Bulimia Nervosa Diagnosis and Procedural Plan

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Diagnosis

Bulimia nervosa

The patient has been showing the tendency to vomit after every instance of food intake, which is the primary sign of bulimia (American Psychiatric Association, 2013). According to the existing definition, the diagnosis of bulimia aligns with the observed symptoms fully (Miller et al., 2021). Therefore, the problem of bulimia is the main issue to be addressed.

Procedural Plan

Managing binge-eating

To ensure that the patient develops healthy eating habits, a schedule for the daily food intake will be provided for K. to follow.

Changing the thinking patterns

K. will need to develop a healthier coping mechanism for managing her anxiety and addressing her emotional needs in a different way than binge eating. Healthy solutions include improving communication with people around K. and introducing a rational problem- and conflict-management technique.

Promoting long-term change

To reduce the threat of relapse in K., the proposed strategy must be based on a long-term framework. Namely, the use of appropriate medications and counseling will be encouraged (Ben-Porath et al., 2020).

Checking progress

It is crucial to keep the process of change continuous, which is why checking on whether K. follows the prescribed strategies will be vital. For this purpose, counseling and visits to a healthcare practitioner will be seen as a part of the treatment plan. As soon as healthy patterns are reinforced and integrated into the patients life, K.s case can be considered resolved.

Pathophysiology and Pharmacology

Bulimia is related to the feeling of lack of control that leads to destructive eating behavior There are often cases of hypokalemia or fluid and electrolyte disturbances (Bulimia Nervosa, 2018). There also can be swollen parotid glands, dental erosion, and scars on the knuckles that are resulted from using fingers to vomit. For the pharmacological treatment of bulimia nervosa, the only approved antidepressant is fluoxetine (Prozac), which is a sort of selective serotonin reuptake inhibitor (SSRI) (Bulimia nervosa Diagnosis and treatment Mayo Clinic, 2018). Other medications will be prescribed based on the presence of physical conditions due to the side effects of the disorder. For example, medications for dental care or stomach issues can be provided.

Additional analysis of the case

There are evidence-based clinical guidelines to follow when dealing with bulimia. The standard criteria that are used to identify bulimia consist of recurrent overeating, regular purging through vomiting, systematic purging behaviors, such as excessive exercising, fasting, and misuse of medication, such as laxatives (Bulimia Nervosa Diagnosis, 2020). Treatment guidelines are offered by various governmental and non-governmental organizations, such as the American Academy of Pediatrics, the American Psychiatric Association, and the German S3 Guideline. There are also other alternative treatment methods that are at the testing and examinations stage.

Follow-up/Referrals

When having the follow-up visit of the patient, the medical professional should further decide the care plan with regard to existing conditions. In most cases, the patient undergoing the cognitive-behavioral treatment is likely to benefit from the program during the period of 1 to 3 years (Hilty, 2021). This suggests that the issue of bulimia should be monitored and controlled for a long time. A professional also can provide additional sessions for the patient if the therapy is going ineffective. Following that, there can be consultations with other medical professionals to make a comprehensive care plan because eating disorder is a complex issue. In addition, there should be the SCOFF Questionnaire and the EAT-26 (Eating Attitudes Test) tests to determine the risk associated with an eating disorder and discuss the result with the treatment team. For further consultations and engaging other medical workers, the patient should give consent.

Quality

Once similar cases appear during the medical practice, I will try to listen to the patient, as bulimia is a deep psychological issue that can be a result of different events or traumas. I will also focus on their background and social relations, asking questions about how they behave in a community. This is because I assume that communicating about the patients feelings towards their self-image and how they think people view them is critical to help the patient. Moreover, informing a patient about complications and methods of treatment should be provided to ensure the patients education and understanding.

By careful examination of the needs and preferences of the patient, I can then plan the treatment. I also want to engage with family members when dealing with eating disorders. I think that eating disorders are not an individual problem but the group one, as family or friends are also affected. So with the active engagement of the family members/friends and the patient themselves, similar cases of bulimia or any other eating disorder can be treated.

Coding and Billing

F50.2 Bulimia Nervosa
F50.81 Binge eating disorder
F50.82 Avoidant/restrictive food intake disorder
F50.89 Other specified eating disorder
F50.9 Eating disorder, unspecified
F50 Eating Disorder

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of mental disorders (5th ed.). APA.

Ben-Porath, D., Duthu, F., Luo, T., Gonidakis, F., Compte, E. J., & Wisniewski, L. (2020). Dialectical behavioral therapy: An update and review of the existing treatment models adapted for adults with eating disorders. Eating Disorders, 28(2), 101-121. Web.

Bulimia Nervosa Diagnosis, DSM-5 Criteria, Diagnostic Tests. (2020). Walden Eating Disorders. Web.

Bulimia nervosa Diagnosis and treatment Mayo Clinic. (2018). Mayo Clinic. Web.

Hilty, D. M., MD. (2021). Bulimia Nervosa Follow-up: Further Outpatient Care, Deterrence/Prevention, Complications. Medscape. Web.

Miller, A. E., Racine, S. E., & Klonsky, E. D. (2021). Symptoms of anorexia nervosa and bulimia nervosa have differential relationships to borderline personality disorder symptoms. Eating Disorders, 29(2), 161-174. Web.

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