Question

Chapter 12 Case Study Nutrition and Physical Activity

Anna is a 15 year old gymnast, who has experienced a 10 lbs weight loss over the past 3 years. She is 5’3 and weighs 95 lbs. She trains 4 hours a day with her team and then runs 6 miles after practice to make sure she does not get fat. Currently she is below the 1%ile weight for height on the growth chart. While Anna’s parents have noticed that she has gotten thinner, it did not raise any alarms. Her parents were concerned about the future possibility of obesity that could result from the typical teenage eating, so snack foods are severely limited at home, in order to teach Anna how to eat like “an athlete”. Her coach advised her team to avoid all white foods to reduce body fat. This was all discovered when Anna was not able to recover after surgery from a sports injury as fast as she should have because of malnutrition. While in the hospital they diagnosed her with osteopenia and an eating disorder.

What type of eating disorder was she diagnosed with and why?

What steps would you take to help Anna?

What would the appropriate amount of calories, carbohydrates and protein needs be for her? Base it on her ideal body weight and her activity level.

Answer 1

1. The diagnosis is Anorexia nervosa. It is characterised by underweight, fear to gain weight or become fat, food restrictions or limitations, strong desire to be lean. This leads to patient eating only certain varities of food, excessive exercise to be thin, eating small amount of food, forced vomitting. It is common in athletics and models.

2. Steps are made to restore the required body weight. Thoughts and activity leading to desire to be thin should be eliminated. Proper balanced diet will help redtore the weight. Psychotherapy is useful whuch includes need to eat healthy and sufficient and self acceptance. Family based therapy is also useful which can be conjoint or separate. Anna’s parents should be counselled on Anna’s health condition and need to eat healthy balanced diet snd maitain recommended weight. They should be made aware about importance of dairy products and their role in body. Cognotive therapy is also useful.

3. Calorie requirement

BMR = 10 × weight(kg) + 6.25 × height(cm) - 5 × age(y) - 161

Anna needs 2,271 Calories/day to maintain weight. But as she is underweight is requires 3,271 Calories/day to gain 2 lb per week.

Carbohydrate requirement can be calculated by 45 to 65 percent of your total calorie intake, and dividing by 4.

To maintain the body weight Anna require 369gm/day carb

Protein requirement : 152gm/day