Anorexia Nervosa – Treatment Overview

All people with anorexia need treatment. In most cases, this involves seeing a doctor and having regular counseling sessions. A hospital stay is needed for those who are seriously underweight or who have severe medical problems. The goals of treatment are to restore a healthy weight and healthy eating habits.

If you have an eating disorder, try not to resist treatment. Although you may be very afraid of gaining weight, try to think of weight gain as a life-saving measure. With help, you can learn to eat well and keep your weight at a healthy level.

Your recovery

Ideally, you can take charge of anorexia with the help of a team that includes a mental health professional (such as a psychologist or licensed counselor), a medical health professional (such as a doctor or nurse), and a registered dietitian.

If your medical condition is not life-threatening, your treatment likely will include:

  • Medical treatment. If malnutrition or starvation has started to break down your body, medical treatment will be a top priority. Your doctor will treat the medical conditions that have been caused by anorexia, such as osteoporosis, heart problems, or depression. As you begin to get better, your doctor will continue to follow your health and weight.
  • Nutritional counseling. A registered dietitian will help you take charge of your weight in a healthy way. You will learn healthy eating patterns and gain a good understanding of nutrition.
  • Therapy. Talking with a psychologist or mental health professional will help you cope with the emotional reasons behind anorexia. For example, you may discuss life stresses, unhelpful beliefs about food and weight, or certain personality traits that may be, in part, causing anorexia.

 

 

How Are Overweight and Obesity Treated?

Successful weight-loss treatments include setting goals and making lifestyle changes, such as eating fewer calories and being physically active. Medicines and weight-loss surgery also are options for some people if lifestyle changes aren’t enough.

Set Realistic Goals

Setting realistic weight-loss goals is an important first step to losing weight.

For Adults

  • Try to lose 5 to 10 percent of your current weight over 6 months. This will lower your risk for coronary heart disease (CHD) and other conditions.
  • The best way to lose weight is slowly. A weight loss of 1 to 2 pounds a week is do-able, safe, and will help you keep off the weight. It also will give you the time to make new, healthy lifestyle changes.
  • If you’ve lost 10 percent of your body weight, have kept it off for 6 months, and are still overweight or obese, you may want to consider further weight loss.

For Children and Teens

  • If your child is overweight or at risk for overweight or obesity, the goal is to maintain his or her current weight and to focus on eating healthy and being physically active. This should be part of a family effort to make lifestyle changes.
  • If your child is overweight or obese and has a health condition related to overweight or obesity, your doctor may refer you to a pediatric obesity treatment center.

Lifestyle Changes

Lifestyle changes can help you and your family achieve long-term weight-loss success. Example of lifestyle changes include:

  • Focusing on balancing energy IN (calories from food and drinks) with energy OUT (physical activity)
  • Following a healthy eating plan
  • Learning how to adopt healthy lifestyle habits

Over time, these changes will become part of your everyday life.

Calories

Cutting back on calories (energy IN) will help you lose weight. To lose 1 to 2 pounds a week, adults should cut back their calorie intake by 500 to 1,000 calories a day.

  • In general, having 1,000 to 1,200 calories a day will help most women lose weight safely.
  • In general, having 1,200 to 1,600 calories a day will help most men lose weight safely. This calorie range also is suitable for women who weigh 165 pounds or more or who exercise routinely.

These calorie levels are a guide and may need to be adjusted. If you eat 1,600 calories a day but don’t lose weight, then you may want to cut back to 1,200 calories. If you’re hungry on either diet, then you may want to add 100 to 200 calories a day.

Very low-calorie diets with fewer than 800 calories a day shouldn’t be used unless your doctor is monitoring you.

For overweight children and teens, it’s important to slow the rate of weight gain. However, reduced-calorie diets aren’t advised unless you talk with a health care provider.

What Causes Acid Reflux Disease?

One common cause of acid reflux disease is a stomach abnormality called a hiatal hernia. This occurs when the upper part of the stomach and LES move above the diaphragm, a muscle that separates your stomach from your chest. Normally, the diaphragm helps keep acid in our stomach. But if you have a hiatal hernia, acid can move up into your esophagus and cause symptoms of acid reflux disease.

These are other common risk factors for acid reflux disease:

  • Eating large meals or lying down right after a meal
  • Being overweight or obese
  • Eating a heavy meal and lying on your back or bending over at the waist
  • Snacking close to bedtime
  • Eating certain foods, such as citrus, tomato, chocolate, mint, garlic, onions, or spicy or fatty foods
  • Drinking certain beverages, such as alcohol, carbonated drinks, coffee, or tea
  • Smoking
  • Being pregnant
  • Taking aspirin, ibuprofen, certain muscle relaxers, or blood pressure medications

What Are the Symptoms of Acid Reflux Disease?

Common symptoms of acid reflux are:

  • Heartburn: a burning pain or discomfort that may move from your stomach to your abdomen or chest, or even up into your throat
  • Regurgitation: a sour or bitter-tasting acid backing up into your throat or mouth

Other symptoms of acid reflux disease include:

  • Bloating
  • Bloody or black stools or bloody vomiting
  • Burping
  • Dysphagia — a narrowing of your esophagus, which creates the sensation of food being stuck in your throat
  • Hiccups that don’t let up
  • Nausea
  • Weight loss for no known reason
  • Wheezing, dry cough, hoarseness, or chronic sore throat

Hypertension/High Blood Pressure

High blood pressure (HBP) is a serious condition that can lead to coronary heart disease,heart failure, stroke, kidney failure, and other health problems.

“Blood pressure” is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the body in many ways.

Overview

About 1 in 3 adults in the United States has HBP. The condition itself usually has no signs or symptoms. You can have it for years without knowing it. During this time, though, HBP can damage your heart, blood vessels, kidneys, and other parts of your body.

Knowing your blood pressure numbers is important, even when you’re feeling fine. If your blood pressure is normal, you can work with your health care team to keep it that way. If your blood pressure is too high, treatment may help prevent damage to your body’s organs.

Blood Pressure Numbers

Blood pressure is measured as systolic (sis-TOL-ik) and diastolic (di-ah-STOL-ik) pressures. “Systolic” refers to blood pressure when the heart beats while pumping blood. “Diastolic” refers to blood pressure when the heart is at rest between beats.

You most often will see blood pressure numbers written with the systolic number above or before the diastolic number, such as 120/80 mmHg. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)

The table below shows normal blood pressure numbers for adults. It also shows which numbers put you at greater risk for health problems.

Categories for Blood Pressure Levels in Adults (measured in millimeters of mercury, or mmHg)

Category Systolic
(top number)
Diastolic
(bottom number)
Normal Less than 120 And Less than 80
Prehypertension 120–139 Or 80–89
High blood pressure
     Stage 1 140–159 Or 90–99
     Stage 2 160 or higher Or 100 or higher

The ranges in the table apply to most adults (aged 18 and older) who don’t have short-term serious illnesses.

Blood pressure doesn’t stay the same all the time. It lowers as you sleep and rises when you wake up. Blood pressure also rises when you’re excited, nervous, or active. If your numbers stay above normal most of the time, you’re at risk for health problems. The risk grows as blood pressure numbers rise. “Prehypertension” means you may end up with HBP, unless you take steps to prevent it.

Headache Treatment

More than 47 million Americans have experienced a severe or debilitating headache in the past three months. Migraines alone affect 9% of the U.S. population and costs $1 billion a year in direct medical expenses.

Take an over-the-counter pain reliever. Most painkillers won’t kick in for about 1-2 hours, so take a dose as soon as you start feeling the headache coming on.[1] Earlier treatment is always better to address a headache. Even if you’re already in the depths of misery, a quick dose of ibuprofen, acetaminophen, naproxen, aspirin or even a capsaicin nasal spray can take the edge off.

  • Be careful not to take medications daily unless you’re told to by your doctor. Everyday use of even over-the-counter medications can be linked to Medication Overuse Syndrome, where a person takes medication they don’t actually need because they’re afraid of future headaches.[2] This misuse can actually cause frequent, recurrent headaches called “rebound headaches”.
  • If you frequently take headache medication 3+ times a week, see a doctor. The more medication is used for treatment, the more tolerant of that medication a patient may become. This can lead to side effects such as a lower pain tolerance and increased occurrence of “rebound headaches.”
  • The treatment for “rebound headaches” is to reduce or stop taking the pain medication. Speak with a doctor to figure out how to effectively manage your medication.

Know when to seek medical assistance immediately. If your headache includes other symptoms, it may be a sign of a more severe condition, such as stroke, encephalitis, or meningitis. See a doctor immediately or call the emergency services if your headache also includes:[3]

  • Trouble seeing, walking, or talking
  • Stiff neck
  • Nausea and/or vomiting
  • High fever (102-104F)
  • Fainting
  • Difficulty using one side of your body
  • Feelings of extreme weakness, numbness, or paralysis
  • Also see a doctor if you have frequent or severe headaches, your medication doesn’t work, or you can’t function normally.

Use caffeine carefully––it can be a double-edged sword. Though caffeine (which is included in some OTC pain relievers) can initially help a headache, it can also lead to more headaches over time by developing or worsening a caffeine dependence. During headache attacks, adenosine is elevated in the bloodstream. Caffeine helps by blocking adenosine receptors.[4]

  • Limit caffeine treatment of headaches to no more than twice a week.[5] More often than this and your body can become dependent on caffeine, especially among migraine sufferers. If you’re a heavy caffeine drinker (more than 200 milligrams per day, or about 2 cups of coffee) and you suddenly take it out of your diet, headaches are a common side-effect.[6] This is because daily use of caffeine dilates the blood vessels in your brain. When caffeine is withdrawn, these blood vessels constrict, causing headaches. Learn how to slowly and effectively overcome caffeine withdrawal if you consume too much caffeine and think this might be contributing to your headaches.
  • If you have frequent headaches, it’s ideal to avoid all caffeine whenever possible.

Drink plenty of water. Dehydration can lead to a headache, especially if you’ve vomited recently or you’re hungover.[8] Drink a tall glass of water as soon as your head starts to hurt, and try to continue drinking small sips throughout the day. You may gradually feel the pain start to ease.

  • For men, drink at least 13 cups (3 liters) of water a day. For women, drink at least 9 cups (2.2 liters) of water a day. You should drink more if you exercise frequently, live in a hot or humid environment, have an illness that causes vomiting or diarrhea, or are breast-feeding.[9] Another way to calculate your daily water needs is by weight; every day, you should try to drink between 0.5 and 1 ounce of water for every pound that you weigh.[10]
  • Don’t drink water that’s too cold if you already have a headache. Extremely cold or iced water can trigger migraines in some people, especially if they’re already prone to migraine headaches.[11] Room-temperature water is a better option.

Burns and Electric Shock

Most minor burns will heal on their own, and home treatment is usually all that is needed to relieve your symptoms and promote healing. But if you suspect you may have a more severe injury, use first-aid measures while you arrange for an evaluation by your doctor.

Immediate first aid for burns

  • First, stop the burning to prevent a more severe burn.
    • Heat burns (thermal burns): Smother any flames by covering them with a blanket or water. If your clothing catches fire, do not run: stop, drop, and roll on the ground to smother the flames.
    • Cold temperature burns: Try first aid measures to warm the areas. Small areas of your body (ears, face, nose, fingers, toes) that are really cold or frozen can be warmed by blowing warm air on them, tucking them inside your clothing or putting them in warm water.
    • Liquid scald burns (thermal burns): Run cool tap water over the burn for 10 to 20 minutes. Do not use ice.
    • Electrical burns: After the person has been separated from the electrical source, check for breathing and a heartbeat. If the person is not breathing or does not have a heartbeat, call 911.
    • Chemical burns: Natural foods such as chili peppers, which contain a substance irritating to the skin, can cause a burning sensation. When a chemical burn occurs, find out what chemical caused the burn. Call your local Poison Control Center or the National Poison Control Hotline (1-800-222-1222) for more information about how to treat the burn.
    • Tar or hot plastic burns: Immediately run cold water over the hot tar or hot plastic to cool the tar or plastic.
  • Next, look for other injuries. The burn may not be the only injury.
  • Remove any jewelry or clothing at the site of the burn. If clothing is stuck to the burn, do not remove it. Carefully cut around the stuck fabric to remove loose fabric. Remove all jewelry, because it may be hard to remove it later if swelling occurs.

Prepare for an evaluation by a doctor

If you are going to see your doctor soon:

  • Cover the burn with a clean, dry cloth to reduce the risk of infection.
  • Do not put any salve or medicine on the burned area, so your doctor can properly assess your burn.
  • Do not put ice or butter on the burned area, because these measures do not help and can damage the skin tissue.

Poison ivy: Tips for treating and preventing

A rash from poison ivy, poison oak or poison sumac is caused by an oil found in these plants called urushiol (you-ROO-shee-all). When this oil touches your skin, it often causes an itchy, blistering rash.

Most people can safely treat the rash at home. However, if you experience any of the following symptoms, go to the emergency room right away.

If you have any of the following, go to the emergency room right away:

 

  • You have trouble breathing or swallowing.
  • The rash covers most of your body.
  • You have many rashes or blisters.
  • You experience swelling, especially if an eyelid swells shut.
  • The rash develops anywhere on your face or genitals.
  • Much of your skin itches, or nothing seems to ease the itch.

 

If you do not have the above symptoms, the rash appears on a small section of your skin, and you are absolutely certain that your rash is due to poison ivy, poison oak, or poison sumac, you may be able to treat the rash at home.

To treat a rash from poison ivy, poison oak, or poison sumac and help stop the itch, dermatologists recommend the following:

  1. Immediately rinse your skin with lukewarm, soapy water. If you can rinse your skin immediately after touching poison ivy, poison oak, or poison sumac, you may be able to rinse off some of the oil. If not washed off, the oil can spread from person to person and to other areas of your body.
  2. Wash your clothing. Thoroughly wash all of the clothes you were wearing when you came into contact with the poisonous plant. The oil can stick to clothing, and if it touches your skin, it can cause another rash.
  3. Wash everything that may have the oil on its surface. Besides clothing, the oil from poison ivy, poison oak, and poison sumac can stick to many surfaces, including gardening tools, golf clubs, leashes and even a pet’s fur. Be sure to rinse your pet’s fur, and wash tools and other objects with warm, soapy water.
  4. Do not scratch, as scratching can cause an infection.
  5. Leave blisters alone. If blisters open, do not remove the overlying skin, as the skin can protect the raw wound underneath and prevent infection.
  6. Take short, lukewarm baths. To ease the itch, take short, lukewarm baths in a colloidal oatmeal preparation, which you can buy at your local drugstore. You can also draw a bath and add one cup of baking soda to the running water. Taking short, cool showers may also help.
  7. Consider calamine lotion or hydrocortisone cream. Apply calamine lotion to skin that itches. If you have a mild case, a hydrocortisone cream or lotion may also help.
  8. Apply cool compresses to the itchy skin. You can make a cool compress by wetting a clean washcloth with cold water and wringing it out so that it does not drip. Then, apply the cool cloth to the itchy skin.
  9. Consider taking antihistamine pills. These pills can help reduce itching, however use with caution. You should not apply an antihistamine to your skin, as doing so can worsen the rash and the itch.

If your rash is not improving after seven to 10 days, or you think your rash may be infected, see a board-certified dermatologist. A dermatologist can treat your rash and any infection and help relieve the itch.

What is skin glue?

Skin glue is a special type of medical adhesive. It joins the edges of a wound together, while the wound starts to heal underneath.

Doctors and nurses may use skin glue to close wounds instead of other methods, such as:

  • stitches (sutures)
  • skin staples
  • adhesive tape

Skin glue can be used for children and adults.

When can skin glue be used?

Skin glue is usually used for simple cuts or wounds that:

  • are small or minor
  • are up to 5cm long
  • have straight edges, which can be pulled together

Skin glue can also be used to close the edges of other wounds that may be larger. For example, over the top of stitches beneath your skin (subcutaneous stitches) or to close an incision made during an operation.

Surgeons may use skin glue after operations or procedures such as:

  • vasectomy (male sterilisation)
  • laparoscopy (a procedure that doctors use to look inside the abdomen)
  • removal of benign skin lesions
  • groin incisions for hernia operations

When is skin glue not used?

Skin glue isn’t normally used to close some types of wound. For example:

  • wounds with uneven or jagged edges
  • deep wounds
  • wounds that are bleeding
  • infected wounds
  • animal bites
  • puncture wounds
  • ulcers

Where can skin glue be used?

Skin glue can be used to treat wounds on most parts of your body, including:

  • your face or head
  • some parts of your arms and legs
  • the trunk of your body (torso)

It may be possible to use it for some wounds on your hands, feet or joints, but this will depend on where the wound is and how much pressure you put on the wound when you move.

Skin glue isn’t usually used on parts of your body that may be moist or damp, such as:

  • your lips
  • inside your mouth
  • your armpit
  • your groin

When Stitches Are Needed

It is important to determine if your wound needs to be closed by a doctor. Your risk of infection increases the longer the wound remains open. Most wounds that require closure should be stitched, stapled, or closed with skin adhesives (also called liquid stitches) within 6 to 8 hours after the injury. Some wounds that require treatment can be closed as long as 24 hours after the injury.

Wash the wound well and stop the bleeding, then pinch the sides of the wound together. If the edges of the wound come together and it looks better, you may want to consider seeing your doctor for treatment. If treatment may be needed, do not use an antiseptic or antibiotic ointment until after a doctor has examined the wound.

The location and type of wound also affects how soon it should be treated.

  • Wounds that have an increased risk of infection, such as dirty cuts or crush injuries, are usually closed within 6 hours after the injury. Occasionally a wound that has an increased risk of infection will not be closed until after 24 hours, or may not be stitched at all, so that adequate cleaning and antibiotic treatment can be done initially to prevent infection.
  • A cut with a clean object, such as a clean kitchen knife, may be treated from 12 to 24 hours after the injury depending on the location of the cut.
  • A facial wound may be treated to reduce scarring.

Water & Dehydration

During hot summer days, it is very necessary to remember to hydrate yourself often.Your body is made up of about 45%-75% water, based on how much fat you have; therefore, water should be part of your daily routine. Lack of water can cause dehydration which can lead to thirst, dry skin, loss of appetite, fatigue/weakness, and much more1. The recommended amount of water needed by CNN Health is a little more than 8 cups2, though for men and women it varies a bit. According to the Institute of Medicine, men need roughly 13 cups and women need about 9 cups3.

In order to achieve the daily recommend water intake amount, try to:

  • Drink a glass of water before meals, during meals, and in between meals.
  • Drink a glass of water before exercising, during exercising, and after exercising.

Just drinking water with each meal, if you eat 3 meals on average, would account for 9 cups a day!Make sure you are drinking enough water, especially during those hot summer days!

Conversion between ounces, cups, quarts and gallons:

1 cup = 8 ounces

1 quart = 32 ounces = 4 cups

1 gallon = 4 quarts = 128 ounces = 16 cups

References:

1http://www.symptomsofdehydration.com/

2http://www.cnn.com/HEALTH/library/water/NU00283.html

3http://www.cnn.com/HEALTH/library/water/NU00283.html

If you are ever facing dehydration or are with someone who might be dehydrated, please visit your local Urgent Care Clinic in Lawrenceville, Sugarloaf Urgent Care.