Case Study: Meet Stella Stella, A 25-Year-Old Female

Case Studymeet Stellastella Is A 25 Year Old Female Who Strongly Ide

Meet Stella… Stella is a 25-year-old female who strongly identifies with the prevalent dominant culture. Because of this, she loves fashion, style, and clothes. However, since turning 18, Stella has noticed that it is harder and harder for her to lose any weight she puts on. Consequently, she spends many hours every day thinking about how to lose weight and looks in the mirror at least 20 times per day obsessing over her size and shape. To make matters worse, Stella’s relationship with her family is often negative and she has only a few close friends to confide in.

Stella’s classmates describe her as sometimes strange and very socially awkward. She often starts trendy crash diets, but ultimately ends up overeating and then feeling guilty for her failure. Because of this guilt, Stella often exhibits an outward depressed and/or angry mood. Even Stella’s doctor says she is at a very normal weight for her age, but deep down inside she lives in constant fear of gaining more and more weight, as time goes by. The purpose of this case study is to give you experience in applying course material to “real-life” situations and to examine issues relating to Health Psychology principles.

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Stella’s case presents significant risk factors for the development of an eating disorder, most notably Anorexia Nervosa or Bulimia Nervosa, given her intense preoccupation with weight, shape, and dieting behaviors. Her obsessive focus on her appearance, combined with excessive dieting, guilt after overeating, social withdrawal, and negative familial relationships, indicates a distorted body image and a compulsive need for control—core features associated with eating disorders. According to the DSM-5 (American Psychiatric Association, 2013), diagnostic criteria for anorexia include restrictions of energy intake leading to significantly low body weight, intense fear of gaining weight, and disturbance in self-perceived weight or shape. Bulimia, on the other hand, involves recurrent episodes of binge eating followed by compensatory behaviors such as purging or excessive exercise (Fairburn & Harrison, 2003). Stella’s behaviors of crash dieting followed by overeating and guilt are characteristic of the binge-purge cycle observed in bulimia nervosa.

Several factors contribute to her risk profile. The societal emphasis on thinness and appearance perpetuated by media and peer pressures fosters an ideal of slimness that Stella strives to attain, though it is unrealistic and unattainable for most (Thompson & Stice, 2001). Her social isolation and negative family relationships further exacerbate her insecurities and emotional distress, which may predispose her to seek control through disordered eating behaviors. Additionally, her social awkwardness and feelings of being strange suggest possible low self-esteem and social anxiety—factors strongly linked to the development of eating disorders (Stein & Cortese, 2020).

Clinicians should vigilantly observe several symptoms to determine if Stella has developed an eating disorder. These include dramatic weight fluctuations, evidence of compensatory behaviors (self-induced vomiting, misuse of laxatives, diuretics, or enemas), and physical signs such as swollen salivary glands, dental erosion, and electrolyte imbalances. Emotional and behavioral symptoms to monitor include preoccupation with weight and food, secrecy around eating habits, mood swings (depression or irritability), social withdrawal, and intense fear of gaining weight that persists despite being within a normal weight range (American Psychiatric Association, 2013). Additionally, her reports of obsessional thoughts, guilt, and mood disturbances align with psychological symptoms often seen in disordered eating.

Effective treatment strategies for Stella’s situation encompass a combination of psychological interventions and medical management. Cognitive-Behavioral Therapy (CBT) is well-established as a frontline psychological treatment for eating disorders, targeting maladaptive thought patterns related to body image, weight, and food, as well as compulsive behaviors (Fairburn et al., 2009). CBT helps patients develop healthier eating habits, challenge distorted beliefs, and improve emotional regulation. Family-Based Therapy (FBT) can be especially helpful if family dynamics contribute to Stella’s distress, fostering supportive communication and resolving conflict (Minuchin & Selva, 2019). Furthermore, addressing comorbid psychological issues such as social anxiety or depression through treatments like Acceptance and Commitment Therapy (ACT) or Dialectical Behavior Therapy (DBT) can be beneficial.

In addition to psychological care, medical interventions are crucial for monitoring and managing physical health risks associated with disordered eating. Nutritional counseling by a dietitian specialized in eating disorders should be integrated into her treatment plan to establish a balanced and sustainable approach to nutrition. Pharmacological options such as selective serotonin reuptake inhibitors (SSRIs) may be considered to reduce obsessive-compulsive symptoms and mood disturbances, especially in bulimia nervosa (Kaye et al., 2003). Combining these approaches yields a comprehensive treatment plan addressing both the psychological and physical aspects of the disorder.

In conclusion, Stella’s case exemplifies how societal, psychological, and physiological factors intertwine to contribute to eating disorder development. Early identification of symptoms via vigilant assessment can facilitate timely intervention, which is essential for positive outcomes. A multidisciplinary approach—incorporating cognitive-behavioral strategies, family involvement, nutritional support, and, when appropriate, medication—offers the best chances for recovery. Preventing the progression of disordered behaviors requires understanding the underlying psychological issues and fostering a supportive environment that promotes healthy body image and self-esteem.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Fairburn, C. G., & Harrison, P. J. (2003). Eating disorders. The Lancet, 361(9355), 407-416.
• Fairburn, C. G., Cooper, Z., & Shafran, R. (2009). Cognitive-behavioral therapy for eating disorders: A "transdiagnostic" perspective. In C. G. Fairburn (Ed.), Cognitive-behavioral therapy and eating disorders (pp. 261–284). Guilford Press.
• Kaye, W. H., Lynn, T., & Lewinsohn, P. M. (2003). Pharmacotherapy of eating disorders. International Journal of Eating Disorders, 34(2), 166-171.
• Minuchin, S., & Selva, J. (2019). Family therapy for anorexia nervosa: Theoretical and clinical perspectives. Family Process, 58(2), 366-377.
• Stein, D. J., & Cortese, S. (2020). Social anxiety disorder and its relation to eating disorders. Journal of Anxiety Disorders, 72, 102224.
• Thompson, J. K., & Stice, E. (2001). Thin-ideal internalization: Mounting evidence for a new risk factor for disordered eating. Current Directions in Psychological Science, 10(5), 181–183.