Assignment task: Jennifer is a 19-year-old woman. Her height is 65" and her weight is 138 lb. Laboratory data: glucose, 82 mg/dL; albumin, 4.2 g/dL; cholesterol, 180 mg/dL; potassium, 2.7 mmollL; serum CO2, 31 mmol/L. Anthropometric status: Skin folds: triceps, 20 mm; biceps, 7 mm; subscapular, 10 mm; suprailiac, 13 mm; rnidarm circumference, 26.7 ern; midann muscle circumference, 20.4 cm. Jennifer has always been unhappy with her weight. She went on every fad diet throughout high school and lost some weight but always regained it. About 1year ago, Jennifer began binge eating. Binge episodes now occur three to four times per week. During these binges Jennifer consumes about 1500 to 2000 kcal in a 2-hour period. Binge foods include ice cream, cookies, potato chips, and other foods. Jennifer describes them as "fattening and unhealthy." After binge eating Jennifer feels extremely guilty, and vomiting is immediately self- induced. Jennifer always tries to eat as little as possible the next day, sometimes consuming only 700 or 800 kcal. Three months ago Jennifer started to overdose on laxatives about three times a week. She occasionally uses over-the-counter diet pills, but they never really help. Jennifer feels fat in her abdomen, buttocks, and thighs. Her physical activity includes 100 sit-ups and 100 leg lifts three or four times per week. Case Study #1 Nutrition Diagnostic Statement Disordered eating pattern related to binging and purging as evidenced by self-induced vomiting following binge episodes accompanied by guilt and restricted eating Nutrition Care Questions
Q1. What are some possible medical complications that Jennifer may develop secondary to binge eating and her compensatory behaviors?
Q2. Discuss her laboratory values and what you might expect to happen to these indices during rehabilitation.
Q3. Determine Jennifer's ideal body weight and goal weight for short-term and long- term treatment.
Q4. Calculate Jennifer's initial caloric prescription and discuss how you arrived at this.
Q5. Plan a sample menu.
Q6. Discuss how you would handle foods that Jennifer considers binge "trigger" foods.
Q7. What would you suggest for Jennifer to help control her episodes of vomiting?