Helena was a 16-year-old girl who lived at home with her parents and younger
sister. Throughout her teenage years, she had been a normal weight, but she worried
a great deal about her body weight and shape. She often compared her body weight
with that of other girls and women she met or saw and then judged herself as too
heavy.
Often, Helena checked her body weight by looking in the mirror. She would
pinch the skin on her sides and notice that her thighs touched each other. At about
age 14 she began to diet, first off and on, and then all the time. At 15, she decided to
become a vegetarian and began to cut out many foods from her diet. She was 56**
and weighed 125 pounds at age 15, but by her 16th birthday she had dropped to 110
pounds.
Rather than being relieved by this weight loss, she kept seeing herself as too
heavy. She weighed herself throughout the day. She spent most of her time worrying
about her weight. Time spent on her weight concerns took the place of other activities
she used to enjoy, such as schoolwork and having fun with friends. She became more
alone. And she kept losing weight.
Her parents became more alarmed about her weight loss and behavior. They
talked about this between themselves and started watching and checking her eating
behavior at meals. They urged her to eat more often, without success. She kept losing
weight, and six months later she weighed 98 pounds.
Helena appeared very thin. She often was withdrawn, hard to talk to and
distracted. She seemed weak but did heavy exercise twice each day. She preferred
to stand or pace rather than to sit and relax. Because of their concerns, her parents
took Helena to see the family doctor for an evaluation.
Helena was diagnosed with anorexia nervosa, restricting type. Her low food
intake, low weight (BMI 15.8), frequent exercise and constant concern about her body
weight despite being very thin are hallmarks of the diagnosis.
Questions:
1. Describe how Helena developed anorexia nervosa.
2. What advice can you give to Helena?
3. If you were Helena, how are you going to deal with anorexia nervosa?
4. What decision-making skills will you use to prevent any type of nutritional problem?​