Helena’s Story

Helena was a 16-year-old girl who lived at home with her parents and younger sister. Throughout her teenage years, she had been a normal weight but she worried a great deal about her body weight and shape. She often compared her body weight with that of other girls and women she met or saw — and then judged herself as too heavy.

Often, Helena checked her body weight by looking in the mirror. She would pinch the skin on her sides and notice that her thighs touched each other. At about age 14 she began to diet, first off and on, and then all the time. At 15, she decided to become a vegetarian and began to cut out many foods from her diet. She was 5’6” and weighed 125 pounds at age 15, but by her 16th birthday she had dropped to 110 pounds.

Rather than being relieved by this weight loss, she kept seeing herself as too heavy. She weighed herself throughout the day. She spent most of her time worrying about her weight. Time spent on her weight concerns took the place of other activities she used to enjoy, such as school work and having fun with friends. She became more alone. And she kept losing weight.

Her parents became more alarmed about her weight loss and behavior. They talked about this between themselves and started watching and checking her eating behavior at meals. They urged her to eat more often, without success. She kept losing weight, and six months later she weighed 98 pounds.

Helena appeared very thin. She often was withdrawn, hard to talk to and distracted. She seemed weak — but did heavy exercise twice each day. She preferred to stand or pace rather than to sit and relax. Because of their concerns, her parents took Helena to see the family doctor for an evaluation.

Helena was diagnosed with anorexia nervosa, restricting type. Her low food intake, low weight (BMI 15.8), frequent exercise and constant concern about her body weight despite being very thin are hallmarks of the diagnosis.

Have a Story of Your Own to Share?

This patient story is excerpted from Understanding Mental Disorders: Your Guide to DSM-5.

Understanding Mental Disorders is a consumer guide designed to promote education and understanding among anyone who has been touched by mental illness.