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From the Eating Disorder Service, NHS

Dear Dr *******,

Re: Lydia Davies. DOB 04.08.1991.

Thank you for referring the above patient to the Eating Disorder Service. Lydia was seen by me for assessment on 12/12/11.

Presenting problem:

Lydia suffers with anorexia nervosa.

Past history:

Lydia describes the problem originating in depression. She has also become vegan as a bet with her brother at Easter 2010, and had started losing weight due to the change in her diet. This got worse in the summer after she was diagnosed with genital warts and found the diagnosis and treatment humiliating and felt unable to tell anyone about it. She spent a lot of time alone over the summer and said she spent too much time thinking, which made things worse. Her weight had dropped from around 60kg at Easter in 2010 to 47kg in the summer of 2011. Since returning to university in September her weight loss seems to have escalated and by the beginning of December 2011 she was 37kg. She is aware that others think this is a problem and she is very underweight, but Lydia’s understanding of how serious this is appears to fluctuate somewhat.

Current eating pattern:

At assessment Lydia described following a vegan diet and avoids wheat as she believes she may be wheat intolerant. She doesn’t eat nuts as she doesn’t like them and tends to avoid carbohydrates.

A typical day’s diet would be:

Breakfast – two spoons of oats

Lunch – salad with beans or tofu

Dinner – soup with salad and some kidney beans