A Life-Threatening Genetic Disorder in Cystic Fibrosis

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Body imagine and disordered thoughts on eating among adolescents with Cystic Fibrosis
Introduction:
In order to orient the reader, the introduction will provide an overview of Cystic Fibrosis (CF) and eating disorders in the general population. This will then be followed by a consideration of both physiological and psychosocial aspects that may offer insight into factors that may make individuals with CF more vulnerable to developing disordered eating thoughts and behaviors in CF.
Background to problem:
Cystic Fibrosis (CF) is a life-threatening genetic disorder that is associated with respiratory and digestive problems and consequently inadequate nutrition and poor growth. Poor nutritional status has been associated with decreased survival rate in those with CF (Schechter, 2003). It is reported that 85% to 95% of individuals with CF have pancreatic maldigestion and malabsorption of nutrients, particularly of dietary fats and fat-soluble vitamins (Moen, Nilsson, Andersson, Fagerland, Fluge & Hollsing, 2011). Achieving and sustaining an ideal nutritional status and body weight is a vital part of the treatment of CF. Consequently, this may contribute to anxiety around food and weight, which are major characteristics of individuals with eating disorders (Johnson & DeSimone, 2013).
The management of nutrition hinges on the maintenance of body weight and therefore a high energy, high fat diet is prescribed. Oral pancreatic enzymes are taken with food to aid the absorption of nutrients. Malnutrition is managed with fat-soluble vitamins and oral feed supplements and/or where required, nocturnal enteral feeding. Some individuals with CF also develop CF-related diabetes which can add more nutritional failure due to the allied p...

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...hape and weight.
• The disturbance does not occur exclusively during episodes of Anorexia Nervosa (Brownell & Fairburn, 2002).
ICD-10 Diagnostic criteria for Bulimia Nervosa:
• There are recurrent episodes of overeating in which large amounts of food are consumed in a short period of time.
• There is persistent preoccupation with eating, and a strong desire or sense of compulsion to eat.
• The patient attempts to counteract the “fattening” effects of food by one or more of the following:
1. Self-induced vomiting,
2. Self-induced purging,
3. Alternating periods of starvation;
4. Use of drugs such as appetite suppressants, thyroid preparations, or diuretics; when bulimia occurs in diabetic patients they may choose to neglect their insulin treatment.
• There is self-perception of being too fat, with an intrusive dread of fatness (Brownell & Fairburn, 2002).

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