Eating Disorder Evaluation and Model Application

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Igor Cunha Lima


From a psychotherapeutic perspective, the study sought to discern the effectiveness of some of the interventions that could be applied to Kimi, as well as the efficacy of diagnostic tools. Based on the case description of Kimi, one of the central issues accounting for her distress or danger entails separation from her husband. Notably, such a state of separation causes sadness, anger, and emotional struggle. The case description indicates that Kimi’s coping strategy, when faced with stressful moments such as divorce and the struggle surrounding her state of self-consciousness, involves eating a lot but again resorts to throwing up to avoid gaining weight, actions that tend to relieve her the distress. From the current literature, possible conditions or eating disorders with which Kimi could be associated include binge-eating disorder, bulimia nervosa, and anorexia nervosa. In this case, the assessment tool that is deemed worthy to apply to the case of Kimi involves the Eating Disorders Symptoms Severity Scale. Based on this scale, Kimi demonstrates severe binge eating (rated at 3) and that there is no food restriction (rated at 0). Also, there is no exercise (rated at 0) but severe vomiting is evident (rated at 3). Regarding the scale’s rating of cognitions, Kimi’s case demonstrates severe dissatisfaction with body image (rated at 3), moderate body distortion (rated at 2), severe fear of gaining weight (due to throwing up – and rated at 3), and severe influence regarding the importance of appearance to self-esteem (also rated at 3). Given that the differential diagnosis reveals that Kimi’s condition is bulimia nervosa (with an ICD-10-CM Code F50.2 and DSM-5 307.51), the current DSM criteria hold that an individual needs to exhibit persistent restriction to energy intake and that this trend causes significantly low body weight. Indeed, four major interventions that are deemed relevant include medications, nutritional counseling, medical care and monitoring, and family psychotherapy, especially given she is accompanied by her mother. Cognitive behavioral therapy has also been documented to be effective in eliminating or reducing purging and binge eating behaviors while family-based therapy has been associated with a beneficial effect of improving moods, eating habits, and regaining weight.

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