Vignette 1: Brandy

This case involves a 19 year old Caucasian female named Brandy. She is 5’5” tall and weighs
116 lbs. She states that on a “good day” she would eat a breakfast of dry toast and juice, a lunch
of turkey or dry tuna on diet bread, and a low fat frozen meal at dinnertime. When she was being
‘bad’ she would include a couple of candy bars and two large ‘gourmet’ chocolate chip cookies.

Brandy says that she feels fat and is sure that others are disgusted by the way she looks. She
doesn’t think that others want to be around her because of her weight “problem” and how she
looks.

She has tried a number of diets to control her weight. A couple of years ago, she saw a
television show that discussed throwing up after eating as a way to control their weight. She has
hidden her habit of purging after eating. She doesn’t want anyone to know.

Brandy has begun to isolate herself and states she feels sad most of the time. She has begun to
have trouble with friends at work because she makes excuses not to go out with them. When
friends express concern, she becomes more distant and becomes agitated with them.

She admits that she doesn’t have much hope that anything will change about her weight or her
feelings.. She mentions that she has stopped having regular periods and developed some dental
problems which causes more concern over the way she looks.

The information regarding Brandy’s family of origin is sketchy, however, Brandy describes her
mother as someone who was severely overweight and was always on a diet. She recalls her
father being particularly cruel to her mother with his snide comments about her weight. Brandy
also remembers times that her father looked at her in ways that made her uncomfortable and his
conversations often included sexual overtones. However, she states that he never touched her
inappropriately.