Cases reported "Body Weight"

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1/4. Self-induced vomiting. Psychiatric considerations.

    Self-induced vomiting has been associated with the psychiatric diagnosis of anorexia nervosa and a newly proposed disorder named bulimia. Two patients with a self-induced vomiting compulsion did not fulfill criteria for either of these diagnoses. One patient had an affective disorder, and the other had no psychiatric illness, but the habit had developed as a weight control measure. Systematic studies of these symptoms are not available. Clinical diagnostic decisions should not be base on one outstanding sign or symptom, eg, self-induced vomiting, unless research clearly relates the sign or symptom to only one disorder.
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2/4. infant of a pregnancy complicated by anorexia nervosa.

    amenorrhea is a common side effect of anorexia nervosa in women; hence, spontaneous conception is rare. The available English language research has recorded only one previous pregnancy since the syndrome has come to medical attention. I report a case in which a woman with chronic anorexia nervosa did conceive and, despite a somewhat problematic pregnancy, was delivered of a child who at 14 months of age appeared to be normal.
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3/4. Unexplained disturbance in body weight regulation: diagnostic outcome assessed by doubly labeled water and body composition analyses in obese patients reporting low energy intakes.

    SUBJECTS: Ten patients who had long-term disturbances in body weight regulation, were referred over a 3-year period for obesity evaluation, and reported low energy intakes (< 1,200 kcal/day). OBJECTIVE: To ascertain whether these patients had a low energy expenditure and thus reduced energy requirement, and/or whether they were misreporting their energy intake. DESIGN: Comparison of outcome measures in referred patients and in obese control patients who did not report low energy intakes and disturbances in body weight regulation. MAIN OUTCOME MEASURES: Low energy expenditure was evaluated with serum thyroid hormone levels, resting metabolic rate (RMR), thermic effect of food (TEF), and total energy expenditure (TEE) by doubly labeled water technique. Misreporting of energy intake was evaluated by comparing patients' self-reported energy intake with energy intake estimated by doubly labeled water and body composition analyses over a 14-day period. STATISTICAL ANALYSES PERFORMED: Low energy expenditure was considered present in a patient if RMR or TEE was more than 15% below predicted values according to results from the control group. Patient group TEF was compared with TEF results observed in the control group. RESULTS: All patients had normal serum thyroid hormone levels. Eight patients had RMR and TEE values within 15% of predicted values and were substantially underreporting their energy intake. One patient had low TEE (-19%) and a normal RMR, a finding that implies a low level of physical activity. This patient also underreported energy intake as estimated by the doubly labeled water technique during the study (-38%). The 10th patient had a low RMR (-23.2%) and TEE (-25.0%), the mechanism of which was uncertain. This patient's reported food intake over the 14-day period was accurate but was less than her long-term intake over months or years as suggested by doubly labeled water TEE estimates. The TEF response in patients was not significantly different from that observed in the control group. CONCLUSIONS: Underreporting of energy intake from foods is a frequent finding in patients with disturbances in body weight regulation who are referred for obesity evaluation. Severe underreporting may be detectable by means of screening measures available to most dietitians. Low energy expenditure, due either to physical inactivity or to metabolic factors, is also observed. Modern evaluation methods provide new insights into patients with weight regulatory disturbances and at the same time stimulate important new research questions.
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4/4. A new method of training for the lower extremity using unloading.

    rehabilitation of the patient with lower extremity dysfunction is frequently limited to open kinetic chain exercise due to pain and weakness in weight-bearing positions. Although hydrotherapy has been used in the past as a method of reducing body weight forces, task-specific training is not possible due to the resistance offered by water and the inability to regulate load. This clinical commentary describes a new form of lower extremity rehabilitation through the use of Unloading, a controlled reduction in body weight during task-specific activities. Two case reports of professional basketball players with foot injuries are presented in order to describe this method of therapy, which, in the authors' opinion, has the potential for broad applications in physical rehabilitation and deserves further research.
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