CASE STUDY
Maria (binge eating disorder)

Maria is a 38-year-old divorced woman who works in a higher level administrative position for a large federal agency. She is well-established in her career and has several close friends with whom she enjoys spending time. She comes to you following years of unsuccessful attempts to get appropriate treatment for her binge eating. She reports a prior experience with counseling during college after she experienced a sexual assault. She shared with her counselor her concerns about binge eating but the counselor told her that they needed to remain focused on working through issues directly related to the sexual assault. Embarrassed for having brought up her binge eating behavior, she waited years to seek help again and, when she did on two other occasions, it was recommended that she meet with a dietitian to “learn how to eat healthily.” She explains to you that she needs help with binge eating and that it’s not a matter of knowledge – “I know what to do. I just can’t do it. I cannot control my eating.” She describes a pattern where she works hard to “get on track” with her eating but finds it difficult to maintain. She is 5’4”and weighs 180 lbs. She first started binge eating in college and her weight quickly increased from 135 lbs. as a freshman to 160 lbs. by graduation. She has been treated for hypertension and high cholesterol for the last 5 years. She is coming for help now at the recommendation of her physician after a recent visit where she reported increasing problems with back and knee pain due to her excess weight.