coming more often as she spirals out of
to increase the likelihood of developing an eatingcontrol. Her doctor tells her that she is borderline
disorder. The group that is most affected by thisfor hypertension and diabetes and that her
eating disorder is adolescent Caucasian femalescholesterol is completely out of control. She starts
who are also more likely to abuse diet pills anda new, healthy dieting plan and starts walking in
laxatives.her neighborhood once a day. To keep herself
Binge Eatingfrom feeling hungry, she uses the 25-gram liquid
Binging is different from the other two eatingprotein shot as a between-meal snack. The
disorders in that there is no effort to lose weight,protein keeps her from feeling hungry and she
no obsessive compulsion to exercise and nogets additional vitamins from the small shot as
supreme need to exercise after eating. The bingewell.
can be compulsive snacking that happens