ANOREXIC JOAN CASE
SYMPTOMOLOGY
A. Joan measured and
weighted all her food
a. Once again she
restricted her weight
after she began to date
Mitch.
This must be a sign of
narcissism because in her social
history it is stated that “she had
high personal standards and
strove to be a perfect child”
And another point> she tried a
conforming behavior to her
parents as she lived in a large
neighborhood filled with lots
of children.
She began dieting, restricting
and her weight dropped to
another low point.
Another important factor is her
restriction on diet was persisted
for about 5 years.
She took her ability to
control her diet + appetite
as a sign of strength
B. She was over
concerned about her
weight while she was
inactive, recovering
from surgery.
b. Joan weighed 100
pounds> still felt
overweight and
believed that she
would look better if
she lost more weight.
One point> To be unhappy
because you are the wrong
weight is a sign of the
overindulgence of our society.
Joan stayed weak most of the
time, even though the people
around her start making her
realize the fact that she was
too thin. In Joan’s mind,
however, she was still too
heavy.
Even though in the midst, she
showed symptoms of binging
and purging but it wasn’t
lasted for once a weeks for
three months. (It doesn’t meet
the criteria)
DISTORTED
THINKING
She believed that food
was bad and that it was a
waste of money
C. Her friends and
family members
told her to change
her behavior but she
still continued her
diet.
c. After the
starvation>
coworkers noticed>
internist noticed her
anorexic behavior>
she left therapy and
continued what she
was doing.
Clear physical effects
 She had problem
with her liver
 Her skin became
dry
 No healthy hair
 Her periods stops
 Would often get
dizzy
After all of this, she still
thought that controlling the
diet is her strength
After Joan had gained few
pounds while she was
drinking heavily > again
restricting diet and start
taking control over it.
What are the factors that may contribute to anorexia, especially media?
 FACTORS
There are quiet few factors that contribute to anorexia
1. Family conflicts > feeling of worthlessness or guilt.
2. Media
3. Parents or siblings advised them to lose weight
4. Stress or examinations> less food intake
5. History of a psychiatrist consultation for reasons other than eating behaviour.
6. Living in hostel or away from home
Interestingly, Sjostedt et al showed that Indian women scored higher on EAT-26 as compared
to Australian women9. In Iran, Nobakht et al. targeted school girls and found a lifetime
prevalence of 0.9% for anorexia nervosa, 3.2% for bulimia nervosa and 6.6% for the partial
syndrome (Nobakht, 2000).
In a study conducted in female university students in Karachi, it was found that there is a
misperception of body weight and one third of female students misclassified themselves as
normal while they were actually underweight ( Sirang& Bashir, et al. 2013).
 MEDIA INFLUENCE:
Multiple studies have tried to explain the reason behind the misperception as the impact of media
on psychology of females which has lead them to eating disorders. It has also been reported that
greater exposure to western culture and urbanization has been a strong influence and predictor of
defective eating attitudes, and impractical body shape insights which could eventually contribute
to depression.
Magazine articles, television shows, and advertisements have also created a social
context that may contribute to body dissatisfaction and disordered eating in girls and women. A
study found a significant increase in advertisements for diet foods and diet products for the years
1973–1991 (Wisemen, 1992)
Not only do the media glorify a slender ideal, they also emphasize its importance, and the
importance of appearances in general. Naomi Wolf argues that our culture disempowers women
by holding them prisoner to an unattainable beauty ideal (Wolf, 1990). The current evidence
suggests that the negative effects of the media are more pronounced for individuals who are
already at-risk or vulnerable (Stice, 2002).