In: Psychology
MH is a 37 year old woman who is 5’3” and 210 pounds, giving her a BMI of 37. She has been overweight since childhood, however she began binge eating about 10 years ago after a failed relationship. She binges at least twice a week by cooking dinner for three, eating all of the food and then having two servings of ice cream and cookies, all in about 30 minutes. She has never used laxatives or purging after her binges. She has tried dieting in the past but now says she has given up. She has no history of substance abuse and is in good health. MH is divorced and has a 15-year-old son, who is normal weight. When he was younger, she confined her binges to the weekends; now that he is off with friends more, her binging has increased. Her divorce was initiated by her husband, partially because of her weight issues. She is a radio announcer and came in for treatment after applying for a job at a cable TV station and realizing that her appearance is what prevented her from being considered. What is the best diagnosis for MH? (Give the reasons for your choice.) What treatment would you recommend?
MH seems to be suffering from Binge eating disorder as she shows the typical symptom of consuming large amount of food at least twice a week and the inability to control her binge sessions for over six months or longer. In her case, her binge sessions have been persisting since 10 years. Moreover,this has led to weight gain which in turn has brought secondary symptoms such as depressed mood due to her failed relationship, low motivation towards healthier life choices such as physical fitness. She also shows the typical symptom of eating large quantities of food in isolation. The negative feelings that usually accompany binge eating such as in the professional situations often lead her to continue to use food to cope; thus creating a vicious cycle.
Keeping in mind the long history of her binge eating in light of her fallout in her marital relationship and her tryst with her professional capabilities, MH will be recommended to seek Dialectical Behavioral Therapy which will help her to focus on the underlying thoughts and emotions and stressful situations which trigger her unhealthy eating habits and increase her resistance to stress. Moreover, in addition to psychotherapy, a supplementary treatment programme with a nutritionist is suggested in order to equip her and make her feel empowered about her ability to control her eating choices and monitor her dietary decisions.