A 14-year-old client is brought to the clinic by her mother. Her mother expresses concern about her daughter’s weight loss and constant dieting.. I just can’t seem to get down to the weight I want to be

A 14-year-old client is brought to the clinic by her mother. Her mother expresses concern about her daughter’s weight loss and constant dieting.

Nurse Kris conducts a health history interview. Which of the following comments indicates that the client may be suffering from anorexia nervosa?

• a. "I like the way I look. I just need to keep my weight down because I’m a cheerleader."
• b. "I don’t like the food my mother cooks. I eat plenty of fast food when I’m out with my friends."
• c. "I just can’t seem to get down to the weight I want to be. I’m so fat compared to other girls."
• d. "I do diet around my periods; otherwise, I just get so bloated."

Answer C.

Low self-esteem is the highest risk factor for anorexia nervosa. Constant dieting to get down to a "desirable weight" is characteristic of the disorder. Feeling inadequate when compared to peers indicates poor self-esteem. Most clients with anorexia nervosa don’t like the way they look, and their self-perception may be distorted. A girl with cachexia may perceive herself to be overweight when she looks in the mirror. Preferring fast food over healthy food is common in this age-group. Because of the absence of body fat necessary for proper hormone production, amenorrhea is common in a client with anorexia nervosa.

The comment that indicates the client may be suffering from anorexia nervosa is:

c. "I just can’t seem to get down to the weight I want to be. I’m so fat compared to other girls."

Here's why:

- Focus on weight and negative body image:

This statement expresses dissatisfaction with current weight and an unrealistic desire for further weight loss, suggesting a preoccupation with weight and a distorted body image.

- Comparison with others:

Comparing oneself negatively to others' bodies is a common symptom of anorexia, indicating envy and low self-esteem related to body image.

- Lack of self-awareness:

Claiming to be "fat" despite visible weight loss reflects a distorted perception of their body size and a denial of the severity of their situation.

Other Options:

While the other options might raise concerns about eating habits or body image, they lack the specific indicators of anorexia nervosa:

• a: Expresses positive self-image and focuses on fitness, not necessarily unhealthy weight loss.
• b: Suggests dietary preference and fast food consumption, not necessarily restriction or fear of weight gain.
• d: Describes premenstrual dieting for symptom management, not necessarily indicative of an eating disorder.

Therefore, option c is the most likely indication of anorexia nervosa based on the specific characteristics it presents.

Remember, this is just one piece of information. A comprehensive assessment by a qualified healthcare professional is necessary to diagnose anorexia nervosa.