Priory eating disorder case study

Emma’s* parents, Mr and Mrs Bond, were worried about their 16 year old; for over a year she had been on a diet that didn’t stop. They didn’t understand because she had never been overweight, and it didn't seem as thought she has secured any happiness from her diet.

Emma's dieting behaviours made her more withdrawn, depressed and anxious. Every time her parents expressed their concerns, she burst into tears or shouted at them. She had stopped eating with the family and spent most of her time in her bedroom. She was still going to school and doing extremely well in her exams, but her friends were worried about her. Emma’s parents had repeatedly suggested that she went to see the doctor but she insisted that there was nothing wrong with her, asking them why they couldn't just leave her alone. Mr and Mrs Bond had started to disagree about how to handle Emma's behaviour and argued frequently. Emma's brother and sister were very angry with her and wouldn’t talk to her.

Finally, Mr and Mrs Bond received a phone call from school to say that Emma had fainted and was in hospital.

eating disorder treatment imageShe was discharged a short while later but with the recommendation that they saw an eating disorders specialist. Emma’s parents took her to the GP who referred her to the Priory eating disorder service. She was admitted immediately because her weight was so low that it was dangerous. Her pulse was 36/min and her temperature 34.5C.

After a thorough assessment of not only her physical condition but also her psychiatric state, Emma underwent a blood test and an electrocardiogram (ECG). Because of her bradycardia and hypothermia she was nursed on bed rest with 24-hour care and was gradually re-fed.

As her weight went up, Emma's observations improved. She began participating in the intensive care programme and was allocated an individual therapist.

After four weeks, Emma was moved to an acute maintenance bed and participated in the group programme of anxiety management, body image and nutritional groups. In her individual therapy, she addressed a number of life events and issues which had caused her considerable distress prior to the onset of the illness.

When Emma was ready for weekend leave, she related much better to her family. They all believed that the family therapy had helped, as well as the carer support group and education sessions.

Emma was pleased that she was able to continue studying for her AS levels whilst an inpatient, and held on to her dream of going to University.

16 weeks later, on discharge, Emma had gained control over her illness, dealt with a number of significant life issues and was looking forward to relating more appropriately with her friends again. Her family were more relaxed as they knew how to help Emma, and no longer felt helpless or fearful for the future.

*  Names have been changed to protect patient identity.