Friday, December 14, 2012

Why testing is important at Upstate New York Eating Disorder Service

Body composition analysis guides us when we work with patients.

By Carolyn Hodges Chaffee
Owner and CEO

Metabolic testing and body composition analysis are two state-of-the-art tests that are used to initially assess every patient treated at the Upstate New York Eating Disorder Service. Ongoing reassessments with these tests guide the treatment recommendations.   

Here are some of the frequently-asked questions we receive and our answers:

Question: What is metabolic testing and what do the results reveal?
Answer: Metabolic testing, or indirect calorimetry, is an actual measurement of the body’s resting energy expenditure (REE). The results are used to accurately assess the nutritional status of the patient. The results of the non-invasive breathing tests show us how the body adapts if it is being underfed. Metabolic testing determines how many calories a body is burning at rest with no activity. It also shows if the body is breaking down its own protein stores.

Q: Why do new patients undergo metabolic testing?
A: It gives us information about how the body is responding to how it is being fed. People can be normal weight or overweight and still be very malnourished. This test shows us what is going on inside the body, and it helps us identify individuals at high risk.
It is also very useful with people who don’t think they have a problem because their weight is normal. It is not unusual to find that these patients are underfeeding their bodies but maintaining a higher weight because their body has slowed down.

Q: How do you use the metabolic profile?
A: It provides us with an accurate picture of how malnourished a person is. We use it as an educational tool with patients. It is very helpful for the patient to know that underfeeding the body is causing the body to break down its own protein stores and it is pre-aging the body.

Q: What is body composition analysis and what do the results tell you?
A: Body composition analysis is a measurement of the body’s lean mass and fat mass. The test also assesses the cell integrity and hydration of the body. The results help determine the long-term effects malnutrition has had on the body.

Q: What are the benefits to you and the patient in using body composition analysis on a regular basis?
A: We use it for many different things. We use it to assess minimum recommended weight, but we mainly use it to guide us when working with the patient. The results help us to see how the body is responding to the food intake. We can also monitor people that are high risk to refeed because of medical complications such as refeeding edema (swelling that occurs when the body is refed). The results also help us identify people who may have low bone density.

Q: What do you tell patients about why you use these tools in their treatment?
A: The results are invaluable. We are able to provide patients with actual tests that show just what is happening to their bodies. Bloodwork seldom shows abnormalities until a patient is severely depleted, and even then, bodies compensate and labs often are within normal limits. Metabolic testing, for example, is a very fine measurement and shows abnormalities much sooner. This type of test helps you determine how much the body is being affected by the symptom use (restricting, bingeing, purging, laxative use, compulsive exercise, etc.).

Q: Why is it important to educate clinicians and patients about the tests?
A: Some clinicians are not familiar with the tests and need to be educated about how to interpret the results. By educating patients, they become much more knowledgeable about what happens when the body is underfed.

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