Nutrition Through the Life Cycle (...

6th Edition
Judith E. Brown
ISBN: 9781305628007



Nutrition Through the Life Cycle (...

6th Edition
Judith E. Brown
ISBN: 9781305628007
Textbook Problem

Ana is a 15-year-old high school student who is active in school activities, loves to run and bike, and has a 3.95 grade point average. She has a close group of friends that she spends her free time with; her parents are very proud of her for her outstanding academic performance.

School Nurse Visit Ana is being seen at the school clinic for a sore throat and fever. The nurse takes her height (5′3″) and weight (107 lb). Ana is diagnosed with strep throat infection and is given antibiotics.

Sports Physical Visit Ana is seen four months later (in early fall) by her pediatrician for a sports physical, since she is planning to join the cross-country running team. Weight at this time is 96 pounds. The physician notes that Ana seems to be tired and has lost weight since her most recent visit to the clinic. Ana replies that she has had a lot of sinus and other infections, which causes her to lose her appetite. She also notes that she has been training hard to make the cross-country team but that her training should become less intense now that she has made the team. Ana assures the physicians that she will try to eat more in the future. The physician encourages her to eat a lot of carbohydrates and protein to improve her sports performance.

Preemployment Physical Visit Ana is seen by her family physician for a preemployment physical in early June. At this time her weight is 91 pounds.

The physician is concerned about her weight, but Ana assures her that she looks and feels fine. The MD refers her to the outpatient clinical dietitian. During the interview with the dietitian, it is noted that Ana eats only twice a day, with many diet beverages in between these meals. The dietitian suggests that Ana increase her weight to at least 95 lb, but she refuses, stating that at this weight she would ''have too much fat in her thighs" for running. When asked about the use of diet pills, laxatives, and other diet aids, Ana states that she doesn't need these because she has enough willpower to reduce her food intake on her own. She also denies vomiting after eating. When asked about her willingness to reduce her running so that she could reach a more healthy weight, Ana get agitated. The dietitian asks Ana how she determines how much or how long she needs to run. Ana states that she runs as long as she needs to so that she can use up all of the calories she has eaten. When the dietitian suggests that this is compensatory exercise and is a form of purging, Ana becomes upset and leaves. The dietitian looks for her parents in the waiting room, and lets Ana's mother know that she thinks there may be an eating issue that the family should deal with. The mother thanks the dietitian for letting her know and leaves, as Ana has already gone to the parking lot.

The dietitian confers with the physician and her parents are send information about eating disorders, including possibly outcomes and treatment options. Three months later, the clinic is notified that Ana has fainted at gym class in school and that the hospital where she was taken has referred her for an in-patient eating disorder evaluation.

How would you classify Ana’s weight status at the school nurse visit?

Summary Introduction

To classify: Person A weight status during school nursing visit.

Introduction: The status of weight among adolescents is assesessed by their body mass index (BMI). BMI of an individual is calculated by dividing a person's weight (kg) by square of his or her height (m2). The BMI value is then used to determine the BMI-for-age percentile on the basis of age and gender of the child, according to which the individual is considered for underweight or  healthy or overweight, or obese.


During a school nurse visit, Person A, who was 15 years old and active as well as had an outstanding academic performance, was prescribed antibiotics after being diagnosed with strep throat infection. Her height and weight were recorded to be 53 and 107 lb, respectively. Four months later, Person A was 96 pounds and appeared tired with decreased appetite. She reported to have suffered from sinus and other infections, besides it was hard to train her for sports team. Her doctor advised her to decrease her training and eat more to which she agreed. But in early June, when Person A was examined by her physician for a pre-employment physical examination, she was 91 pounds and that concerned her physician although Person A assures that she feels and looks fine.

On the MD physician’s reference, she consulted an outpatient clinical dietician, and it was then that her dependence on diet beverages came to light. Person A strongly disagrees on using dietary aids claiming to have enough will power to reduce food intake. However, she is not willing to reduce the intensity of her training, which was a sign of compensatory exercise, which in medical terms is a form of purging. Person A’s mother was later informed by the dietician about a possible eating disorder.

The dietician conferred with the physician and Person A’s parents and sent information about eating disorders, possible outcomes, and treatment options

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