A teenage girl with low body mass index due to restricting food intake

2021 ◽  
pp. 181-188
Author(s):  
Kathryn S. Czepiel
Keyword(s):  
Body Weight ◽  
Vital Signs ◽  
Primary Treatment ◽  
Evidence Based ◽  
Teenage Girl ◽  
Refeeding Syndrome ◽  
Intense Fear ◽  
Low Body Mass Index ◽  
Family Based ◽  
Evidence Based Psychotherapy

Anorexia nervosa (AN) is an eating disorder that is characterized by restriction of energy intake leading to significantly low body weight, an intense fear of gaining weight or persistent behavior that interferes with weight gain, and disturbance in the way one’s body weight or shape is experienced. Because many patients with AN attempt to conceal their efforts to lose weight and minimize their symptoms, obtaining information from a caregiver is an important part of the assessment. A medical history and physical examination must be completed to assess medical stability, including review of vital signs, electrocardiogram, and laboratory studies. Medically unstable patients require a medical admission for refeeding and stabilization, including monitoring for refeeding syndrome. Pharmacotherapy should not be used as the primary treatment for patients with AN. The most evidence-based psychotherapy approach for children and adolescents is family-based treatment (Maudsley family therapy).

Effectiveness of a Multidisciplinary Lifestyle Intervention to Reduce Obesity among Children and Adolescents

2020 ◽  
Vol 35 (2) ◽  
pp. 111-118
Author(s):  
Md Rizwanul Ahsan ◽  
Sabrina Makbul ◽  
Probir Kumar Sarkar
Keyword(s):  
Body Composition ◽  
Body Weight ◽  
Children And Adolescents ◽  
Physical Performance ◽  
Cardiometabolic Risk ◽  
Dietary Habits ◽  
Obese Children ◽  
Height Ratio ◽  
Waist To Height Ratio ◽  
Family Based

Background: Now a days unhealthy lifestyle primarily responsible for the dramatic increase obesity among children and adolescents. Objective: The purpose of the study is to see the effects of a multidisciplinary lifestyle intervention to reduce obese children and adolescents. The main outcome was cardiometabolic risk based on the waist-to-height ratio (WHTR) measurement. Secondary outcomes were (1) changes in body composition; (2) adherence to a Mediterranean diet; and (3) physical performance. Methods: The study involved 64 overweight/obese children or adolescents conducted at Dhaka Shishu Hospital from October 2017 to September 2018. The intervention was multidisciplinary including nutrition, exercise, and psychological aspects based on a family-based approach; it was delivered for six months for children and three months for adolescents. Before and after the intervention, several anthropometric measures height, body weight, body mass index (BMI), waist circumference, and body composition, cardiometabolic risk index waist-to-height ratio (WHTR), and dietary habits of the participants and their families were evaluated. In addition, a set of functional motor fitness tests was performed to evaluate physical performance measures. Results: After the intervention both children and adolescents showed a significant reduction in body weight, BMI, waist circumference, fat mass, and WHTR index and an improvement of fat-free mass, adherence to the Mediterranean diet, and physical fitness performance. Conclusion: A short term family-based multidisciplinary approach is effective in ameliorating the health status, dietary habits, and physical performance in children and adolescents. DS (Child) H J 2019; 35(2) : 111-118

Systematic review of the effects of evidence-based psychotherapies on neurocognitive functioning in mood disorders

2021 ◽  
pp. 000486742110314
Author(s):  
Samantha J Groves ◽  
Katie M Douglas ◽  
Melissa Milanovic ◽  
Christopher R Bowie ◽  
Richard J Porter
Keyword(s):  
Systematic Review ◽  
Mood Disorders ◽  
Interpersonal Relationships ◽  
Neurocognitive Impairment ◽  
Neurocognitive Functioning ◽  
Evidence Based ◽  
Current Standard ◽  
Treatment Protocols ◽  
Analytic Review ◽  
Evidence Based Psychotherapy

Objective: Neurocognitive impairment is considered a core feature of mood disorders. Research has shown that neurocognitive impairment often persists beyond mood symptom resolution and can have significant deleterious effects on interpersonal relationships, academic achievement, occupational functioning and independent living. As such, neurocognitive impairment has become an important target for intervention. In this systematic review, we aimed to examine the extant literature to ascertain whether current standard evidence-based psychotherapies can improve neurocognitive functioning in mood disorders. Method: Studies examining changes in neurocognitive functioning following evidence-based psychotherapy were identified using MEDLINE, PsycINFO and Web of Science databases. Given the heterogeneity of study procedures, treatment protocols and patient samples, a narrative rather than meta-analytic review technique was employed. Results: Nineteen studies (21 articles) met inclusion criteria. There was preliminary evidence of improved executive functioning following evidence-based psychotherapy for Major Depressive Disorder and Bipolar Disorder. There was also some signal of reduced negative biases in emotional information processing following psychotherapy in depression. Due to methodological variability across studies however, it was difficult to draw clear conclusions. Conclusion: Findings from the current review suggest that evidence-based psychotherapies may influence some aspects of neurocognitive functioning in mood disorders. This continues to be an ongoing area of importance and warrants further research.

scholarly journals Effects of Three Different Family-Based Interventions in Overweight and Obese Children: The “4 Your Family” Randomized Controlled Trial

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 341
Author(s):  
Panagiotis Varagiannis ◽  
Emmanuella Magriplis ◽  
Grigoris Risvas ◽  
Katerina Vamvouka ◽  
Adamantia Nisianaki ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Weight ◽  
Screen Time ◽  
Overweight And Obesity ◽  
Z Score ◽  
Obese Children ◽  
Group 3 ◽  
Group 2 ◽  
Family Based ◽  
Family Based Interventions

Childhood overweight and obesity prevalence has risen dramatically in the past decades, and family-based interventions may be an effective method to improve children’s eating behaviors. This study aimed to evaluate the effectiveness of three different family-based interventions: group-based, individual-based, or by website approach. Parents and school aged overweight or obese children, 8–12 years of age, were eligible for the study. A total of 115 children were randomly allocated in one of the three interventions, and 91 completed the study (79% compliance); Group 1 (n = 36) received group-based interventions by various experts; Group 2 (n = 30) had interpersonal family meetings with a dietitian; and Group 3 (n = 25) received training through a specifically developed website. Anthropometric, dietary, physical activity, and screen time outcomes were measured at baseline and at the end of the study. Within-group comparisons indicated significant improvement in body weight, body mass index (BMI)-z-score, physical activity, and screen time from baseline in all three study groups (p < 0.05). Furthermore, total body fat percentage (%TBF) was also decreased in Groups 2 and 3. Between-group differences varied with body weight and %TBF change, being larger in Group 3 compared to Groups 1 and 2, in contrast to BMI-z-score, screen time, and health behaviors, which were significantly larger in Group 2 than the other two groups. In conclusion, personalized family-based interventions are recommended to successfully improve children’s lifestyle and body weight status.

scholarly journals Using evidence-based psychotherapy to tailor treatment for patients with FND

2021 ◽  
pp. 100478
Author(s):  
Myers Lorna ◽  
Sarudiansky Mercedes ◽  
Korman Guido ◽  
Baslet Gaston
Keyword(s):  
Evidence Based ◽  
Evidence Based Psychotherapy

scholarly journals IV fosphenytoin in obese patients

2016 ◽  
Vol 7 (1) ◽  
pp. 45-52 ◽  
Author(s):  
Sarah L. Clark ◽  
Megan R. Leloux ◽  
Ross A. Dierkhising ◽  
Gregory D. Cascino ◽  
Sara E. Hocker
Keyword(s):  
Body Weight ◽  
Adverse Events ◽  
Vital Signs ◽  
Drug Distribution ◽  
Retrospective Chart Review ◽  
Current Method ◽  
Liver Function Tests ◽  
Excess Body Weight ◽  
Obese Patients ◽  
Bonferroni Adjustment

AbstractBackground:Previous studies evaluated the disposition of IV phenytoin loading doses and found that obese patients had increased drug distribution into excess body weight, larger volumes of distribution, and longer half-lives when compared to their nonobese counterparts. We assess the safety and efficacy of fosphenytoin loading doses in patients with different body mass indices (BMIs).Methods:A retrospective chart review was conducted in 410 patients who received fosphenytoin. Patients were divided into 2 groups: BMI <30 (nonobese) and BMI ≥30 (obese). Patient demographics, fosphenytoin dose administered in mg/kg body weight, renal and liver function tests, fosphenytoin drug levels, and pre- and post-fosphenytoin administration vital signs were collected to assess for adverse events. Necessity of additional antiepileptic loading doses was used as a surrogate for clinical efficacy.Results:The median dose of fosphenytoin administered was 19 mg/kg (interquartile range 15–20). The most frequently encountered adverse event was hypotension, which occurred in 39% of the cohort. Using a Bonferroni adjustment for multiple comparisons, there were no differences in adverse events between the 2 groups. The need for additional antiepileptic loading doses was not different between the 2 groups (p = 0.07).Conclusions:The incidence of adverse events and the need for repeat loading antiepileptic medications was similar between the 2 groups. From our findings, the patients in our study did not receive empiric loading dose adjustments and the current method of loading fosphenytoin achieves similar outcomes, regardless of the patient's BMI.

scholarly journals Translating evidence-based treatment for digital health delivery: a protocol for family-based treatment for anorexia nervosa using telemedicine

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
A. Hambleton ◽  
D. Le Grange ◽  
J. Miskovic-Wheatley ◽  
S. Touyz ◽  
M. Cunich ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Young People ◽  
Treatment Effectiveness ◽  
Digital Health ◽  
Evidence Based ◽  
Treatment Needs ◽  
Evidence Based Treatment ◽  
Face To Face ◽  
Family Based Treatment ◽  
Family Based

Abstract Background Family-based treatment (FBT) is an efficacious outpatient intervention for young people diagnosed with Anorexia Nervosa (AN). To date, treatment to protocol has relied on standard face-to-face delivery. Face-to-face therapy is subject to geographic, temporal and human factors, rendering it particularly susceptible to inequities and disruption. This has resulted in poorer service provision for rural and regional families, and recently a significant challenge to providing face-to-face services during the COVID-19 global pandemic. The present study examines whether FBT for AN can be successfully translated to a digital delivery platform to address these access issues. Method Forty young people aged 12 to 18 years who meet DSM-5 diagnostic criteria for AN, and live in a rural or regional setting, will along with their family be recruited to the study. Trained therapists will provide 18 sessions of FBT over 9 months via telemedicine to the home of the young person and their family. The analysis will examine treatment effectiveness, feasibility, acceptability, and cost-effectiveness. Discussion The study addresses the treatment needs of families not able to attend face-to-face clinical services for evidence-based treatment for eating disorders. This might be due to several barriers, including a lack of local services or long travel distances to services. There has been a recent and unprecedented demand for telemedicine to facilitate the continuity of care during COVID-19 despite geographical circumstances. If delivering treatment in this modality is clinically and economically effective and feasible, it will facilitate access to potentially lifesaving, evidence-based treatments for families formerly unable to access such care and provide evidence for the continuity of services when and where face-to-face treatment is not feasible.

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