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CASE STUDY DETAILS
Maria is a 38-year-old, divorced woman who works in a higher level administrative position for a large federal agency. She is well-established in her career and has several close friends with whom she enjoys spending time. She comes to you following years of unsuccessful attempts to get appropriate treatment. She states that she has struggled with eating excessive amounts of food during one sitting in brief periods of time. She reports that she underwent prior experience with psychotherapy during college after she was sexually assaulted. She shared with her therapist at that time about her concerns about such periods of excessive eating but the therapist told her that they needed to remain focused on working through issues directly related to the sexual assault. Embarrassed for having brought up her eating behavior, she waited years to seek help again and, when she did on two other occasions, it was recommended that she meet with a dietitian to "learn how to eat healthily." She explains to you that she needs help with this excessive eating and that it's not a matter of knowledge - "I know what to do. I just can't do it. I cannot control my eating." She describes a pattern where she works hard to "get on track" with her eating but finds it difficult to maintain. She is 5'4"and weighs 225 lbs. She first started such voracious eating at a time in college and her weight quickly increased from 135 lbs. as a freshman to 175 lbs. by graduation. She has been treated for hypertension and high cholesterol for the last 5 years. She reported that such frenzied eating, especially in the evening, increases during times of high work stress, and during her divorce process, and after recent relationship break-ups. She is coming for help now at the recommendation of her physician after a recent visit where she reported increasing problems with back and knee pain due to her excess weight.
What is her likely diagnostic issue?
Any secondary issues?
Describe the development of her issue? Any key triggering events?
What are her current environmental stressors?
Any related medical/physical health issues?
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