Anorexia nervosa (AN) is an eating issue that has been shown to be especially hard to treat. Even when clients are admitted for inpatient treatment, diet and nutrition remain significant obstacles for improving outcomes. One reason for this could be inconsistency in diet among hospitals. There is no specific diet regimen designed to improve body mass index, vitamin deficiency, or overall caloric intake for people with AN. But other factors also contribute to the maintenance of AN, including excessive exercising. Janine Higgins of the School of Medicine at the Department of Pediatrics at the University of Colorado wanted to find out if diet or exercise, or both, predicted inpatient treatment for AN in a group of young women.
Reduction of calories directly affects energy and can impact how much exercise a person performs. Higgins theorized that women at risk for inpatient treatment would be those who consume the fewest calories and expend the most energy through physical activity. To test this theory, Higgins reviewed surveys from 20 women ranging in age from 11 to 19. The women reported their exercise and caloric intake during the six months prior to being admitted.
Higgins found that in general, the women did not decrease their caloric consumption in the week prior to entering the facility. However, they did increase their exercise by almost four times prior to being hospitalized. Higgins also discovered that macronutrient deficiency was evident in most of the women. In particular, the women had decreased their supplement intake over the six months preceding hospitalization, but had extremely low levels of Vitamin A and Vitamin D consumption the week prior to being admitted.
In sum, these findings show that women at risk for hospitalization for AN may be those who focus most on burning calories, rather than restricting them. Even though caloric intake was low for all the women, those who did get hospitalized were most likely to have no drastic changes in caloric intake, but significant changes in exercise prior to needing inpatient care.
Perhaps the low levels of macronutrient absorption also put these women at heightened risk for intensive treatment. Higgins added, “Physical activity and Vitamin A and D intake should be carefully monitored following initial AN diagnosis, as markers of disease progression as to potentially minimize the risk of medical instability.”
Higgins, J., Hagman, J., Pan, Z., MacLean, P. (2013). Increased Physical Activity Not Decreased Energy Intake Is Associated with Inpatient Medical Treatment for Anorexia Nervosa in Adolescent Females. PLoS ONE 8(4): e61559. doi:10.1371/journal.pone.0061559
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