Reference no: EM133503786

Denine is a 31-year-old married African American female with two children, ages 3 and 1. She was referred to counseling by her primary care physician after her most recent physical examination. Denine reported that she was very reluctant to talk about her bingeing, as she feels a great deal of shame and embarrassment. The client reported that she will consume a high amount of food/calories in a short period of time at least twice each week. She believes that her binge eating is triggered by negative emotions, and cited that her last binge, yesterday, followed being reprimanded at work for a minor mistake. Denine feels immense guilt after bingeing, and feels that she has "totally lost all control" of herself. She typically binges in her car, where she is not around others.

Denine works for a vending company and stocks local vending machines in her area. She is able to eat for free at work, which she shared makes it easier for her to collect sweets and other high calorie foods that she likes to consume during binges. Denine's husband recently went back to college and is no longer employed, so she has become the financial provider for the family. This role has placed a lot of strain on Denine's relationship with her husband, and she "feels like a huge weight is on my shoulders now." Denine shared that she wants to be able to provide for her children to have new toys and things that they want as they get older, and never have to want for things like she did during her childhood.

Denine reported that she has been overweight since childhood, and that her mother died when she was a teenager after having a heart attack. She shared that her father also has health complications related to being overweight.

Denine is embarrassed by her weight, and cried as she expressed her fears about dying young and leaving her children behind. She also worries that as her children age, their friends will make fun of her weight. Denine's social interaction with others is limited, and she shared that she worries about others judging her appearance in public. She shared that when she has been grocery shopping, people will "make comments as I walk by, calling me names or making fun of my weight." Denine pointed out that these comments make her feel bad about herself, and often trigger her to binge.

Denine has several supportive people in her life, including her father, brother, and several extended family members. She regularly attends church on Sundays with her family, and enjoys singing in the choir. Denine also enjoys reading and taking her children to the library.

Questions:

1. Of the disorders covered in this week's readings, which do you think Denine shows the most evidence of (and why)?

2. Identify relevant biological, psychological, and sociocultural factors contributing to Danien's disorder.

3. Describe how you might treat Danine's disorder.