When 15-year-old Melanie went through puberty, she experienced an increase in appetite and gained about 20 lbs. Her family laughingly referred to her as “chubby,” not realizing how deeply she was affected by their teasing. Melanie began using diet pills she ordered out of the back of a magazine as well as greatly restricting her food intake. She lost the 20 lbs. very quickly, and she received many compliments about how good she looked. Melanie lost another 15 lbs. on top of that, and when she received comments about looking too thin, she began to wear baggy clothing to hide her frail figure. Her daily food intake by this point was restricted to one small bag of pretzels, one apple, and one small container of yogurt. Melanie would exercise for up to 2 hours per day to burn off the calories from the food she had consumed. She found the diet pills were causing her to feel sleepless and irritable; however, she was afraid to stop taking them for fear of regaining the weight she had lost. She ended up increasing the dose. Finally Melanie’s parents, concerned about her appearance, sought help for her.
Is Melanie suffering from an eating disorder as described in the final section of chapter 8 in the text? Does she meet any criteria for a substance use disorder? Devise a plan, based on the model of health promotion and disease prevention, to address the problems she is experiencing. Include areas of both physical and psychological wellness.
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