Patient discussions
Patients should be informed of the importance of maintaining healthy weight for protection of fertility and avoidance of long-term health consequences, many of which are severe. Patients should be encouraged to attend therapy and to enlist support of friends and family.[67]
Patients should also be advised of the importance of avoiding laxatives, enemas, diuretics, and emetics. Explain that laxatives, enemas, and diuretics do not reduce calorie absorption and so do not help with weight loss.[67] Encourage people with an eating disorder who are vomiting to have regular dental and medical reviews, to avoid brushing teeth immediately after vomiting, to rinse with non-acid mouthwash after vomiting, and to avoid highly acidic foods and drinks.[67]
During adolescence patients are in a growth phase both in terms of weight and height. Patients may achieve an ideal weight but need to be prepared to gain additional weight over time in order to remain on their own personal growth curve. Educate patients and their parents about this. It is helpful to know the adolescent’s weight history so that his or her own personal growth curve can be shown. Use of the growth chart with the patient’s weight and height history often helps clarify the issue, allowing the expected pattern of weight gain to be discussed with the patient.
Although exercise can be very helpful during the recovery of some patients by promoting healthy behaviour and reducing anxiety, exercise can become problematic. Some patients exercise in an unhealthy way: they may exercise to lose weight when they need to gain weight or they may exercise to compensate for appropriate calorie consumption. In these situations, exercise should be discouraged. Patients with comorbid obsessive compulsive disorder may be particularly prone to overuse of running. In such cases running may need to be avoided. When weight is restored, it is recommended to redirect goals towards fitness and not solely weight loss.
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