EDs are psychiatric pathology with the highest mortality rate: up to 8 times higher than that of healthy people of the same age group. Together with the professionals of mental health, dietitian-nutritionist, specialized nurse and occupational therapist, Dr. Miguel Civeramember of the Management Committee of the Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN), demands that patient care be carried out within teams “in which the participation of the endocrinologist is considered essential”. Also, specialized units in those hospitals where they do not exist, because they “associated with better clinical outcomes“.
LA SEEN emphasizes that the approach to disorders It must be multidisciplinary. And they complain, in public health, the resources “are clearly insufficient”. According to their data, in 2021, only 29% of hospitals had specific consultations for ED care. The figure increased to 40% in hospitals with more than 500 bedsdespite which they continue “to be very deficient,” indicates Dr. Miguel Civera, specialist in Endocrinology and Nutrition.
His partner, Dr. Samara Palma, also a member of the Management Committee of the Nutrition Area of the SEEN, provides another piece of information: in the Clinical Nutrition and Dietetics Unit of the Endocrinology and Nutrition Service, from the La Paz Hospital (Madrid), They see people over 18 years old. After the pandemic, they observed an increase in demand “both to evaluate patients for the first time and to reevaluate those who were already being followed up and who had experienced a flare-up of the disease“.
The scientific society aims to “many concerns” around these pathologies. Like the “linking of success to thinness” or “the denial of the disease that we encounter in consultations, a very important barrier to achieving restoration of nutritional status and the normalization of eating behavior,” says the specialist.
Severity of cases
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He also talks about the “seriousness of the cases” they deal with, with altered nutritional status, both by default (malnutrition) and by excess (overweight and obesity), sometimes accompanied by purgative behaviors (self-induced vomiting, surreptitious use of weight control medication, diuresis etc.), binge eating etc. “With the impact that this has on the patient’s health“remarks the specialist.
Some of the consequences for the body, the specialists describe, are extreme malnutrition; the deficiency of specific nutrients (iron, vitamin D, thiamine, zinc); hydroelectrolyte alterations caused by purgative maneuvers -self-induced vomiting, abuse of laxatives and/or diuretics… -such as dehydration, water overload, hyper/hyponatemia, hypokalemia and hormonal alterations such as amenorrhea, growth arrest or the development of osteoporosis/osteomalacia.