By Emilia Manzato (auth.), Renata Strumia (eds.)
At least forty pores and skin symptoms are linked to consuming problems (EDs), and a few of them are thought of guiding indicators simply because they're indicative of an another way hidden ED. The position of the dermatologist during this context is to suspect the presence of a hidden ED in line with those guiding symptoms. With this in brain, an important experts within the box come jointly during this booklet to record the entire dermatological features of EDs. basic issues akin to class of EDs, epidemiology, and clinical issues are first addressed, and dermis indicators brought on by quite a few motives are then mentioned in a chain of exact chapters. attribute alterations within the hair, nails, and oral hollow space also are rigorously documented, and the remaining chapters deal with a variety of different similar problems with curiosity. "Eating issues and the surface" can be a useful resource of updated info for either amateur and skilled dermatologists, in addition to different practitioners, psychiatrists, and nurses.
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Additional resources for Eating Disorders and the Skin
Diuretic or laxative misuse may be responsible for decreased magnesium and calcium levels particularly when they are associated with an inadequate dietary intake in chronic starvation: in this case, not only the risk for arrhythmias is higher but other symptoms such as weakness, constipation, seizures, and tetany may complicate the clinical course. The physician must pay great attention during the refeeding phase: he must be very careful in refeeding the subject and apply a slow and gradual administration of nutrients; otherwise, magnesium will rapidly move into the cells together with glucose with a consequent dangerous hypomagnesemia [80, 81].
Any other therapy in the absence of nutritional intervention will be ineffective. In case of a noncompliant chronic subject, refractory to gain a safe weight, the physician may be required to limit the major systemic and organ-specific complications as far as possible: for instance, electrolyte replacement or estrogen therapy may contribute to limit the cardiovascular risk or the progressive bone loss, despite of its poor efficacy in emaciated subjects. In the process of refeeding, an outpatient should receive the calories required to increase ½ kg/week, while an inpatient should receive the calories required for an increase of 1 kg/week.
NPY is involved in the regulation of the HPG axis: if it remains elevated in the CSF of AN patients after the recovery of normal body weight, it could play a role in the maintenance of amenorrhea. Its elevated levels may represent a homeostatic tool to stimulate feeding and reduce energy expenditure; in the same way, it may contribute to the onset of binge eating that often occurs after periods of food restriction. Endogenous opioids stimulate hunger too; an increased overall opioid tonus has been described in symptomatic anorexic patients, even if the b-endorphin circadian rhythm has been found to be reduced by some authors.