Eating Disorder

© 2020. Grand Canyon University. All Rights Reserved.

PSY-352 Topic 7 Eating Disorder Case Study

Isabella is a 22-year-old who has a history of physical abuse by her biological father. Her parents divorced when she was 13 years old, and she lived primarily with her mother. She would see her father on the weekends and holidays when he was with extended family. Her mother is remarried, and Isabella likes her stepfather. While she is close to her extended family, there are some generational differences and tension due to family history and her parents’ divorce. This would often bring negativity, leaving Isabella feeling “in the middle” or having to choose sides. Isabella’s mother is petite and has never had issues with weight. As a role model for Isabella, her mother would wear the latest fashion and encourage Isabella to wear the same clothing. Her stepfather always showers her mother with compliments, affection, and gifts, in addition to telling her often that she is “beautiful.” Isabella could not always fit into the same clothing her mother encouraged her to wear because she has struggled with her weight her entire life. Instead of compliments from her mother, she became accustomed to hearing her mother say, “Find something else to wear, that is too tight.” In Isabella’s first year of high school, her mother and stepfather moved to a nearby suburb, forcing Isabella to change schools. She felt under pressure to fit in, and the girls in her high school were into social media, reality television, and the latest trends in clothing. Isabella was shy and started to feel depressed about her new school and not having any close friends. In addition, peers would gossip when she was not around, telling Isabella’s classmates that she is “socially awkward and strange.” When Isabella was younger, she was active in sports such as swimming, soccer, and softball; however, when she entered high school, she put on more weight, less active in physical sports, and more interested in art and music. She had difficulty making friends, and was convinced that if she could lose weight, she would have a boyfriend, and be able to wear the latest fashion of clothing. Consequently, she spent many hours daily thinking about how to lose weight and would look in the mirror at least 20 times per day obsessing over her size and shape. Currently, Isabella does not feel good about herself. She is suffering from anxiety, depression, and self-esteem issues. Isabella often feels angry with herself, family, friends, and peers at college. At the time of her parents’ divorce, she began to experiment with food, sometimes starving herself and other times overindulging. Isabella is starting to eat “comfort food” such as ice cream, chips, and donuts to feel better. She always feels better after indulging in foods her Mother told her she could not eat growing up. Isabella told herself it was okay to eat sugar and unhealthy foods because she would go to the gym and work out until all the calories she consumed were burned off. Sometimes, she would be in the gym for 3 hours.

Isabella noticed that she gained more energy when she worked out at the gym, so when she finished working out, she would eat a high-fat meal and purge the meal within minutes of binging. She noticed that this, in conjunction with using laxatives allowed her to eat what she wanted and not put on weight. Afterwards, however, she felt shame, guilt, depression, and anger. Currently, Isabella’s grades are being affected. No matter how much time she spends studying, her grades continue to fall. She often falls asleep in her classes and she is no longer focused on her friends and family as she was before. Isabella’s family and friends are concerned; however, she does not seem interested in what they think. She resents their attempts to stop or change her behaviors. She withdraws and has started to wear baggy clothes to mask her body shape. She spends a lot of time in front of the mirror examining her body for changes. Isabella has not visited a medical doctor since high school, but agreed to make an appointment, when her mother told her she needed to. Isabella is worried the doctor might find out what she is doing, and she does not want to stop. Isabella feels this is the only way to get the results she wants and to lose weight. Her medical doctor becomes concerned after completing blood work and interviewing Isabella. The doctor is recommending immediate treatment.

This case study is a general example of Bulimia Nervosa in alignment with DSM-5 wording.