Guest guest Posted December 3, 2004 Report Share Posted December 3, 2004 other than her wt loss I'd want to know about her other clinical indices- like labs, s/s vit/mineral deficiencies- etc.. she may need a combination of hydration or PPN w/micronutrients as well as a TF for trophic feeding. Is she taking any anti-depressants? Is she in psychotherapy? She'll need to take oral feeding as a goal. Technically, she's not under weight- so the rate which she's lost weight is also important. I'd be interested to know how she does. Eva H. RD LD CNSD Nutrition Support Program Coordinator- NCI 301-362-7840 -------------- Original message -------------- I have a pt that is admitted for anorexia. This has been going on for a while starting weight 400 at 4'11 now 125# she has that fine hair all other her. any suggestions on what to do with her. I haven't seen her today yet she was sleeping yesterday. Thanks ideas calorie count, PPN or TF. I think she would be ok with PPN as she as had it before and knows the calories are low and no CHO. Janelle Heusinger RD/LD Grinnell Medical Center 641-236-2488 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 26, 2007 Report Share Posted January 26, 2007 Hi folks: Here is an article on slimness in fashion models: http://www.foxnews.com/story/0,2933,247162,00.html Of course, anorexia is no joke and people on CR probably need to be well aware that, among those who decide to eat less in the interests of their health, in a very small percentage of cases, eating less can 'get away on them on the downside' and they lose control. The article of course makes no reference to the dangers of obesity, or even that optimal health is probably associated with a caloric intake a lot closer to the low end of the known range of intakes, than the high end. It refers to a model who recently died " from anorexia " called Ana Carolina Reston. It says that she ate only apples and tomatoes. The issue this raises is not only eating excessively few calories, which of course is not desirable, but, at least as important, NOT GETTING THE RDAs OF ALL THE NECESSARY NUTRIENTS WHATEVER ONE'S CALORIC INTAKE. Take a look at the following for example. Suppose Ana Carolina had been eating plenty of calories of only apples and tomatoes - say 1600 kcal/day - half from apples, half from tomatoes. Her diet would have had a low fat content, but probably not dangerously so. She would have had zero or close to zero intake of five amino acids; zero intake of selenium, and vitamins B12 and D; and less than one-fifth the RDAs for: folate, B3, B5, E, Ca, Fe, Mg, Mn and Zn. And she would not have been ingesting 100% of the RDA for any micronutrient. So I doubt she died from insufficient calories. More likely it was the result of starvation of vital nutrients, without which the body cannot function. Of course one does not need to be a fashion model to have some, or possibly several, nutrient deficiencies. And it is very difficult to know without checking one's food intake for at least a week. But perhaps the emphasis of the fashion industry should be on teaching young impressionable girls the fundamentals of nutrition, which entails more than just eating extra calories to fatten up to a BMI of 18. It is worth taking a look at Michelangelo's sculpture of for reference. Notice particularly that his ribs are clearly visible. Are fashion models in dangerous territory just because their ribs are showing? I doubt it. I have suggested here before that a working definition of 'anorexia' might be: " failing, after checking one's nutrient intake in detail, to fix any micronutrient deficiencies when they turn up, preferably from food sources. Or refusing to do the check. " Perhaps a certain minumum body fat level should also be incorporated into that definition. But my principal point here is that nutrient deficiencies are not confined to fashion models, and fashion models who die may not be dying of too few calories. Rodney. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 14, 2007 Report Share Posted August 14, 2007 I too, was anorexic when I was 14. That was 20 years ago. I got down to a dangerously low weight and was hospitalized at Children's Hospital in Boston. Although I don't agree 100% with their treatment plan at the time, I did within a year decide on my own that I had had enough and that was it, I slowly got better. I have moved on and have put on pounds having children and joined WW and gotten down to a healthy, not skinny, weight for myself in a slow and healthy way. It's hard to be a teenage girl and even harder with OCD. My prayers are with you both. > > Grace, > > I am touched by your story. How old is your daughter? > Is she still in treatment for the anorexia? Are her > OCD compulsions and fears related to food and body > image? > > When I was 17, I was anorexic. Back then, (1972) no > one used that term, but that was my condition. Anyway, > I walked for hours every day, exercised like crazy, > constantly thought about how to avoid eating, and > barely ate anything. I " dieted " all the time, though I > hovered at 100 lbs. and looked terribly thin. (I am 5' > 6 " .) I have no idea how I got out of that anorexic > state. Somehow I went into adulthood without this > emotional plague. > > I kept a reasonable, healthy weight throughout my life > until the last few years, when I have put on a lot of > extra pounds. (Probably related to my depression, > exacerbated by my marital problems.) I just want to > say that it is possible to leave anorexia behind, and > I hope that your daughter will heal and be able to > address the OCD without the disabling and dangerous > anorexia underlying it. > > in VA > > > > ________________________________________________________________________________\ ____ > Take the Internet to Go: Go puts the Internet in your pocket: mail, news, photos & more. > http://mobile./go?refer=1GNXIC > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 14, 2007 Report Share Posted August 14, 2007 I too, was anorexic when I was 14. That was 20 years ago. I got down to a dangerously low weight and was hospitalized at Children's Hospital in Boston. Although I don't agree 100% with their treatment plan at the time, I did within a year decide on my own that I had had enough and that was it, I slowly got better. I have moved on and have put on pounds having children and joined WW and gotten down to a healthy, not skinny, weight for myself in a slow and healthy way. It's hard to be a teenage girl and even harder with OCD. My prayers are with you both. > > Grace, > > I am touched by your story. How old is your daughter? > Is she still in treatment for the anorexia? Are her > OCD compulsions and fears related to food and body > image? > > When I was 17, I was anorexic. Back then, (1972) no > one used that term, but that was my condition. Anyway, > I walked for hours every day, exercised like crazy, > constantly thought about how to avoid eating, and > barely ate anything. I " dieted " all the time, though I > hovered at 100 lbs. and looked terribly thin. (I am 5' > 6 " .) I have no idea how I got out of that anorexic > state. Somehow I went into adulthood without this > emotional plague. > > I kept a reasonable, healthy weight throughout my life > until the last few years, when I have put on a lot of > extra pounds. (Probably related to my depression, > exacerbated by my marital problems.) I just want to > say that it is possible to leave anorexia behind, and > I hope that your daughter will heal and be able to > address the OCD without the disabling and dangerous > anorexia underlying it. > > in VA > > > > ________________________________________________________________________________\ ____ > Take the Internet to Go: Go puts the Internet in your pocket: mail, news, photos & more. > http://mobile./go?refer=1GNXIC > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 14, 2007 Report Share Posted August 14, 2007 hi My dd is 15 and still in treatment. Since I still view the ocd rules as primary, I feel we have alot of trouble adressing the anorexia in context of ocd. My dd never had any of the more typical tiggers or onset, with dieting, body image, peers, excessive exercise etc. (She was homeschooled and we do not have emphasis on fashion appearance weight etc-though new providers alway ask her if I diet or obsess over my body so on). She got two severe viruses back to back and was no longer able to eat without fear afterwards. She claimed to hear messages telling her not to eat (of course there was alot of talk about hospitalization during the ilnness b/c she was thin in 10th percentiles to start out- this must have scared her and ramped up her anxiety) . She also had a history of veering towards delusionality and somewhat abnormal cosnciouness during fevers anyways. So she lost 12 lbs from illness and was not able to gain anything back. She devised rituals to make eating safe, whereby she could eat things most anorexics would avoid. This led to a hospital discharge one time b/c she happened to eat a good breakfast and they could not see how that could constitute anorexia. She had aso had as her last meal (before going on a 3 day fast trigering that admission) a birthday dinner of pizza and cake. It was the fasting that did her in, she would go on a fast for as long as 3 days if her rules were messed up, or she would pre-emptive fast if she foresaw that her rules would be messed up by outings or company etc. I guess it came to be more like anorexia over time. I still believe these ocd rules underly her eating behavior, but she goes along with the perception she is just into typical bu obsessive dieting to keep her T off the trail. For example she is fine with mainatining weight, so her UCLA discharge was a weight she maintained for several months, but she cannot volunatrily gain a single lb, that violates the rules. Her current weight loss started when her therapist and dietician took away the fixed meal plan she followed from UCLA, b/c it was too inflexible, and she needed to become more indepenedent and intuitive in her eating. Taking away her rules and routine did not help, b/c it immediately triggered weight loss, though eating in that fashion is not considered normal or healthy either. But bottom line she began losing wieght in therapy and it has been slow but steady. I have had her out of therapy to see if she would return to old eating routine, but no. Then recently she became ill with a prolonged virus again and is now 10 lbs down from her disharge weight. I know in my mind, that no matter how much her team persuades begs or threatens, she will not gain a lb volunatrily b/c the rules do not allow it. That is just how absolute her thinking is. So I am in a quandary again. She needs to gain but how....otherwise her behaviors are much better than before UCLA, they found a med that calms her anxiety and sensory stuff alot, but not enough I guess to eliminate the rules. nancy grace , ----------- <design4waves@...> wrote: > > Grace, > > I am touched by your story. How old is your daughter? > Is she still in treatment for the anorexia? Are her > OCD compulsions and fears related to food and body > image? > > When I was 17, I was anorexic. Back then, (1972) no > one used that term, but that was my condition. Anyway, > I walked for hours every day, exercised like crazy, > constantly thought about how to avoid eating, and > barely ate anything. I " dieted " all the time, though I > hovered at 100 lbs. and looked terribly thin. (I am 5' > 6 " .) I have no idea how I got out of that anorexic > state. Somehow I went into adulthood without this > emotional plague. > > I kept a reasonable, healthy weight throughout my life > until the last few years, when I have put on a lot of > extra pounds. (Probably related to my depression, > exacerbated by my marital problems.) I just want to > say that it is possible to leave anorexia behind, and > I hope that your daughter will heal and be able to > address the OCD without the disabling and dangerous > anorexia underlying it. > > in VA > > > > ______________________________________________________________________ ______________ > Take the Internet to Go: Go puts the Internet in your pocket: mail, news, photos & more. > http://mobile./go?refer=1GNXIC > Quote Link to comment Share on other sites More sharing options...
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