Error and Determinations of Decision-Making Capacity in Mentally Ill Patients
Fritz Allhoff, Sandra L. Borden in Ethics and Error in Medicine, 2019
It is clear that psychiatric illness does not always render a person incapacitated, and that the requests of mentally ill patients with capacity should, in general, be respected. However, anorexia may pose some unique challenges to decision-making capacity in the context of VPS. As the Mayo Clinic characterizes it, anorexia involves “an abnormally low body weight, intense fear of gaining weight and a distorted perception of body weight” (Mayo Clinic Foundation for Medical Education and Research 2018). If an anorexic person prioritizes not eating over living on the basis of her fear of gaining weight or inaccurate conception of her body as being too large, then she is choosing on the basis of a skewed perception of the world that is rooted in psychological illness, which would preclude her from being able to make a reasoned decision with capacity.
Bodily Resistances
Lenore Manderson, Elizabeth Cartwright, Anita Hardon in The Routledge Handbook of Medical Anthropology, 2016
Megan Warin is concerned with the particular socialities of a group of women who have anorexia, a common eating disorder that often co-occurs with bulimia. Anorexia is a serious psychiatric illness, marked by the refusal to eat, or to eat such miniscule amounts of food so as to prevent the person from maintaining an adequate, healthy body weight. Bulimia nervosa is characterized by recurrent binge eating in combination with some form of unhealthy compensatory behavior (Arcelus 2011). It is estimated that less than half of patients diagnosed from anorexia fully recover; the remainder experience recurring bouts with the illness over many years. Anorexia was once seen to be a young women’s disease in the ‘North’; now women and men, in many different social contexts, are recognized as suffering from it. The refusal of food is a form of bodily resistance that is, because of organ failure, particularly lethal (Gooldin 2008; Hardon and Moyer 2014; Rich 2006).
Palliative Medicine
John S. Axford, Chris A. O'Callaghan in Medicine for Finals and Beyond, 2023
Causes of anorexia are: Disease itself, with high metabolic rateFear of vomitingPresentation of food (too much, unappetizing)ConstipationOral problems (e.g. oral candidiasis, mouth ulcers, dry mouth)Oral tumourBiochemical abnormality (e.g. hypercalcaemia, uraemia, hyponatraemia)Medications, radiotherapyDepression or anxiety
The mentalization profile in patients with eating disorders: a systematic review and meta-analysis
Published in Nordic Journal of Psychiatry, 2020
Caroline Bach Simonsen, Anne Gade Jakobsen, Simon Grøntved, Gry Kjaersdam Telléus
Eating disorder (ED) is characterized by disturbed eating or eating-related behavior resulting in impaired physical health and psychosocial functioning. Anorexia nervosa (AN) is characterized by a fear of gaining weight with a disturbance in the way the individual experiences body weight and/or shape. Furthermore, a restrictive eating pattern is present resulting in significant weight loss or being underweight. AN subtypes are anorexia nervosa restricting type (AN-R) with no binge eating or purging behavior while anorexia nervosa binge-eating/purging type (AN-BP) describes recurrent episodes of binge eating and/or purging behavior. Bulimia nervosa (BN) is characterized by binge eating with subsequent compensatory behaviors, e.g. self-induced vomiting or misuse of laxatives. Binge eating disorder (BED) is also characterized by binge eating without subsequent compensatory behavior. Other specified feeding or eating disorder (OSFED) is diagnosed when ED symptomatology is present without meeting all symptom criteria for either AN, BN or BED. OSFED diagnosis can be specified as atypical anorexia nervosa (AN-atypical), atypical bulimia nervosa (BN-atypical), or night eating syndrome (NES) among several other possible types of specifications [1].
The intestinal microbiota and metabolites in patients with anorexia nervosa
Published in Gut Microbes, 2021
Petra Prochazkova, Radka Roubalova, Jiri Dvorak, Jakub Kreisinger, Martin Hill, Helena Tlaskalova-Hogenova, Petra Tomasova, Helena Pelantova, Martina Cermakova, Marek Kuzma, Josef Bulant, Martin Bilej, Kvido Smitka, Alena Lambertova, Petra Holanova, Hana Papezova
Anorexia nervosa (AN) is a complex eating disorder characterized by self-starvation, excessive weight loss, modified body self-perception, and an intense fear of gaining weight. This severe psychiatric illness is one of the most common chronic diseases with onset in female adolescence, usually gradually associated with various medical and psychiatric comorbidities. AN has the greatest mortality rates of any psychiatric disorder in young females. According to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), patients with AN can be classified as restrictive or binge-eating/purging subtypes. While the restrictive subtype is characterized by starvation and frequent physical hyperactivity, the binge-eating/purging subtype is defined by self-induced vomiting and misusing laxatives, diuretics, or enemas.1
The impact of nutritional status on pancreatic cancer therapy
Published in Expert Review of Anticancer Therapy, 2022
Gabriele Capurso, Nicolò Pecorelli, Alice Burini, Giulia Orsi, Diego Palumbo, Marina Macchini, Roberto Mele, Francesco de Cobelli, Massimo Falconi, Paolo Giorgio Arcidiacono, Michele Reni
Pain is a cardinal symptom of PDAC, being the first complaint in some 25% of the patients [10]; it has a strong prognostic significance as it is secondary to neuroinvasion [13], but lack of pain control is also associated with decreased caloric intake [14] and should be treated proactively during the course of the disease. While the treatment is typically established by pain specialists, interestingly, it has been recently reported that pain is often undertreated, resulting in very frequent interference with daily activities and that being treated by a gastroenterologist is associated with less undertreatment of pain, possibly due to the relevance of digestive functions [15]. As for GOO, recent guidelines suggest treating patients with a better life expectancy and good functional status with either surgical or endoscopic ultrasound-guided gastrojejunostomy, while duodenal (enteral) stenting use should be limited to patients with a worse prognosis [16,17]. Anorexia, defined as the loss of desire to eat, can also be caused by a) gastrointestinal complaints, such as bloating, nausea, dysmotility, or constipation that require specific treatment; b) fatigue, anxiety, and depression; c) changes of smelling and taste that can be caused by therapy [18].
Related Knowledge Centers
- Binge Eating
- Eating Disorder
- Infertility
- Laxative
- Overweight
- Underweight
- Vomiting
- Osteoporosis
- Calorie Restriction
- Body Image Disturbance