NUTRITIONAL AND METABOLIC ALTERATIONS IN A PATIENT WITH ANOREXIA NERVOSA AND THE IMPORTANCE OF EXPERIENCED DIETICIAN IN THE TREATMENT TEAM: CASE REPORT

Objective: This study aims at assessing the nutritional and metabolic alterations in patients suffering from Anorexia Nervosa (AN) and the importance of a qualified and experienced dietician in the treatment team.

Methods: Our test sample is a twenty-four year old female, who failed in the University entrance examination about five years ago and started to diet the same year, an act, which resulted in excessive weight loss and then her hospitalization. At the beginning of hospitalization, the patient’s biochemical, psychometric, nutritional and anthropometric assessments were performed, the measurements taken and was repeated regularly. Psychotherapy, pharmacotherapy and nutritional therapy have been combined and cooperation has been provided by other units.

Results: Measurements of her initial weight, height, waist circumference, BMI and percentage of body fat and body water values were 30 kg, 159 cm, 52 cm, 11.9 kg/m2, 11.3% and 86.8% respectively. After six months of the therapy those measurements changed to 58.5 kg, 159 cm, 79 cm, 23.2 kg/m2, 29.5% and 49.2% respectively. Our patient has restricted type of AN, no electrolyte imbalance has been detected. The initial biochemical results revealed leucopenia, thrombocytopenia, iron deficiency anemia, hypoproteinemia and hypoalbuminemia as well as fasting hypoglycemia. Nutritional and metabolic problems in our patient returned to normal in a reasonable time period with an effective diet counselling and team solidarity.

Conclusion: Early diagnosis of Eating Disorder (ED) cases and implementation of therapy procedures by an experienced team will not only reduce health expenditures, but also contribute to increase the quality of life of the patients. Because the training required for this specialty is not incorporated into the core curriculum of dietetic programs, dieticians must constantly improve on their knowledge and experience to be more beneficial to patients with ED.