M05 Writing Case Study 1 - Brandy
M05 Writing Case Study 1 - Brandy
M05 Writing Case Study 1 - Brandy
Maximo Green
Brandy is a 19-year-old Caucasian female who stands at 5’5” and weighs 116 lbs.
Brandy is a patient who is insecure about her weight, and how she thinks others may perceive
her. She believes that she is fat, and is certain the other people view her as disgusting. Her
insecurity has led her to follow very strict diets and the habit of throwing up after eating to lose
weight. It is also of note that she has isolated herself from her friendships and she has been
depressed since she believes the others won’t like her because of her weight. The patient presents
symptoms and signs such as cessation of menstrual periods, misuse of laxative or purging, binge
The patient has said that she experiences what seems to be a state of constant depression
which has come about due to her negative views about her own weight. The patient's way of
living has also interfered with her social life, mainly with her friends. Brandy has mentioned that
whenever her friends express concern about her eating habits, she tends to become agitated, and
then distances herself from her friends. This isolation may also be a main factor in her constant
depression. Anxiety disorders and mood disorders are characteristic symptoms of anorexia
nervosa and bulimia nervosa. Brandy has also developed dental issues, which are a result of her
purging.
iron, and especially calcium. Stomach acid permanently erodes the protective enamel of the
teeth, which can ultimately lead to severe tooth sensitivity when it comes to eating food. The
stomach acid will then break away at the calcium in the teeth, causing tooth discoloration, and
then decay (Bhandari, 2022). The patient has also developed a cessation with her menstrual
periods (amenorrhea).
This is a warning sign that the body is not in proper function due to little or no nutrition,
however it is not a constant factor since it does not happen in all cases. These symptoms are
present in eating disorders such as anorexia nervosa and bulimia nervosa (Barlow, 2016). Also,
patients that could have bulimia nervosa tend to be ashamed of their eating problems and attempt
to hide them. According to the DSM-5 official and diagnostic criteria, the patient presents a clear
Differential Diagnosis
Even though the patient shows symptoms present in bulimia nervosa, there is a possibility
that she also suffers from anorexia nervosa. Both disorders carry similar symptoms, and it's
entirely possible that a patient can show symptoms of both disorders.The DSM-5 Disorder
criteria of anorexia nervosa are symptoms such as depression, anxiety, and intense panic
(Barlow, 2016). Another similar symptom is the cessation of menstrual periods. According to the
clinical history of the patient, Brandy has also explained amenorrhea to be within the list of
physical symptoms.
If we were to make this diagnosis, we’d have to consider predominant symptoms in said
patient to diagnose the possibility of an additional diagnosis, seeing as there are subtypes to
anorexia nervosa. The DSM-5 has specified anorexia nervosa in two subtypes: the restricting
type and binge-eating–purging type. For example, Brandy has had negative thoughts about her
appearance, and believes that she is overweight. This is a shared symptom between bulimia, and
thus could fit in as an additional diagnosis if needed. According to the symptoms documented,
Brandy could suffer from the subtype of binge-eating–purging type (Bulimia Nervosa, 2018).
This additional diagnosis is strengthened by the fact that the patient has been practicing the act of
Treating bulimia is something that falls under both conventional medicine, and
psychology, because it is a disorder that not only attacks the body, but the mind as well.
guidelines suggest that a treatment consisting of both psychotherapy and nutritional counseling is
administered. (Harvard Health Publishing, 2009). CBT (cognitive behavioral therapy) can be
effective when it comes to talking about behavior, while learning to solve problems and manage
a patient's symptoms. Another option is an eating disorder clinic, which is specifically designed
Weekly individual and group programs are good steps that one can take to help treat the
disorder. Nutritional therapy has also proven very effective when it comes to battling an eating
disorder. With nutrition therapy, a registered dietitian will help you develop meal plans, find
what’s best to eat and what to avoid, and create better feelings about food in general. When it
antidepressant Prozac is the only bulimia nervosa medication approved by the Food and Drug
Prognosis
When it comes to the patient, it is safe to say that a treatment that includes both psychotherapy,
legitimate nutritional counseling, and medication can show improvement over a period of time.
Despite her views about her weight, a weight of 116 lbs at 5’5” is considered ideal on the BMI
Barlow D. H., Durand M. V., & Hofmann S. G. (2016). Essentials of Abnormal Psychology (8th
ed.). Cengage.
https://www.webmd.com/mental-health/eating-disorders/bulimia-nervosa/bulimia-effects-body
https://www.health.harvard.edu/newsletter_article/Treating-bulimia-nervosa.