Week 5

Areas of concern:

        The appearance of the patient would be the first element which I would notice. The patient lacks physical strength and seems emaciated. Her claim of difficulty focusing in class would be the next element of concern which I would approach. Eating problems are linked to somatic problems that affect all major body systems, as well as psychological consequences. This individual may be suffering from serious underlining mental conditions that are affecting not just her looks but also her mental function, endurance, digestion, and reproductive functions " Anorexia has the greatest fatality rate of any mental health disorder, with a five-year fatality rate of 14% to 20%, with electrolyte imbalances, starvation, and suicide accounting for the preponderance of fatalities (Moore.Bokor 2021).

Screening tools for a better diagnostic

Even the finest health care practitioners overlook eating problems because they are not as easy to reveal or recognize as one might imagine. Because eating problems have the greatest death rate of any psychiatric condition, it is critical that they be identified and treated as quickly as possible. The SCOFF survey is a short, easy, and standardized tool provided to physicians to identify if their patients are displaying signs of an eating problem.  The term SCOFF stands for the 4 survey questions:

1. Sick: Do you ever puke by making yourself nauseous after a meal because you are overly full?
2. Control: Do you find yourself often overeating?
3. One stone: Has the individual dropped one stone or 14 pounds in the last three months?
4. Fat: Do you think you're obese despite the fact that others say you're too slender?
5. Food: Is eating the center of your universe?

With specificity and sensitivity of 93.5 and 53.7 percent, if the individual responds positively to 2 or more of the statements mentioned, it is likely that the individual has bulimia or anorexia (Mitchell,Peterson,2020).

Health promotion strategy:

Because an eating problem is complicated, with a psychiatric and behavioral aspect, it is important to examine the full person, and also their familial situation, when formulating a therapeutic strategy. Obtaining a thorough medical status and doing a thorough physical examination are the first steps in formulating a treatment strategy. This patient appears incredibly weak and fragile, which may be the initial indication that something is wrong. Her concern of difficulties focusing in class is the next indication, that is another prevalent problem when it comes to losing weight. In combination with blood results such as a Complete Blood Count, thyroid status tests, liver functioning tests, urinalysis, the next stage is to provide a standardized questionnaire to obtain more data from the individual. A bone densitometry examination to check for low bone density or an estradiol measurement to check for non-detectable or low levels are two further procedures to consider (Moore,Bokor,2021).

The aim of the therapy is to return the individual to a healthy body weight and a balanced dietary habit, with the intensity of therapy varying depending on the severity of the patient's condition. Antidepressant drugs have proven almost no effect in people with eating problems, despite the fact that eating disorders are regarded as mental conditions.  They demand eating analysis and supervision from a nutritionist or dietitian, as well as dietary rehabilitation with healthy meals and enough caloric intake for eating disorder treatmentBehavioral monitoring is also suggested and proven to be successful. Presently, family-based therapy (FBT) is perhaps the most effective in helping patients lose weight, but it falls short when it comes to mental problems. Blood counts, electrolytes, and micronutrients will all need to be examined on a regular basis to spot any irregularities or shortages that could require treatment, by putting the patient in danger. Once the sufferer's body weight has been regained and he or she is no longer at risk of further issues, behaviorally oriented therapy will be employed to avoid recurrence  (Moore,Bokor,2021).

References

Mitchell JE, Peterson CB. (2020) ,Anorexia Nervosa. N Engl J Med. 2020 Apr 2;382(14):1343-1351. doi: 10.1056/NEJMcp1803175. PMID: 32242359.

Moore CA, Bokor BR. Anorexia Nervosa. [Updated 2021 Sep 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459148/