Ukubuyisela iMpilo Yempilo kwi-Anorexia Nervosa Recovery

Izicwangciso zokutya ze-Anorexia Nervosa Recovery

Ukungondleki okuhamba kunye ne- anorexia nervosa kunokuchaphazela kakubi zonke iistim zomzimba. Ngoko ke, ukubuyiswa kwesisindo kunye nempilo yondlo yinkalo ebalulekileyo yonyango ye-anorexia nervosa. Ukubuyiselwa kwesondlo esingasondliyo nge-anorexia nervosa kunokuthatha inyanga okanye iminyaka. Abagulane ne-anorexia nervosa kufuneka ngokubanzi banakekelwa yinkampani yokonyango, ngokuqhelekileyo ibandakanya ugqirha wezonyango, umlo wesondlo ophelisweyo , isifo sengqondo, kunye nesifo sengqondo.

Nabani na oqala ukulungiswa kwesondlo kufuneka aqaphele isifo sengqondo sokufa . Eli nqaku liqala ngeemfuneko zokulinda ukuphepha le nxalenye. Emva koko inikeza izicwangciso zokuphucula ukondliwa kwesondlo, izicwangciso zokutya eziphakanyisiweyo, izicwangciso zokufumana ubunzima obongezelelweyo, kunye neengcebiso zokunqoba iingxaki eziqhelekileyo zokufumana ukuphucula.

Ukuphepha Ukuphelisa I-Syndrome

Enye ingozi ebangela ukuba ingqwalasela ngaphambi kokuqala ukulungiswa kwesondlo isifo se-syndrome. I-syndrome ye-Refeeding ibangelwa ukupheliswa ngokukhawuleza komntu kwimeko yendlala, ngokuqhelekileyo kungapheliyo, kwaye kungase kube yingozi. Ubonakaliswa yi-electrolyte kunye nokutshintshwa kwamanzi okuxhatshazwayo okungaqhelekanga kwizigulana ezingenakulungeleka ukulungiswa kwesondlo.

Ngaba ekugqibeleni ungadla emva kwenkcitho yendlala kunokuba yingozi kumzimba? I-biochemistry isitshela ukuba imizimba ye-ketone kunye namafutha e-free acids avela kwi-breakdown (catabolism) ye-muscle kunye ne-adipose tissue ithatha i-glucose njengomthombo omkhulu wamandla kwindlala.

Ngethuba lokuphelisa, kukho ukutshintshelwa kwinqwelo kwi-carbohydrates metabolism. Ukuphuma kwe-insulini ekhutshwe kwi-pancreas kwandisa ukwenziwa kwesellu ye-glucose, i-phosphate, i-potassium, i-magnesium, i-sodium kunye namanzi. Umzimba uphinde ushintshe kwisakhiwo (i-anabolic) isimo seprotheni synthesis, efuna ukungena kwamanzi kwiseli.

Umzimba usemngciphekweni wokungabikho okwaneleyo kwezi zondlo ezisisiseko kwigazi. Imiphumo yezonyango ingabandakanya ukungafihli kwentliziyo, ukungaphumeleli kwintliziyo, ukuphefumula ukuphefumula, i-coma, ukutshatyalaliswa, ukunyameka kwamathambo, ukulahleka kokulawulwa kwemizimba, kunye nokulimala kwengqondo.

Ukuze ugweme ukuguqulwa kwesifo, amanqanaba e-phosphorus, i-magnesium, i-potassium, i-calcium, ne-thiamin kufuneka ihlolwe kwiintsuku ezi-5 zokuqala kunye neminye imihla ngeveki ezimbalwa. I-Electrocardiogram (EKG) nayo kufuneka iyenze. Kuyafuneka ukuba uphononongo olusisiseko.

IsiGqeba sikaZwelonke seMpilo kunye neCliniki yokuBaluleka kweZigulane zezigulane zicebisa ukuba kukho umngcipheko omkhulu wokuphelisa i-syndrome ukuba iqalo lakho lokuqala li-1,000 okanye iikhalori ezimbalwa ngosuku. Ukujongana nengozi yesifo se-syndrome kwanda kakhulu ngala:

• Izigulane ezinezinye zezi zilandelayo:
  • Isalathisi sobunzima besigqeba esingaphantsi kwe-16
  • Ukunciphisa ukulahlekelwa kwama-15 ekhulwini kwiinyanga ezi-3-8 ezidlulileyo
  • Ukuncinci okanye ukungabikho kokutya okunomsoco kwimihla engaphezulu kweentsuku ezili-10
  • Amanqanaba aphantsi we potassium, i-phosphate, kunye / okanye i-magnesium ngaphambi kokuphelisa
• Izigulane ezinezinto ezimbini okanye ngaphezulu kwezi zilandelayo:
  • Isalathisi sobunzima besigqeba esingaphantsi kwe-18.5
  • Ukunciphisa ukulahleka kweepesenti ezingaphezulu kwe-10 kwiinyanga ezi-3-6 ezidlulileyo
  • Ukuncinci okanye ukungabi nondlo olusondlo lweentsuku ezingaphezu kwama-5
  • Imbali yokusetyenziswa kakubi kotywala okanye iziyobisi, kuquka i-insulin, i-chemotherapy, i-antacids okanye i-diuretics

Isikhokelo esongezelelweyo malunga nokukhuselwa kwesifo se-refeeding sifumaneka kwi-Academy yokuSondeza iNgxaki yeZiphumo zoLawulo lweZonyango. Ngaphantsi kwezi meko, ukubuyiswa kwesondlo kufuneka kuhambe ngokukhawuleza ukukhusela isifo se-refeeding syndrome. Iqela lezonyango liyimfuneko kubandakanywa ugqirha wezonyango kunye noDisitereji weDetitian Nutritionist (RDN) ukubala, ukubeka esweni, nokwandisa ukutya kwansuku zonke kunye nokutya kwamanzi kunye nokubeka iliso i-plasma kunye ne-electrolytes yomchamo, i-plasma glucose, imisebenzi ebalulekileyo kunye nesiginci senhliziyo ngaphambi naphakathi ukufezekisa.

Ngenxa yomngcipheko we-refeeding syndrome kunye neminye imiba engaphantsi kwimiba yonyango enxulumene nendlala, ezininzi izigulane ezine-anorexia nervosa ziqala ukulungiswa kwezondlo kwizibhedlele zonyango okanye kumaziko okunyanga.

Intsalela yale nqaku ijoliswe kubo abangenako ingozi yokuphelisa isifo kwaye bahlanjululwe ngokugqithiseleyo ukuba baqale okanye baqhubeke nokulungiswa kwesondlo kwisithuba sengqesho.

Ukuphulukiswa kweZondlo eziPheleleyo

Uphando olutsha luye lwabonisa ukuba kwizigulane ezingekho kwisichengeni sokuguqula i-syndrome, izigulane ezikhuselekileyo kunye nokukhawuleza ukubuyisela iziphumo zikhokelela ekuphuculeni ngokukhawuleza kunye neziphumo ezingcono. Akuqhelekanga kwiimfuno zekharori zemihla ngemihla zabantu abayifumana kwi-anorexia ukuya kuma-3,000 ukuya ku-5,000 iikhalori zansuku zonke kwisiqingatha esaneleyo esingamaqingatha ezimbini ukuya kwimizuzu yesibini ukuya kwinqanaba lomlinganiselo. Oku kuyinyani kubantwana abaselula abasakhulayo nabaselula.

Iintsholongwane ezithatha inxaxheba kwiNyango eSebenziselwe iNtsapho kunye nabazali abaphethe inkxaso yokuncedisa imfuyo ngokuqhelekileyo banokukwazi ukukhuseleka ngokukhuselekileyo kwi-2,000 ukuya kuma-2 500 khalori ngosuku. Iqela elixhasayo lixhasa kunye nokubeka iliso, abazali bavame ukukhuthazwa ukuba banyuse izicwangciso zokutya ezi-3,000 ukuya kuma-5,000 khalori ngosuku ngokubuyisela isisindo.

Abazali nezigulane badla ngokuphazamiseka kwiimfuno zekhalori eziphezulu njengenkqubela phambili. Kutheni bephakamileyo kangaka? Abantu abane-anorexia nervosa bavame ukuba yi-hypermetabolic, oku kuthetha ukuba imetabolism yabo iqhubekile kwisiganeko esiphezulu njengoko umzimba uzama ukwakha zonke izicubu ezilahlekileyo ngexesha lendlala. Abantu ngabanye bafumana ukufudumala komzimba ophezulu njengoko ukutya kwamanzi kunokuguqulwa kukushisa, kunokuba kusetyenziswe kuphela ukwakha izicubu. Esi sibonakaliso esiyingozi siyanceda siphume ngakumbi.

Ukongezelela, ezininzi izigulane ezine-anorexia nervosa zibandakanya ukuzivocavoca ngokugqithiseleyo nangona kunzima ukuphazamiseka. Ukuzilolonga okunjalo kungafihlakele kwaye kungaphinda kuqhekeze iinzame zokuzuza ubunzima ngokunyusa i-calorie inkcitho. Ukuzivocavoca kaninzi akucebisi ngezilwanyana kumanyathelo okuqala okubuyiswa kwesondlo, kodwa izigulana zingadinga ukubeka iliso ukukhusela.

Kubalulekile ukuba uqaphele ukuba ngenxa yokwandisa i-caloric intake kubangela ukuxhalaba okukhulu kulabo abane-anorexia nervosa, ukufikelela kwezi njongo zekhariki kunokuba ngumceli mngeni nakwenkxaso eyongezelelweyo. Nangona kunjalo, kuyimfuneko ukuvumela i-caloric eyaneleyo ukuba umzimba uphinde uphinde ufumane. Iinjongo zokunyusa kufuneka zihlale zibalwe liqela lakho lonyango. Ukubuyiselwa kwama-femens kubalulekile . Kwakhona iqela lezonyango likwacelwa ukubala izidingo zakho zekhalori ngamnye njengoko zitshintsha ngexesha lokubuyisela.

Izikhokelo zokutya eziphakanyisiweyo

Ukuba uyadla ngaphezu kwe-1 khalori ngosuku njengendawo yakho yokuqala, akuyiyo ingozi yokuphelisa i-syndrome njengoko kuchaziwe ngasentla, kwaye sele ususwe ngokusesikweni ukuba wenze njalo, ngoko unokuqwalasela ukuqala ukulungiswa kwesondlo.

Nceda uqhagamshelane nogqirha wezonyango kunye ne-dietitian obhalisiweyo ukuba wenze iziphakamiso ngokuthe ngqo kumzimba wakho. Ngokomzekelo, isincomo sokuvuselela isondlo sesigulane esingama-90 esikwiimeko ezingekho mngcipheko we-refeeding syndrome ingaba ngale ndlela.

• Usuku 1-4: i- 1,200-1,600 iikhalori / imini
• Umhla wesi-5-7: Ukuba akukho nzuzo yokugcina umzimba, ikhutshwa ngama-calorie angama-400 ngosuku ukuya kwii-1,600-2,000 iekorikhi / imini (Ukuba inzuzo yesisindo iyenzeka unako ukwandisa ngokuthe ngcembe.)
• Usuku lwe-10-14: Ukuba ukufumana ubunzima obunzima bufikelele kuma-1 ukuya kuma-2 iipounds ngeliveki, ukwandisa ukuphindwa kwansuku zonke ngee-400-500 khalori / imini ukuya kwi-2,000-2,500
• Usuku 15-21: 2,500-3,000 iikhalori / imini
• Usuku 20-28: ii- 3,000-3,500 iikhalori / imini

Khumbula ukuba i-caloric idinga ngokunyuka ukwanda ngokomzimba. Ngenxa yoko izigulane eziphulukisayo kwi-anorexia nervosa zifuna ukuba i-caloric ingeniso ekunyuseni ukwenzela ukugcina inzuzo engqongqo. Ngenxa yesi sizathu, i-weekly weigh-ins ukuba inkqubela phambili ifaneleka. Ukuba kwaye xa isantya sobunzima siphula okanye siyeka, ukunyuswa kwekharori kufuneka kwandiswe.

IsiCwangciso seNdlela yokuPhumela impumelelo

Ekubeni isicwangciso sokutya esijoliswe kwikhalori sinokubangela ukuba abo bahlaselwe kwi-anorexia, akusona okokuqala ukukhetha izidlo ezidityanisiweyo zokuncoma. Nangona kunjalo, kunokuba luncedo ukuba nombono woluphi uluhlu lwekhalori olujoliswe kuyo, ngakumbi xa ufunda ibhaleyile yokutya kunye namamenyu. Ulawulo oluhle lokuqala lwesigwondlo kukutya ezintathu ukuya ku-800-khalori kunye kunye ubuncinane be-300-calories e-snacks (emva kokuqikelelwa kwekharori yokuqala kubalwa kwaye kuhlolwe kwaye kugcinwe i-syndrome). Kwakhona, amanqanaba eekhalori ayisoloko ejoliswe kuyo, kuxhomekeke kwisantya sokufumana ubunzima.

Imodeli yesicwangciso sokutya ekhethiweyo ye-anorexia nervosa yokubuyisela yinkqubo yokutshintsha . Ngokuqhelekileyo isetyenziselwa esibhedlele, ukuhlala kunye nokuphulukana nezidlo zokuphulukana kwezifo zokugula. Eyenziwe ngokukodwa kwizigulane ezineesifo sikashukela, le nkqubo ihamba ngokugqithiseleyo ngenxa yokuthatha ingqalelo kwi-macronutrient proportions (iprotheni, i-carbohydrates, i-fat) ngaphandle kokugxila ngqo kwiekorikhi. Izibalo zisoloko zijolise ekufikeleleni kwi-50-60% yeekhalori ezipheleleyo ukusuka kwi-carbohydrate, i-15-20% ukusuka kwiprotheni, kunye no-30-40% ukusuka kwintlobo yokutya okunamafutha okusebenza kakuhle. "Ukutshintshana" ngamnye (isitashi, iziqhamo, imifuno, ubisi, amanqatha, iiprotheyini / inyama) zilingana nokutya okuthethiweyo kunye nesayizi sabelo. Oku kuvumela ukugxila ekukhethweni kweqela lokutya ngokulinganisela ngexesha lokucwangcisa ukutya.

Nangona kunjalo, ukutya okunokulinganisela kungabalulekanga njengoko ukwandisa i-caloric intake ngexesha lokubuyiswa kwesisindo. I-Dietitian Dietitian Nutritionist ingakunceda ukubala kunye nokucwangcisa izicwangciso zesidlo sokutya okuthabatha konke oko.

Isicwangciso sokutya se-3,000-khalori yeSicwangciso soTshintsho seNkqubo yoSuku seentsuku singabandakanya isitashi esine-12, isiqhamo sesine, ubisi obisi-4, imifuno emi-5, inyama elinesithoba kunye namafutha angama-7. I-regimen yemihla ngemihla iyakwazi ukwahlula ukutshintshiselana ekudleni kunye nokutya okuninzi njengendlela elandelayo:

Ukutya kwasekuseni: 2 Isitashi, 1 I-Fat, 2 inyama, 1 i-Milk, 2 Izithelo

• Iziqwenga ezi-2 ze-toast (2-exchange exchange) kunye ne-1 tsp. ibhotela (1 utshintshiselwano lwamafutha)
• Amaqanda ama-2 (ii-2 zintengiselwano zenyama) ezenziwe ngo-2oz ubisi wonke kunye ne-6oz yobisi bonke kwicala lokusela (ukutshintshiselana kwebisi-1),
• 4 oz ye juice ye-orange kunye ne-1/2 yekomityi yesaladi yesithelo (i-total-2 exchange exchanges)

Ukutya: 2 Isitatshi, 2 Imifuno, 3 inyama, 2 i-Fat, 1 Milk

• I-sandwich eshiciweyo ishizi: ii-2 zeesonka (i-2 exchange exchanges), i-2 tsp ibhanti (i-2 fat exchange), i-3 tisi zeshizi (i-3 exchange exchanges)
• Isobho seTamatato (1 inkomishi isobho le-tomato isonka-2 imifuno yezityalo) ezenziwe nge-1 inkomishi yobisi lonke

Ukutya isidlo: 4 isitashi, 3 inyama, 3 i-Fat, 2 i-Vegetable, 1 Fruit

• 1 indebe ephekwe ipasta (i-2 exchange exchange)
• 2 uqhekeza iigallic (ast 2) kunye no-2 tsp ibhanti (2 exchanges)
• 3 oz yeefomo yomhlaba okanye i-turkey (3 i-meat exchange) ebomvu kwi-1 tsp yeoli yeoli (i-1 exchange exchange)
• ½ inkomishi i-tomato sauce kunye ne-½ indebe ephekwe i-broccoli (i-exchange exchange plants)
• 1 i-orange (1 yokutshintshela izithelo)

I-Snack # 1: 2 Isitashi, 1 Ubisi

• 1 i-muffin enkulu (i-2 exchange exchange)
• 1 inkomishi yobisi lonke (ukutshintshiselana ubisi - isahlulo nesiqingatha singenakongezwa ngeekhalori ezingaphezulu)

I-Snack # 2: 1 Izithelo, 1 Ubisi

• I-banana e-½ (1 utshintshiselwano)
• 1 indebe ye-yogurt yobisi (i-milk exchange)

I-Snack # 3: 1 Inyama, 2 isitatshi, 1 Imifuno, i-1 Fat

• 1 tsp i-peanut okanye ibhotela (i-1 exchange exchange)
• 2 isinkwa sesinkwa (i-2 exchange exchange)
• 1 inkomishi izahlulo ezihlaza (1 utshintshiselwano lwezityalo), i-oz oz hummus (i-1 exchange exchange)

Amanye amaqhinga okufumana isisindo

Ukuze ukwandise i-caloric intake ukuphumeza inqanaba lokuzuza ubunzima, unokuhlala ukhumbula ezinye iindlela ezilula:

• Ukwandisa ixesha lokutya (ukususela kathathu ngosuku ukuya kwezihlandlo ezithandathu ngosuku)
• Ukwandisa ubungakanani benxalenye yesabelo
• Ukwandisa i-caloric ukunyaniseka (wongeza amafutha xa upheka njengeoli, ibhotela, ukhilimu, ushizi onokunyusa iikhalori ngaphandle kokukhula kwesahluko)
• Khawukhumbule izithelo kunye nemifuno enobumba engabangela ukuzaliswa kwangaphambili
• Ukuxhaswa nokutya okunomsoco (Qinisekisa ngakumbi, i-Boost Plus) ukubonelela ngeekhalori ezingama-350-360 nge-ounces eziyi-8 kunokubonisa uncedo kakhulu kwi-caloric. Ukutya okunesondlo kule fomu kunconywa ngokukhawuleza njengokutshintshwa kwezidlo ezinqabileyo okanye ezingapheliyo okanye ukutya okutyiwayo.

Ukulwa neengxaki kwiNdlela yokuNciphisa ukubuyiswa

Ekubeni uphawu oluphambili lwesifo luyithintelo lokutya, yiyiphi isigulane nge-anorexia iya kuzidla ngokuzithandela ngaphezulu? Ukuchasana kuqhelekile kwaye kucela inkxaso ecacileyo kubathandekayo kunye neqela labaqeqeshi abangakwazi ukunceda izigulane ziphendule izicwangciso zokutya kunye nokuzuza ubunzima kunye nocelomngeni wokukhathazeka kwengxaki yokutya kunye nokukhuthaza ukusetyenziswa kokutya kokutya imihla ngemihla. I-Vegetarian, i-fat fat, i-carb ephantsi kunye nokutya okungekho yobisi kufuneka idikibala (ngaphandle kokuba ifunyanwe i-allergies) njengoko ihlala isisifo se-disorder kwaye ingaxhomekeke kwimpembelelo yezempilo.

Ukulibazela isisu esiswini okanye i-gastroparesis iyaxhaphaka nge-anorexia nervosa kwaye inokufaka isandla ekuzaleni kwangaphambili kunye nokuqhaqha. Oku kuhambelana nenkqubo yokuvuselela njengokutya ukutya okufunekayo kwandiswe kungenakulungeleka. Ukutya okunesondlo-ukutya okunomdli kunye nokutya okutya okuvumela ukuba iincinci ezincinci ngaphandle kokubingelela umxholo wekhalori kuyisitshixo sokunqoba le nto. Ukutya kwamaqela okuphulukana kwezifo kunokuncedisa ukuxhaswa kwemiphumo yomzimba kunye nokuxhatshazwa kwengqondo kwiimeko ezinjalo zokubuyiselwa. Amaqela ngokuqhelekileyo afaka ugqirha wezonyango, obhaliweyo bezondlo zokutya, isifo sengqondo, kunye nesifo sengqondo. Xa kukhangela kunye nokwakha amaqela angaphandle, kuyacetyiswa ukuba uqinisekise ukuba oogqirha abanezakhono kwiinkqubo zokuphazamiseka kokutya.

Ukuvumela umntu othandekayo ukuba ancede ekuphenduleni kwaye anike inkxaso ngenkxaso yokubuyisela inamandla kakhulu ekubuyiseni. Uhlobo olususelwa kwintsapho (i-FBT okanye i-Maudsley) lukhokelo olusekelwe kubungqina bokubonisa abazali njengenkxaso eyona nto yokuxhaswa kwabantwana kunye nabaselula kunye ne-anorexia nervosa. Amanye amanyathelo enyango enika inkxaso yentsapho kubantu abadala abane-anorexia nervosa sele iphuhlisiwe.

Ukubuyiselwa akusiyo inkqubo engqinelanayo kwaye inokuphuza. Khumbula ukuba uxinzelelo lobomi kunye noshintsho olukhulu lobomi lunokuba luncedo ukuvuselela kwakhona . Inkxaso kunye nokuhlaziywa kwakhona kwenqubekela phambili kunye neenjongo zifuneka rhoqo. Ukwenza uxolo kunye nokutya nokubuyiselwa kwengqondo, ngokomzwelo, nangokwenyama kunye nenhlalakahle kunokwenzeka.

> Imithombo:

> I-American Psychiatric Association. (2006). Unyango lwezigulane ezineengxaki zokutya, umxholo wesithathu. I-American Journal ye-Psychiatry, 163 (7 iNcediso.), 4-54.

> Crook, MA, V. Hally, kunye neJV Panteli. "Ukubaluleka kweSyndrome Syndrome." Isondlo 7-8 17 (nd): 632-37. Hopkinsmedicine.org . Elsevier Science Inc., 2 Jan. 2001. IWebhu.

> Garber, AK, Mauldin, K., Michihata, N., Buckelew, SM, Shafer, M.-A., & Moscicki, A.-B. (2013). Ukutya okuphezulu kwe-calorie Ukunyusa izinga lokufumana isisindo kunye nesibhedlele esifutshane Hlalani kwi-Adolescent ye-Hospitalized Nge-Anorexia Nervosa. Umbhalo Wempilo Yengane Yomntwana : Ukupapashwa ngokusemthethweni koMbutho weNtsholongwane kaGawulayo , 53 (5), 579-584.

> Marzola, E., Nasser, JA, Hashim, SA, Shih, PB, & Kaye, WH (2013). Ukulungiswa kwempilo kwi-anorexia nervosa: ukuhlaziywa kweencwadi kunye neziphumo zonyango. I-BMC Psychiatry , 13 , 290.

> Mehanna, Hisham M., uJamil Moledina, noJane Travis. "Ukuxhatshazwa kwesifo: Yintoni okuyiyo, kunye nendlela yokuKhusela nokuPhatha." I-BMJ: iBritish Medical Journal . BMJ Publishing Group Ltd, 2008. I-Web. 27 uNovemba 2016.

> Waterhous, T. & Jacob, Melanie A .. "Ukungenelela kokuNyango kwiNyango yokuPhalaliswa kokutya." Iphepha lokuSebenza le-American Dietetic Association: i- American Dietetic Association, iWeb. 27 uNovemba 2016.