Case Study 2 – Eating Disorders Not Otherwise Specified (EDNOS)
This 14 year-old female was admitted to the Mandometer® Clinic in San Diego. She had a one-year history of EDNOS according to the DSM-IV criteria. Her weight dropped from 165 lbs to 137 lbs and her menses stopped. She initially received compliments for her weight loss, but then her parents grew concerned because of her lost menses and her rapid weight loss. The patient was exercising excessively and engaging in restrictive eating patterns that alternated with periods of binge eating. Due to her low pulse and low blood pressure, she was evaluated at Stanford Hospital and had two other hospital stays prior to Mandometer® treatment. She denied using laxatives or vomiting. The patient was a high achiever with good grades, had friends and had no legal problems, financial problems, or problems with illegal drugs.
The patient was diagnosed as with EDNOS according to DSM-IV criteria and presented with a weight of 140.8 lbs and a BMI of 19.2 kg/m2. The patient exercised excessively and did 1,000 gymnastic bridge bends per day, along with continually bouncing and standing. The patient restricted her food intake to eating less than 500 K/cals per day. Her psychiatric symptoms were elevated; obsessional acts and thoughts tested at 17.5 with 6 as normal, anxiety tested at 13.0 with 6 as normal, and depression tested at 18.0 with 6 as normal. Her physiological status was abnormal with glucose levels at 50 mg, phosphate levels at 4.9 mg/dL and TCO2 at 19 mEq/L.
She started the Mandometer® treatment program five days per week from 8:00 am to 4:00 pm. The patient exercise routine was decreased and she was placed on 1,640 K/cals per day, spread over six meals. She normalized her eating behavior in one month with the use of Mandometer® and a highly structured treatment program. The patient began a home schooling program five days per week and gradually decreased her time in the clinic. After three months of treatment, her weight was normal at 143 lbs and her BMI was in the normal range (19.5 kg/m2). Her psychiatric status was normal; obsessional acts and thoughts 3.0, anxiety 2.0, and depression 4.5, and her physiological status was normal. The patient went back to school and was receiving straight A’s.
She fulfilled the remission criteria after three months of treatment, with normal body weight, normal eating behavior, normal physiological status, normal psychiatric status, and she was back in school. She will be followed for five years (11 medical check ups).