Case Study 145 Anorexia Case Study (Winningham’s)
1.Using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria, how is the
diagnosis of anorexia nervosa determined?
•Restriction of energy intake relative to requirements leading to a significantly low body weight in the
context of age, sex, developmental trajectory, and physical health
•Intense fear of gaining weight or becoming fat, even though underweight
•Disturbance in the way in which one's body weight or shape is experienced, undue influence of body
weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
2.Identify eight clinical signs or symptoms of anorexia nervosa. Place a star or asterisk next to those that J.M.
has.
•Emaciated and malnourished appearance*
•Hypotension (She has been blacking out, which can indicate hypotension. No vital signs were provided,
but students might star this item.)
•Dysrhythmias, bradycardia
•Pale conjunctivae and mucous membranes
•Poor skin turgor and muscle tone
•Peripheral edema
•Excessive hair loss and dryness*
•Cold extremities*
•Lanugo
•Yellow skin
•Amenorrhea
•Headaches, sore throat, vague physical complaints
•Chronic urinary tract infections
•Constipation
•Memory deficits
•Fatigue
•Insomnia
•Depressed immune system
•Obese or overweight person: electrolyte imbalance, hypothermia, weight loss
of more than 2 pounds per week, perception of being obese despite weight
loss
, 3. What other disorders might occur along with anorexia nervosa? Name at least four.
•Major depression
•Posttraumatic stres/ s disorder (PTSD) or other anxiety disorders
•Bulimia nervosa
•Obsessive-compulsive disorder (OCD)
•Eating disorders not otherwise specified
•Binge-eating disorder
•Cardiac dysrhythmias
4. How does bulimia nervosa differ from anorexia nervosa?
•Anorexia nervosa is refusal to maintain body weight at a minimum level for
age and height or failure to gain weight during a period of growth, resulting in
body weight less than 85% of what is expected. The person has an intense
fear of gaining weight or becoming fat, even though the person is
underweight. The person may have a persistent inability to recognize the
seriousness of the very low body weight and extreme weight loss. Some types
of anorexia nervosa involve periods of binging and purging behaviors.
•Bulimia is characterized by recurrent periods of binge eating and recurrent,
inappropriate behaviors to prevent weight gain (such as self-induced
vomiting; use of laxatives, enemas, and diuretics to lose weight; fasting; or
excessive exercise). This cycle occurs, on average, at least once a week for 3
months.
5. Name five behaviors that J.M. or any other patient with anorexia may engage in other than self-
starvation.
•Excessive daily exercise
•Binging and purging
•Intense food rituals
•Use of diuretics
•Laxative or enema abuse
•Denial
•Wearing loose clothing
1.Using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria, how is the
diagnosis of anorexia nervosa determined?
•Restriction of energy intake relative to requirements leading to a significantly low body weight in the
context of age, sex, developmental trajectory, and physical health
•Intense fear of gaining weight or becoming fat, even though underweight
•Disturbance in the way in which one's body weight or shape is experienced, undue influence of body
weight or shape on self-evaluation, or denial of the seriousness of the current low body weight
2.Identify eight clinical signs or symptoms of anorexia nervosa. Place a star or asterisk next to those that J.M.
has.
•Emaciated and malnourished appearance*
•Hypotension (She has been blacking out, which can indicate hypotension. No vital signs were provided,
but students might star this item.)
•Dysrhythmias, bradycardia
•Pale conjunctivae and mucous membranes
•Poor skin turgor and muscle tone
•Peripheral edema
•Excessive hair loss and dryness*
•Cold extremities*
•Lanugo
•Yellow skin
•Amenorrhea
•Headaches, sore throat, vague physical complaints
•Chronic urinary tract infections
•Constipation
•Memory deficits
•Fatigue
•Insomnia
•Depressed immune system
•Obese or overweight person: electrolyte imbalance, hypothermia, weight loss
of more than 2 pounds per week, perception of being obese despite weight
loss
, 3. What other disorders might occur along with anorexia nervosa? Name at least four.
•Major depression
•Posttraumatic stres/ s disorder (PTSD) or other anxiety disorders
•Bulimia nervosa
•Obsessive-compulsive disorder (OCD)
•Eating disorders not otherwise specified
•Binge-eating disorder
•Cardiac dysrhythmias
4. How does bulimia nervosa differ from anorexia nervosa?
•Anorexia nervosa is refusal to maintain body weight at a minimum level for
age and height or failure to gain weight during a period of growth, resulting in
body weight less than 85% of what is expected. The person has an intense
fear of gaining weight or becoming fat, even though the person is
underweight. The person may have a persistent inability to recognize the
seriousness of the very low body weight and extreme weight loss. Some types
of anorexia nervosa involve periods of binging and purging behaviors.
•Bulimia is characterized by recurrent periods of binge eating and recurrent,
inappropriate behaviors to prevent weight gain (such as self-induced
vomiting; use of laxatives, enemas, and diuretics to lose weight; fasting; or
excessive exercise). This cycle occurs, on average, at least once a week for 3
months.
5. Name five behaviors that J.M. or any other patient with anorexia may engage in other than self-
starvation.
•Excessive daily exercise
•Binging and purging
•Intense food rituals
•Use of diuretics
•Laxative or enema abuse
•Denial
•Wearing loose clothing
