Case Study -

Tania

Tania is a 20 year old woman who is studying to be a lawyer. She lives in the city area with her parents who are both busy doctors, and her younger brother Dylan, who s h e describes as outgoing and popular and who is also studying law. Tania describes the family as very close and loving despite both parents working long hours. Tania began preparing meals for the family 12 months ago but now refuses to eat with them. S he p ref er s to t a ke he r me a ls i nto he r be dr oom a nd cla im s tha t she i s s tud yin g whi le sh e eat s . Her weight has dropped from 66kg to 40kg in the past year. She is 164cm tall.

The parents are very concerned about Tania’s weight loss, her food restrictions and what they describe as excessive exercising over the last six months. They point out that she has been dieting off and on since she was 14 years old but this is the first time that they have been troubled by such “severe weight loss”. The parents report that Tania had been an exceptional child who achieved all of her developmental milestones in good time. Tania denies vomiting or laxative abuse but believes she needs to continue losing weight as she is “fat”. She believes her parents are making a fuss over nothing and she cannot understand their concerns. She believes they are interfering in her life and simply can’t accept that she is now an independent adult. This is causing increasing disharmony and arguments between the family members. Tania appears very thin and looks much younger than her 20 years. She has dark circles under her eyes, obscured initially by wearing dark sunglasses into the room. She has soft downy hair apparent on her arms otherwise there are no remarkable distinguishing marks, scars or tattoos apparent. She wears a little makeup that is appropriately applied and has her long brown hair pulled back into a pony tail. She is wearing gym wear with a loose and baggy sweat shirt on top. Tania reports that she does not smoke cigarettes or use drugs. She has not consumed alcohol for more than a year because “they are empty calories”. She is not prescribed any medications but says she takes a multivitamin and spirulina tablets daily. She has a few close friends and some acquaintances at uni. She has not gone out with her friends in recent months because she says she has felt under pressure with her studies.

Tania describes her childhood as “wonderful” and without any traumatic events. She says she has a loving family and felt well supported until recently. She did well at school and has been doing exceptionally well at uni. She is completing the second year of Law and currently has a GPA of 6. However, she admits that she has been having difficulty concentrating recently and has had to apply for assignment extensions. Tania does not have a history of mental illness or mental health concerns. There is no family history of mental illness either. She is usually physically well but she has been seen by the family GP over the last two months for gastrointestinal disturbances (feeling bloated and constipated) and feeling faint on some occasions. She was advised to eat more fiber and to have an ECG.