The Effect Of Nutritionist On Health Treatment Of Bn

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The nutritionist’s role in treatment of BN is to help develop a reasonableplan of controlled eating while assessing the patient’stolerance for structure.Immediate goals must beinterruption of the binge-and-purge cycle, restoration of normaleating behavior, and stabilization of body weight, even if already overweight. Attemptsat dietary exacerbatebinge-purge behavior.Metabolic state must be considered when prescribing thebaseline diet.Assessment ofclinical signs of ahypometabolic state, like a low T3 level and cold intolerance, is useful in determining the caloric prescription. If a low metabolismis suspected, a caloric prescription of 1600 to 1800calories daily is a reasonable startbut this prescriptionshould be titrated upwards, in 100 to 200 calorie increments,to stimulate the metabolic rate. Ultimately, a weightmaintenance diet of 2200 to 2400 kcal/day is attainable and welltolerated (Halmi, 2005). Body weight should be monitored with a goal of stabilization;however, BN patients need a great deal of encouragement to followweight maintenance versus weight loss diets. They must bereminded that attempts to restrict caloric intake may only increasethe risk of binge eating.A balanced macronutrient intake is essential for the provisionof a regular meal pattern. This should include sufficientcarbohydrates to prevent craving and adequate protein and fatto promote satiety. In general, a balanced diet providing 50% to55% of the calories from carbohydrate, 15% to 20% from

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