Introduction
Her family background is not clear but Brandy describes her mother as severely overweight and as someone who is always on a diet. As she was growing up, she remembers how her father always made harsh comments about her mother’s weight. In addition, there were times when Brandy recalled her father giving her looks that had sexual overtones and how they made her feel uncomfortable. However, she states that her father has never touched her in an inappropriate manner.
Symptoms and Diagnosis
Preliminary diagnosis would indicate Brandy’s condition to be Bulimia Nervosa. This is a potentially life-threatening eating disorder that is characterized by the individual secretly binging, that is eating huge amounts of food and then purging or attempting to get rid of the excessive calories in an unhealthy manner (Mayo Clinic, 2012).
One of the DSM 5 criteria for this disorder is “Eating, in a discrete period of time, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances” (T.H.E. Center for Disordered Eating, n.d.). This is evident in Brandy’s behavior in that she admits to eating a couple of candy bars and two large gourmet chocolate chip cookies on a bad day. This also coincides with the second criterion, which is “a sense of lack of control over eating during the episode” (T.H.E. Center for Disordered Eating, n.d.). Another criterion is a recurrent inappropriate behavior in order to prevent weight gain. These behaviors include excessive exercise, fasting, diuretics or other medications, misuse of laxatives, and self-induced vomiting. The DSM 5 criteria also indicate that this behavior must be occurring at least once a week for three months. In the case of Brandy, it is indicated that she has a hidden habit of purging and that this has been going on for two years.
As a final criterion, “self-evaluation is unduly influenced by body shape and weight” (T.H.E. Center for Disordered Eating, n.d.). At 5’5” and 116 lbs, Brandy has a BMI of 19.3, which makes her a little underweight. However, she believes that she has a weight problem, which makes her purge and which makes her isolate herself.
Differential Diagnosis
Another possible diagnosis or additional diagnosis is Anorexia Nervosa. This is a life-threatening disease that is characterized by a negative body image, excessive weight loss, and self-starvation (The Center for Eating Disorders, n.d.).
One of the DS 5 criteria for this disorder is “Restriction of energy intake relative to requirement” (The Center for Eating Disorders, n.d.), which leads to a considerably low body weight in the context of physical health, developmental trajectory, sex, and age (The Center for Eating Disorders, n.d). Brandy indicates that on a good day, she would eat a breakfast of dry toast and juice, a lunch of turkey or dry tuna on diet bread, and a low fat frozen meal at dinnertime. However, given that she’s underweight, she could be eating more.
Another criterion is the “intense fear of gaining weight or of becoming fat” (The Center for Eating Disorders, n.d), which also includes behavior that prevents weight gain even when the individual’s body weight is already significantly low (The Center for Eating Disorders, n.d ).The Center for Eating Disorders, n.d). In the case of Brandy, she is already underweight and yet she feels that she has a weight problem. This is also consistent with the last criterion for this disorder, which is the “disturbance in the way in which one's body weight or shape is experienced” (The Center for Eating Disorders, n.d). Brandy feels that she has a weight problem, which makes her friends avoid her. She also feels that nothing will change her weight.
Treatment
Prognosis
References
Mayo Clinic. (:2015). Bulimia nervosa. Retrieved from http://www.mayoclinic.org/diseases-conditions/bulimia/basics/definition/con-20033050
