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Case study, number 2 of 3.
Miss E weight loss
Miss E came to see me asking for help to lose weight. Miss E is 27 years old and other than her weight is a fit and healthy young lady. She works full time as a staff nurse in a busy city centre hospital. Miss E is currently single and sharing a flat with her older sister who is also a nurse at the same hospital. Initial consultation
Having filled in her initial consultation form and establishing that there were no ethical issues that would prevent me from working with Miss E. I began by asking her what she hoped I could help her with. Miss E didn’t appear to me to be obese. At 1.65m tall she was unhappy with her weight which was currently 77kg. I wanted to establish how much weight she realistically thought she should lose. Using her weight and height I calculated her Body Mass Index at 28.30 , this meant that her goal of a one and a half stone (9.53kg) weight loss was realistic and achievable. We chatted for the next thirty minutes, in which time I discovered that Miss E had always had a problem with her weight but her biggest problem was not the loosing of the excess pounds but keeping them off. She was a classic yoyo dieter. I asked her how old she was when she first felt unhappy with her weight. She replied by telling me she could not remember a time when she felt happy with the way she looked. The youngest of four sisters, she explained that her mother and sisters were constantly dieting when she was a child and she grew up thinking it was normal to constantly criticise the way you looked. Food was seen as the enemy but also the source of comfort. There were always cupboards full of biscuits and crisps, but these were forbidden and only there for their father, although in times of stress or reward they were all allowed them as a treat (which happened on an almost daily basis). Having established the source of Miss Es negative body image we talked about her current eating habits. It was easy to see where she was going wrong. Her daily routine was to skip breakfast and buy a sandwich from the canteen in her lunch break. Dinner was often eaten on her own as she and her sister never seem to be on the same shifts. They had no set routine when it came to food shopping, both of them stocking the fridge whenever they had time. I asked if they still had a cupboard with biscuits and crisps in, not always she replied, only if their parents were visiting. She also told me that the staffroom was always full of tempting chocolate and homemade cakes, presents from grateful relatives to the nurses on the ward. Those tempting treats were always going to be there we both agreed, but hopefully with my help she would be able to resist them, most of the time. We then went on to talk about a time when she had felt really happy and relaxed. She told me about a holiday her and her sister had taken three years ago just after she had qualified. It had been a last minute deal, two weeks in Portugal all inclusive. I asked her to describe the place to me and what it was about the holiday she found most relaxing. Miss E talked in great detail about the pool the sun the relative quiet having studied hard for three years it was nice to have nothing to worry about. It had all been so last minute that she had not even had time to go on a diet before hand, something everyone did before their holidays. I asked her how she felt about her body during the holiday. She told me she would have liked to have been a stone lighter than she was but that she was very good at keeping covered up, only dropping her towel at the pool side before jumping in. She agreed that that was what she was hoping for, although she felt that she had gained an extra half a stone since the holiday that she was also keen to lose. I explained that realistically she should hope to lose...