Question

Eating disorder case study

Jennifer is a 19 years old women. Her height is 165.1 cm and her weight is 62.59 kg. laboratory data: glucose, 82 mgdl; albumin, 4.2 g/dl; cholesterol, 180 mg/dl; potassium, 2.7 mmol/l; serum co2 mmol/l. Anthropometric status: skin fold: triceps, 20 mm; biceps 7 mm; subscapular 10 mm; suprailiac 13 mm; midarm circumference 26.7 cm; midarm muscle circumference 20.4 cm.

Jennifer has always been unhappy with her weight. she went on every fed diet throughout high school and lost some weight but always regained it. About 1 year ago, Jennifer began binge eating. Binge episodes now occur three to four times per week. During these binges, Jennifer consumes about 1500 to 2000 kcal in a 2-hour period. Binge foods include ice cream, cookies, potato chips, and other foods. Jennifer describes them as “fattening and unhealthy” after binge eating Jennifer feels extremely guilty, and vomiting is immediately self-induced. Jennifer always tries to eat as little as possible the next day, sometimes consuming only 700 or 800 kcal. Three months ago, Jennifer started to overdose on laxative about three times a week. She occasionally uses over-the- counter diet pills, but they never really help. Jennifer feels fat in her abdomen, buttocks, and thighs. Her physical activity includes 100 sit-ups and 100 leg lifts three or four times per week.

• Calculate the nutritional requirements and write the Nutrition Care Process

• plan a sample menu

Answer 1

Jennifer should maintain a healthy balanced diet inorder to improve her quality of life. High fat, high energy dense food and sedentary life style are the main cause of weight gain. A low fat diet contribute to the good health. Type of fat a person eat is important than the amount they eat.

No estimation equation accuratly estimates the requirements in obese individuals. Indirect colorimetry remains as gold standard. Estimating requirements are just starting point only. Nutrition monitoring is essential including blood glucose and respiratory functions. In indirect colorimetry as food is oxidised oxygen is ultilised and CO2 is produced. Then energy expenditure is calculated.

Higher protein diet seems to have some advantages for weight loss. It will give more satiety, greater thermic effect which will help to burn energy.

Replacing red and processed meat with nuts, beans and fish lower the risk of many diseases.

Intake of lower carbohydrates and higher protein can help to weight loss in short term. Fiber are best solution for weight loss as they are slowly digested so can curb hunger.

The whole grains, brown rise, barely etc which in less processed forms are digested more slowly than refined grains. Thus intake of this food can cut back on calories from other foods. Limit sugared beverages and refined grains.

A meditatarranean diet plan can be recommended for jennifer.

Breakfast: seven grain hot cereal with yoghurt and fig preserves.

Lunch: grilled chicken pitas, with sesame drizzle.

Dinner: seared salmon salad with black berries.

Snacks: beet chips, rosemary roasted almonds, vegetables with yoghurt dip.