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Advice Pool - Disordered Eating: Treatment and Nutritional Strategies
The Female Athlete Paradox
There is indeed a paradox when it comes to female athletes and energy intake. On the one hand, they may need to consume a high calorie diet because of their extreme training intensity. On the other hand, they may feel that they are eating too much compared to non-athletes, they may develop self-imposed weight restrictions, and coaches may propose team-imposed
There is indeed a paradox when it comes to female athletes and energy intake. On the one hand, they may need to consume a high calorie diet because of their extreme training intensity. On the other hand, they may feel that they are eating too much compared to non-athletes, they may develop self-imposed weight restrictions, and coaches may propose team-imposed
According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product
weight limits. These factors can influence behaviors to the point where an athlete can develop disordered eating patterns. Lori Gross describes disordered eating and its relationship to The Female Athlete Triad. In this article, I presents treatment and nutritional strategies for eating disorders.
Treatment
The general principles of treating an athlete afflicted with a disordered eat
Treatment
The general principles of treating an athlete afflicted with a disordered eat
; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.
Examples of combination products may in
Examples of combination products may in
ing behavior (i.e. anorexia nervosa or bulimia nervosa) involve education about the physiological and psychological consequences, encouragement to begin eating a healthy diet and control eating behaviors, and emotional support for the patient and family. Mild cases of disordered eating behavior can be managed by the family physician, but a great deal of time and sincere interest are req
lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.
uired. More severe cases are best treated by those experienced in treating the disorder. These cases require various combinations of support, psychological counseling, and diet counseling.
Outpatient treatment addresses the patient’s fears and misconceptions surrounding eating. Psychological counseling addresses personal, family, and social issues that exist. For younger patients under
Outpatient treatment addresses the patient’s fears and misconceptions surrounding eating. Psychological counseling addresses personal, family, and social issues that exist. For younger patients under
here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
parental supervision, the parents must be involved in the treatment program. While a variety of treatment techniques exist, none appear to be better than the others. Important factors in determining the success of the treatment program are considering the individual needs of the patient in planning the treatment program and the characteristics of the patient and the illness.
When weig
When weig
d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.
Combination pro
Combination pro
ht loss, binging, or purging continue despite outpatient treatment efforts, intensive hospital treatment is required. The decision to hospitalize a patient is based on the extent of weight loss, the inability to control a self-destructive eating behavior, presence of a severe electrolyte disturbance, depression, family conflicts, and the patient’s lack of motivation for change. Hospital
ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc
treatment requires the teamwork of a physician, psychiatrist, social worker, nurse, and dietitian. All of the involved personnel should be familiar with the patient’s treatment plan and individual needs. While the patient does not need to be admitted to an “eating disorders unit”, the hospital unit that is treating the patient should be geared towards treating eating disorders.
Nutrit
Nutrit
easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi
ional Strategies
Treatment of disordered eating syndromes involves the joint efforts of a physician and a dietitian. They usually meet with the patient separately, once per week. With anorexic patients, the dietitian deals with the effects of semi-starvation diets, energy needs, nutrient needs (allowing for growth if an adolescent) and the dietary modifications necessary to reestablish
Treatment of disordered eating syndromes involves the joint efforts of a physician and a dietitian. They usually meet with the patient separately, once per week. With anorexic patients, the dietitian deals with the effects of semi-starvation diets, energy needs, nutrient needs (allowing for growth if an adolescent) and the dietary modifications necessary to reestablish
nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
normal eating patterns and the restoration of normal weight. Given the lack of calories and nutrients in anorexic patients, it is not surprising to find nutritional deficiencies. Increased oxidative stress due to inadequate Vitamin E intakes, elevated plasma total-homocysteine due to a folate deficiency, and various other deficiencies have been reported in the scientific literature. In
and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ
addition, resting energy expenditure is reduced, but often increases markedly in association with refeeding.
A review of previous studies that examined micronutrient status in anorexia nervosa concluded that due to the tremendous variability of the population, the cross-sectional nature of the investigations, and the use of inappropriate methods to determine nutrient status reported i
A review of previous studies that examined micronutrient status in anorexia nervosa concluded that due to the tremendous variability of the population, the cross-sectional nature of the investigations, and the use of inappropriate methods to determine nutrient status reported i
ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
nconsistent and sometimes contradictory conclusions. Abnormal nutritional findings in patients with anorexia nervosa are primarily a consequence of semi-starvation. Neuroendocrine abnormalities, degree of recovery, and the phase of treatment can affect the interpretation of the data. Despite the importance of nutritional rehabilitation, few controlled studies that address the clinical e
ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.
Following aspects would a
Following aspects would a
fficacy of various dietary treatment regimens have been conducted.
In the case of anorexia nervosa, the initial nutritional strategy should involve the cessation of weight loss and improvement of the nutritional state. During this period weight may be maintained while nutritional status is improved. Over time the focus is shifted towards gaining weight gradually through normal self fee
In the case of anorexia nervosa, the initial nutritional strategy should involve the cessation of weight loss and improvement of the nutritional state. During this period weight may be maintained while nutritional status is improved. Over time the focus is shifted towards gaining weight gradually through normal self fee
dd to the challenges in developing combination products:
Which markets to tap where the combination products can do fairly well?
Which combination prod
Which markets to tap where the combination products can do fairly well?
Which combination prod
ding. Supplemental foods or parenteral feeding (delivering nutrients through the vascular system) is not necessary. It must be remembered that since anorexic patients have hypometabolic rates, their energy needs and nutrient needs may be quite low. So initially, unusually small quantities of food may be sufficient. Calorie needs should be adjusted based upon the measured basal metabolic
cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin
rate. The initial use of small quantities is sound therapeutically because it meets the psychological needs of the patient who may be guarding against gaining weight. Encouraging the patient to consume large quantities of food or high calorie products like weight gain shakes is counter-therapeutic at this stage. As the patient becomes less fearful of gaining weight, physiologically acc
tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
What would be the developing cost?
How to tackle the risks encountered during combination product developmen
eptable weight goals can be established based upon the patient’s height, frame size, and weight history.
In the case of bulimia nervosa, the initial nutritional strategies are for the patient to gain control over eating binges, to encourage regular eating habits, to avoid fasting, and to minimize the likelihood of eating binges. The emphasis during the early stages should be on weight
In the case of bulimia nervosa, the initial nutritional strategies are for the patient to gain control over eating binges, to encourage regular eating habits, to avoid fasting, and to minimize the likelihood of eating binges. The emphasis during the early stages should be on weight
t?
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
stabilization while a normal, healthy eating pattern is developed. Treatment plans used in anorexia nervosa can be adapted for use with bulimia nervosa. The treatment plan should include an educational component about the nutritional and health consequences of bulimic behaviors. After the patient has demonstrated confidence in controlling binges and follows a consistent eating pattern,
ping new procedures for reviewing their safety, efficacy and quality.
Professional from academic institutions, pharmaceutical industries, health care indust
Professional from academic institutions, pharmaceutical industries, health care indust
the need for a weight loss plan can be assessed.
Important Reminders for the Female Athlete
It may be helpful in treating athletes with disordered eating patterns to discuss the fact that poor nutrition and weight loss can eventually result in poor sports performance. The combination of low caloric intake and the resulting fluid and electrolyte reduction decreases endurance, strength,
Important Reminders for the Female Athlete
It may be helpful in treating athletes with disordered eating patterns to discuss the fact that poor nutrition and weight loss can eventually result in poor sports performance. The combination of low caloric intake and the resulting fluid and electrolyte reduction decreases endurance, strength,
y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
reaction time, speed, and concentration. These conditions impair athletic performance and increase the risk for injuries [4]. In addition, the harmful physiological side effects of food restriction can manifest themselves in amenorrhea, osteoporosis, and possibly even death.
Prevention
To reduce the potential for disordered eating, everyone involved with the female athlete, including
Prevention
To reduce the potential for disordered eating, everyone involved with the female athlete, including
.
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
the athlete herself, should make decisions regarding weight loss. The coach, athlete, medical, and nutritional personnel should all agree if weight loss is necessary, the amount of weight loss needed, and the method. All weight loss plans should be designed for an individual, not a team. Eating disorders begin when athletes are made to conform to unrealistic weight goals or when coache
elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.
Companies that provide selfless information through particip
Companies that provide selfless information through particip
s, friends, or parents comment negatively on an athlete’s weight. Athletes should be discouraged from fad and crash diets as that will promote disordered eating patterns and result in unhealthy weight loss. Remember that disordered eating patterns have psychiatric, physiological, and social factors that make a team approach the most effective treatment strategy.
References upon request
tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products
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