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Biopsychosocial Assessment of an Anorexic Client

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Biopsychosocial assessment of clients in medical fields involves the assessment of the biological, psychological and social factors in human functioning with regards to diseases and ailments. It recognizes that thoughts, emotions and behavior play significant roles in the normal human functioning (Nurse Blog, 2009). One of such areas where thoughts, emotions, and social behavior have such impact is in psychiatry. Anorexia is one such psychiatric disorders resulting from an unexplained fear of weight gain, self denial of food and conspicuous distortion of the body image. The Cleveland Clinic (2007) describes the anorexic client as obsessed with getting increasingly thinner and thus compromising his/her health through food ration and starvation. This paper is based on a biopsychosocial assessment of an anorexic client and focuses on the client’s symptoms, issues, strengths, recourses and finally proposes a treatment plan.

Symptoms an Anorexic Client

Common Symptoms

Anorexic patients suffer from conditions of rapid weight loss, unusual interest in food, nutrition or cooking, intensive fear of weight gain, strange eating habits and routines and social withdrawal. Aylet (2001) explains that anorexia is more common in females who may also experience infrequent and irregular menstrual periods. Backer and Wilgram (2009) assert that compulsive exercising, and depressive conditions like anxiety and irritability are also common symptoms of anorexia disorder in patients.

Long-term Physical Symptoms

Medics on the other hand, have identified long term physical symptoms as low tolerance to cold weather, brittle hair and nails, lack of blood, constipation and change in skin color. With regards to my client she presented more outward signs such as depression, brittle hair, withdrawal behaviors, weight loss, swollen joints and strange eating habits. Such symptoms manifest commonly among anorexic patients (Cleveland Clinic, 2007).

Anorexic Patient’s Strengths

It is an issue of concern for medical practitioners on how anorexic patients undergo long periods of fasting and weight loss. Backer and Wigram (1999) indicate that anorexic symptoms are “very understandable and meaningfully seen from the client’s point of view”. For example, the fact that my client could observe the advanced physical symptoms of anorexia in her, it was surprising that she still wanted more weight loss. Ayelet (2001) explains that anorexic clients enjoy dieting with an intention of loosing weight and live in a condition of self denial. They have the ability to progressively reduce weight even when their weight is already low (Backer and Wigram, 1999).

Ability to Derive Satisfaction  

The assessment of the client’s nutritional routine revealed one of self-starving with a degree of satisfaction.  Sturmey (2009) reveals the aspect of enjoyment in starvation asserting that persons with anorexia “typically restrict food intake in a rigid and extreme way”. Thus, these patients have the ability to derive satisfaction from restricted food intake. My client informed me that she uses laxative and diet pills to reduce weight gain and consequently feels much happier than ever before. This behavior is confirmed in Ayelet (2001) when she asserts that anorexic patients derive pleasure “from the sensation of starvation.”

Exhibition of Self Critical Ability

My client also exhibited self critical ability which enabled her to strive for perfection in all that she undertook without much criticism. First, she wore lose clothing to hide her weight loss from her parents and teachers. She underscored the fact that she looses weight in order to look good and hence attract more friends. Ayelet (2001) identified “the constant feeling of success, self control and accomplishment” as some of the factors which make adolescents loose weight.  Ayelet (2001) also describes anorexic patient’s self critical skills as enabling them explore various ways of having a better control of their body and nutrition even amidst criticism from peers.

The Anorexic Patient’s Recourse


Most anorexic patients resort to other means to achieve their objectives in weight loss and distortion of their bodies. This section discusses four mechanisms that my client uses to attain success even amidst anxiety, stress and guilt. These mechanisms include management of depression through suicidal tendencies, physical exercising to substitute the urge for food, binging and purging and lastly conditioned hunger inhibition.


Most anorexic patients undergo a history of depressive symptoms which include low mood, tiredness, social withdrawal and a feeling of guilt, shame and failure. Sturmey (2009) explains that depressions may also cause a change in eating habits of an individual. My client expressed depressive symptoms of guilt, shame and social withdrawal. She had a low self esteem with a distinctive loss of self confidence from her weight loss. Ayelet (2001) explains that stress, insecurity and anxiety are more familiar with anorexic patients. She further explains that such patients value death as a solution to their withdrawal and weight loss problems. Its is no wonder that most anorexic patients have suicidal habits.  

Physical Exercising

Studies have shown that most anorexic clients undertake alternative reinforcing activities in order to compete with the reinforcing value of food (Sturmey, 2009). In other words, competing alternative reinforces are able to compete with the reinforcing value of food. Despite the fact that my client had a decreased time for eating, she had allocated more time for physical activities, watching movies, studies and other social activities. Not only does physical and social activities preoccupy the anorexic patients mind to avoid meals but also help in weight loss itself. Ayelet (2001) indicates that she developed a comprehensive plan to enable her exercise with the intention of loosing more weight and forgetting food. She writes “I was preoccupied and obsessed with all these aspects of my program”. Backer in Backer and Wigram (1999) confirmed the effect of physical activity in anorexic clients when one of his clients told him that he liked playing the piano because it made her forget all her thought.

 Binging and Purging

The second recourse for anorexic patients is what is referred to by Sturmey (2009) as bulimia-type behavior. My client displaced a history of vomiting and self induced constipation. Ayelet (2001) explains that anorexic patients are experienced at forcing themselves to vomit and hiding and throwing away food. The misuse of laxatives and diuretics are also other ways used by anorexic patients (Sturmey, 2009). My client reported that she started purging and binging by initially digging her fingers down her throat and then later down her abdomen.

Hunger Inhibition  

Sturmey (2009) indicates that anorexic patients may develop a conditioned anticipator response to inhibit feelings of hunger and desire to eat even while seeing food. This condition is developed by the body because of the patient’s history of eating limited variety of food at decreased intervals. My client informed me that she drinks a lot of water in between meals. However, Sturmey (2009) argues that the amount of water taken during a meal should be regulated for it affects the self-reported feelings of hunger and satiety during a meal.

Treatment Plan as an Anorexic Client

This paper has underscored the multidimensional aspect of the anorexic disorder. An appropriate treatment plan should address both physical problems caused by the patient’s eating disorder and the psychiatric problems such as depressions, anxiety and the suicidal thoughts. Sturmey (2009) argues that a good treatment plan should have the maximum magnitude of effect and address the behavioral and the causative dimensions. Such treatment plans should involve psychotherapy and nutritional counseling and be as supportive as possible to alleviate denial and rebellion. They should recognize that most anorexia patients are in a state of self denial and may refuse to follow the treatment plan (Backer and Wigram, 1999).

Psychotherapy Treatment an Anorexic Client

Psychotherapy should be accompanied by medical and nutritional support and guidance. It involves changing the cognitive and behavioral thinking and actions of a patient. However, this plan should be undertaken after the review of the client’s history, the current symptoms, assessment of the physical status and other psychiatric issues like depression and anxiety (Ayelet, 2001). Such review would help the medical practitioner to ascertain the level of medication required and whether inpatient or outpatient attention is necessary.

The treatment should address the underlying psychological, interpersonal and cultural forces contributing to the weight loss. Ayelet (2009) explains that eating disorder could be attributed to social factors. My client informed me that she recognized herself as criticized, neglected, isolated and insecure in her family. On the other hand, Ayelet (2001) explains that she suffered from heavy cramps during her first period and realized that loosing weight was a successful way to prevent both painful periods and growing up.

Nutritional Counseling and Support Groups

Nutritional counseling provides a good opportunity for the patients to understand the importance of good eating behaviors and to incorporate such behaviors in their daily life. Of importance is also the formation of support groups to offer advice on appropriate eating habits. Sturmey (2009) asserted that good nutritional treatment should not only target eating behavior itself but also the behaviors that are related to eating. Family and group support is very necessary in treatment of this disorder. Ayelet (2001) asserted that persons with anorexia require a supportive family where they could discuss openly their feelings and concerns. They also need to share their experiences and problems to those who share the same problems and are undergoing treatment.

Medical Monitoring

Medical treatment may be required to treat severe weight loss and other serious mental or physical health symptoms such as heart disorders, depressions. The Nurse Blog 2009 reports that Anorexia may cause serious medical complications like malnutrition, dehydration and electrolyte imbalances in the body. The result of such complications may lead to serious health complications and conditions like bowel disease, heart failure anemia and even infertility. Thus, regular medical monitoring is a necessity in the treatment of this condition.

Challenges in Implementation of the Medical Plan

Further, it should be noted that any behavioral change process may result into other problems which may require medical attention (Ayelet, 2001). For instance, clients may develop harmful physiological effects, resistance, social isolation and extreme depressive moods which if not monitored may result to resistance, medical complications and even death. My client may develop resistance to nutritional advice and support groups’ and family counseling.   


This paper has discussed the biopsychosocial assessment of a client suffering from anorexia disorder. It has found out that anorexia is a condition of unexplained weight loss due to starvation. It also involves a severe disturbance of the body image and a general fear by the patient of weight gain (obesity). While discussing this condition, the paper has prioritized on the symptoms of the disorder, the strengths of the patients and has finally presented a treatment plan.  The treatment plan highlighted addresses both the symptoms and the destructive eating habits. It attempts to look at the root cause of the problem, whether triggered by emotional, social or biological factors that lead to disordered eating. This paper also takes cognizance of the fact that any treatment plan should first be discussed with the anorexia client before it is implemented. This is due to the other conditions that may arise from an attempt to change behavior and emotions.  

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