Case Study 5 – Anorexia Nervosa
A 16 year-old girl, with a four-year history of anorexia nervosa, was admitted to the Mandometer® Clinic in Stockholm. She had previously been treated unsuccessfully five times; she had been hospitalized twice in a psychiatric ward, with temporary improvement, but her condition worsened as her body weight decreased and her psychiatric condition deteriorated.
The patient fulfilled the DSM-IV criteria for anorexia nervosa. She had a restrictive food intake, excessive physical activity, body dissatisfaction and strong fear of gaining weight. Her BMI was 14.5 kg/m2, her psychiatric symptoms were highly elevated: with normal status at 6, she tested on obsessional acts and thoughts as 14.5, anxiety 14.5 and depression 16.0. She admitted to having suicidal thoughts and was on Zoloft (100 mg). Her physiological status revealed a depressed metabolism with abnormal thyroid function tests and abnormally high plasma ferritin.
She started the Mandometer® treatment program as an inpatient. Her physical activity was decreased significantly and she was placed on 1,500 kcal per day, spread over six meals. The Zoloft medication was gradually eliminated.
She is currently an outpatient and is making progress in the treatment with a daily intake of 2,600 kcal per day, a BMI of 15.6 kg/m2 and her psychiatric symptoms have improved: obsessional acts and thoughts 6.5, anxiety 7.5 and depression 7.5. She has eaten different "forbidden" foods. After she reaches remission, she will continue to receive care in follow-up sessions at the Mandometer® Clinic in Melbourne.