What’s the best way to man­age male anorexia?

Sunday Herald Sun - Body and Soul - - HEALTH DEBATE -

age (the ideal BMI for adults is 17.5kg/m²)*, al­though usu­ally ema­ci­a­tion is ev­i­dent.

It is cru­cial to en­sure the pa­tient is med­i­cally sta­ble by as­sess­ing heart rate, blood pres­sure and tem­per­a­ture, check­ing elec­trolytes and hor­mone lev­els (via blood tests), and do­ing an ECG (elec­tro­car­dio­graph). If any of these are ab­nor­mal, ur­gent hos­pi­tal ad­mis­sion is re­quired.

Once the pa­tient is med­i­cally sta­ble, treat­ment may in­clude re­fer­ral to an eat­ing dis­or­ders unit, to a psy­chi­a­trist for in­di­vid­ual or fam­ily ther­apy and to a di­eti­tian for nu­tri­tional rehabilitation. In some cases, med­i­ca­tion such as an­tide­pres­sants may be con­sid­ered. *Body mass in­dex (BMI) is a weight-for-height in­dex de­fined by the World Health Or­ga­ni­za­tion as the weight in kilo­grams di­vided by the square of the height in me­tres (kg/m²). For ex­am­ple, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9.

Anorexia is de­fined as a lack of ap­petite. What we’re talk­ing about here is anorexia ner­vosa, the de­bil­i­tat­ing psy­cho­log­i­cal con­di­tion. Some statis­tics in­di­cate that Aus­tralia has some of the worst lev­els of male anorexia in the world. How­ever, it’s hard to know whether the in­ci­dence is ac­tu­ally in­creas­ing or whether it is be­ing iden­ti­fied more as peo­ple are en­cour­aged to seek help.

Anorexia is a psy­cho­log­i­cal and phys­i­cal con­di­tion. Peo­ple need to be re­viewed and coun­selled thor­oughly and to de­velop an hon­est, trust­ing re­la­tion­ship with their prac­ti­tion­ers. The pa­tient, natur­opath, GP, di­eti­tian and coun­sel­lor must all work to­gether as a team. Once a di­ag­no­sis is made and a col­lab­o­ra­tive care team de­vel­oped, each prac­ti­tioner can use their strengths to achieve a pos­i­tive out­come.

From a natur­o­pathic per­spec­tive, the se­vere nu­tri­tional de­ple­tion needs to be thor­oughly as­sessed and treated. The most im­por­tant nu­tri­ents are pro­tein for re­pair and zinc. Sev­eral stud­ies show that zinc de­fi­cien­cies are ev­i­dent in anorex­ics. Zinc helps to im­prove mood and self-per­cep­tion by reg­u­lat­ing brain chem­istry; it reg­u­lates ap­petite and im­proves di­ges­tive func­tion, so the per­son can bet­ter ab­sorb nu­tri­ents; and it also sta­bilises hor­mones, specif­i­cally testos­terone, which is of­ten de­fi­cient in male anorex­ics.

A sim­ple mul­ti­vi­ta­min is bet­ter than noth­ing, but key nu­tri­ents need to be pre­scribed in high doses to achieve psy­cho­log­i­cal and phys­i­cal changes. Work­ing with an ex­pe­ri­enced prac­ti­tioner is es­sen­tial, as is a com­pas­sion­ate, holis­tic ap­proach.

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