Food/Nutrient Interventions/Pharmacotherapy


131


Table 8.2 Micronutrient Deficiencies and Supplementation Guidelines for Eating Disorders (continued)


Nutrient


Preferred Method to Assess Deficiency in Eating Disordered Patients


Vitamin D a


Serum 25-hydroxy-vitamin D < 20ng/mL


Eating Disorder– Specific


Supplementation Guidelines


No consensus. Note that abnormal blood values of these nutrients reflect long-term and/or serious


whole-body deficiency. These should be medically evaluated and checked daily during the first week of nutritional rehabilitation because levels can decrease even with supplementation. Source: Adapted with permission from Setnick J. Micronutrient deficiencies and supplementation in anorexia and bulimia nervosa: a review of literature. Nutr Clin Pract. 2010;25:137–142.


MEDICATION USE IN EATING DISORDER TREATMENT


Rationale


Eating disorder behaviors such as binge eating, self- induced vomiting, laxative abuse, fasting, exercising, and self-harm are thought to cause brain chemistry changes that relieve stress and balance brain chemistry. For some patients, the only way to stop the eating disorder behav- iors is to provide a replacement medication, which may be required temporarily until healing has occurred, or perma- nently if needed. The goal of psychoactive medications in the treatment


of eating disorders is to promote improved brain chemis- try. In rare cases, medications alone have been known to resolve eating disorder symptoms. For most patients with eating disorders, a combination of medications plus other treatment is required. By decreasing impulsivity, obses- sions, anxiety, depression, and other psychiatric condi- tions, these medications do not instantly resolve eating


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