Symptoms, Investigations and Treatment in Eating Disorders

Overview: The book is about medical symptoms, signs, investigations, how to interpret the findings, advice on management of the blood test findings and the clinical situation, when, where and how soon to treat the medical conditions with the use of a shade system. The book is designed to meet the clinical need of professionals with varying degrees of medical knowledge and expertise. Such clinicians face many medical aspects of eating disorders in their day to day practice as professionals working in this field. This book would give information about common symptoms, interpretation of blood results, when to act urgently, outline of treatment of medical complications (minor or major, acute or chronic, common or uncommon) in a reader friendly manner. Themes and objectives: The book starts with symptoms and signs of various systems in the body (e.g Gastroenterology, cardiology etc. Symptoms that are relevant in ED settings and the context in which they might occur has been explained hence the clinicians need not go through various medical textbooks to understand what the patient is presenting with. Often the medical symptoms in ED settings are non specific. This combined with varying degrees of medical expertise amongst eating disorder professionals (psychologists, social workers, nurses, psychiatrists and general practitioners), often leads to request for a wide variety of blood results that would cover most of the common causes for these symptoms. This book captures this clinical reality. Interpreting the symptoms, understanding the blood results in the context of the symptoms and deciding on the type and location of the intervention is what this book is about. Each macro or micronutrient e.g potassium, magnesium, vitamins, information will have the following information: • Functions of that element in the body e.g what does potassium do in the body • Normal range( would be a useful guide since it includes ranges of rare blood test results, hence a quick reference guide) • Food that are rich in that element - useful in offering advice to patients who show mild level of changes in the blood • Eating disorder specific points of interest about that element e.g a mouthful of vomit contains 5 mmol of potassium but in patients with chronic vomiting this level would be low. • High or low levels of that nutrient and when will this be observed in eating disorder setting. • Correlation with the `traffic light system' which is unique to this book. To our knowledge there is no other book in this field that describes this topic in this manner. Even these books do not give information about how to interpret various levels of the blood changes and the corresponding treatments. The 'shade system' (which can be easily understood) is the unique point for this book. Chapter headings and synopsis: First Chapter is about common symptoms and signs in the context of eating disorders. Second chapter is about minerals and trace elements relevant to eating disorders. It describes how to identify, treat, higher and lower levels of these elements in eating disorder settings etc. Third chapter is about vitamins. The chapter covers the role of vitamins, foods that are rich in vitamins, points of interest for eating disorder clinicians, hypo and hypervitaminosis and treatment of such conditions. Fourth chapter deals with kidney functions in relevance to eating disorders. Common tests, how to interpret the findings, management, points about education to the patients are all covered. Fifth chapter covers endocrinology. Various topics like hypopituitarism, thyrotoxicosis factitia, diabetes mellitus, amenorrhoea are discussed in the context of eating disorders. Sixth chapter deals with fluid balance in eating disorder patients. Physiological effects of water loading, diuretic abuse, maintenance of plasma volume, fluids in a different compartment of the body are discussed in this chapter. Seventh chapter deals with miscellaneous topics like laxative abuse, amphetamine abuse, selected difference in metabolism between adult and children in eating disorder context etc. This is followed by a glossary of terms and definitions to ease the understanding of some of the medical terms used in the book. The book is primarily aimed to aid all the professionals working with eating disorder patients. The book will be useful for professionals like psychologists, therapists, dieticians, trainee doctors, psychiatrists, general practitioners and professionals working in A&E. The book will be useful in countries like USA and other European countries where the treatment of eating disorders are carried out either solely or in conjunction with a medical expert i.e psychiatrist, paediatricians, hospital physicians etc) by various non medical professionals e.g psychologists, nurses, dietician, social workers etc). Hence these professionals would find this book as a quick reference guide to act on a medical condition. This would avoid the delay in initiating treatment in urgent medical situations. In summary, some of the advantages of our book are: - Easy to understand - Shade system linked with setting and nature of the treatment with finding in the investigations - Practical information about when, where and how to treat complications - Tips about food that are rich which could be used to educate the patients - Various levels of blood test range and the corresponding symptoms - Introduction with common signs and symptoms that doesn't require huge amount of medical knowledge or skill to elicit and understand