Case study:
Kathleen is a 5'6", 130-pound, 20-year-old college junior. Over the last few years she has gained and
then lost ten to fifteen pounds several times. Recently she has been trying hard to keep her weight down.
Like many college students, Kathleen goes out every weekend and tends to overindulge. During the week
she lives the life of a serious student, eating very little and getting 7-8 hours of sleep every night. By
Friday she is ready to have some fun. She usually goes out with friends to a nearby burger or taco shop
and then finds a party. At the party Kathleen will have four or five drinks and munch on chips or pretzels.
By 3 a.m., when she and her friends are ready to call it a night, they usually are hungry again. This
means finding pizza, waffles, or any other food they can find at that hour of the morning. After a late night
out, Saturdays are spent catching up on some sorely needed sleep. By Saturday night she is ready to go
out and do it all over again. Sundays are usually spent relaxing at a hearty Sunday brunch, watching
movies with her friends accompanied by a giant bowl of popcorn, and finishing homework that's due
Monday morning.
Kathleen realizes that her weekend binges may cause her to gain weight, so she cuts way down on
calories Monday through Thursday. Kathleen has been trying to stay active and build up some muscle
mass by running. Recently, her strict dieting is making this more difficult. During the week Kathleen eats
so little that she often feels weak or lightheaded, especially following her long-distance runs. Although she
is running a great deal, her muscles are not getting as large as she had hoped. On Mondays and
Tuesdays her diet is very hard to stick to. Kathleen is always starving. However, by the end of the week
she no longer feels so hungry. Kathleen also notices that she has a much harder time paying attention, is
sensitive to the cold temperatures, and finds it all too easy to catch a cold or flu.
For a while she was able to overcome this and still go out on the weekends, but she is starting to feel that
it is not worth being so miserable during the week, no matter how much fun her weekends may be.
Kathleen knows she is putting her body through a lot of stress, but needs someone to explain what is
happening as she experiences the consequences of a weekly roller coaster ride from feasting to fasting.
Answer the following as a RDN
1. a) Over the weekend, I eat a lot of more food compared to the weekdays. How does my body
handle all of that extra calories? (Discuss the body's reaction to excess carbohydrate, protein,
and fat.)
b.) On the weekends, I like to go out drinking with my friends. Is that really going to affect my
health? (1. Explain alcohol's effects on the liver, both short term and long term 2. Explain the
long-term consequences of Kathleen's eating pattern and alcohol consumption on her vitamin
status )
c.) During the week when I donât eat a lot, what is my body running on for fuel? (During periods
of fasting, how are metabolic fuels used differently compared to their use with a healthy,
consistent diet? Describe some of the negative effects associated with this.)
d.) How is this fuel different when I am eating a lot over the weekend? (During periods of
feasting, how are metabolic fuels used differently compared to their use with a healthy,
consistent diet?)
