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Moreover, there is evidence that she has at least situational depression, if not endogenous depression (Levy, Dixon, and Stern, 1989). Her support networks are poor, and she prefers a lonely life, and thus it can be suspected that she is isolated due to her depression (Wiederman and Pryor, 2000).

As per UK Dietary Reference Values (DRV. British Nutrition Foundation, 2004), Susan belongs to the adult age group, and hence her energy requirements are lower, so are the requirements of energy will be lower, although they vary according to age, gender, and activity level. With the data provided, Susan’s BMI would be 30, which as per references is class I obesity (Buttriss, 2000). Taking the ideal BMI to be 20 to 24.9, for Susan, it would be ideal to keep a target of 22 as the BMI, and to achieve that she will have to bring her weight back to 56 kg. This means she will have to lose about 23 kg of weight. She is a secretary by profession, hence her lifestyle may be considered as sedentary. Diet analysis of Susan indicates that she has consumed 2765 Kcal on an average per day (Swan, 2004). This comes from on an average of 672 g of carbohydrate and related food consumed including sugar and starch. According to DRV, this itself is higher since this should be (50 + 10) % to (47 + 11)% maximum. Although the average British intake is higher, since Susan is overweight she needs to reduce the energy intake by about 1000 kcal a day so over a period of 23 weeks, she will achieve the target weight (Ruxton et al., 1996). Since there is a program for physical activity, an exercise programme comprising of brisk walking and running at a speed of 10 minutes a mile would cause a total loss of 375 kcal per day (Swan, 2004). Having this allowance based on DRV, her energy requirement may be adjusted to omission of fatty food totally and carbohydrate restriction to 200 g (Millward, 2004). Moreover, her protein consumption is within normal limits (Millward, 2004). The values must be adjusted at least roughly, since the dietary reference data cannot provide the accurate amount available from the food or different food elements (DRV, 2004).

Bulimia Nervosa

Subjects suffering from BN are strongly preoccupied with their weight and afraid of growing fat. BN patients surrender to frequent episodes of binge eating (Boskind-White and White, 1983). This also involves a sense of lack of control over eating during episodes (Keel et al., 2007).

Binge Eating

Given the data, Susan has indeed an episode of binge eating on the weekend. however, other history is not available (Brownell and Fairburn (eds) 1995). To avoid overdiagnosis, a strict adherence to the DSM-IV criteria mentioned is required (American Psychiatric Association, 1990). An additional inspection may therefore be necessary (American Psychiatric Association, 1990) (Murray, 2003). Since in case of Susan the psychological background supports this diagnosis, entry into the checklist supports the diagnosis, and she should be referred to a suitable healthcare professional (Andersen, 1985).

Anorexia Nervosa

Anorexia nervosa is described in the ICD 10 Classification of Mental and Behavioural Disorders as deliberate weight loss, induced and/or sustained by the patient’ (WHO, 1992).

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