The Case
Ann's parents take her to the family physician because they are alarmed at her emaciated appearance.
She contends that she has no medical problem, but is simply "counting calories" to maintain a body
weight that will permit her to pursue a career in modeling which has been her goal for several years. The
physician finds that in addition to Ann's low blood pressure and reduced heart rate she is also
dehydrated and suffering from general muscle weakness.
What is the physician's diagnosis of this patient?
The physician’s diagnosis takes into consideration some key factors from the interview with Ann as well
as observations made during their meeting. Ann’s emaciated appearance (thin, wasted, shrunken, and
withered) is uncharacteristic of a young active youth with no medical history and concerned parents. In
addition, her obsession with counting calories, low blood pressure, and low heart rate lead the physician
to the ultimate diagnosis of Anorexia (Wikipedia).
Is Ann simply "counting calories" as she claims?
Based on the signs and symptoms, this is more than counting calories to lose a couple pounds. A person
with anorexia usually exhibits a number of signs and symptoms like malnutrition, weight loss, obsession
with physical appearance, low blood pressure, and low heart rate. According to the interview done by
the physician, Ann exhibits all these signs and symptoms (University of Maryland Medical Center).
What other activities may Ann be engaging in and not reporting to the physician?
In addition to limiting food intake, Ann could be using medication to support her. Because this could
cause judgment from others, it is likely that Ann would not reveal this information to her physician.
Many people use an assortment of dangerous over-the-counter medication while in the clutches of their
eating disorder. Diet pills range from appetite suppressants (such as phenylpropanolamine), caffeine
pills (for energy and stamina) and ephedrine hydrochloride. Diet pills, both over-the-counter and
prescription, (as recommended, continuously, or in excess) can cause these additional symptoms:
nervousness, restlessness, insomnia, high blood pressure, fatigue, hyperactivity, heart arrhythmias,
palpitations, congestive heart failure or heart attack, stroke, headaches, dry mouth, vomiting, diarrhea
or constipation, intestinal disturbances, tightness in chest, tingling in extremities, excessive perspiration,
dizziness, disruption in menstrual cycle, change in sex drive, hair loss, blurred vision, fever and urinary
tract problems (The Something Fishy Website). Clearly when altering the food intake to unnatural and
unsafe levels, your body has natural reactions to alert you of a serious problem.
What is the cause of the dehydration and muscle weakness?
Dehydration is caused by the depletion or lack of intake of fluids in the body, or by the restriction of
carbohydrates and fat. Because people fear “water-weight”, it is most common to limit liquids in order
to drastically and quickly reduce excess body weight. In addition, muscle weakness is an example of
malnutrition, caused by under-eating (Wikipedia). Malnutrition indicates a deficiency of energy, protein
and micronutrients. The body will absorb what it can from food and reduce energy and strength to
conservative levels, resulting in lower muscle tissues throughout the body (Wikipedia).
What underlying problems must be addressed before Ann's condition may improve?
The underlying problem that must be addressed is a distorted body image. Unfortunately, our society
depicts unrealistic standards on youths, and even when extremely thin girls think they are fat, they
won’t maintain proper weight. Anorexia is an emotional disorder that focuses on food, but it is actually
an attempt to deal with perfectionism and a desire to control things by strictly regulating food and
weight. People with anorexia often feel that their self-esteem is tied to how thin they are (University of
Maryland Medical Center). It is vital that Ann’s physician coordinate a complete treatment program
focusing on the root of the issue rather with psychological and emotional support.
How should this issue be addressed in society?
Our psychological boundaries develop early in life, based on how we are held and touched, or lack
thereof. A person who is deprived of touch as an infant or young child may not have the sensory
information she/he needs to distinguish between what is inside and what is outside her/himself. This
could cause the person to have difficulty getting an accurate sense of his/her body shape and
satisfaction with it (The Something Fishy Website). Effective parenting is key, and with more broken
homes these days, children are hurting and looking for acceptance; unfortunately, the media is willing to
help in the worst way possible. Perhaps feminist writer Kim Chernin said it most accurately, “if we place
pornography and the tyranny of slenderness alongside one another we have the two most significant
obsessions of our culture, and both of them focused upon a woman’s body.” (International Eating
Disorder Referral Organization).
What impact has the recent craze of diet manipulation (low fat, high carb ,low carb, high protein,….)
for various reasons had?
It is a conspiracy between the slimming diet industry, the media and ordinary, gullible people. They tell
you of the latest diet craze, even if it is the exact opposite of the truth, science, or even next month’s
new diet craze (University of Maryland Medical Center). People are exploited because there is a lot of
confusion about health and fitness goals. Trying to lose weight is not the same thing as becoming
aerobically fitter, stronger, or even healthier. A healthy diet is not the same as the diet of an athlete or
slimmer. Things are getting worse when the gullible can be so easily exploited! The bottom line is the
media is painting a picture for our youth that is the exact opposite of healthy. It is key to support youths,
as they are going through significant physical changes and are emotionally vulnerable, to avoid serious
diseases such as anorexia (Wikipedia).
Resources
"Anorexia nervosa." http://www.umm.edu/altmed/articles/anorexia-nervosa-000012.htm. University of
Maryland Medical Center , 12082008. Web. 3 Aug 2011.
"Physical Dangers and Effects of an Eating Disorder." http://www.somethingfishy.org/dangers/dangers.php. The Something Fishy Website on Eating Disorders, 01132007. Web. 3
Aug 2011.
"Anorexia nervosa." http://en.wikipedia.org/wiki/Anorexia_nervosa. Wikipedia, 08032011. Web. 3 Aug
2011.
"Body Image." http://www.edreferral.com/body_image.htm. edreferral.com, n.d. Web. 3 Aug 2011.