Downey Amanda E, Richards Alexis, Tanner Anna B
Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States.
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States.
Front Psychiatry. 2023 Mar 3;14:1094222. doi: 10.3389/fpsyt.2023.1094222. eCollection 2023.
While the assessment of acute medical stability in patients with eating disorders should never be minimized, careful attention toward other specific age-related consequences of malnutrition can improve psychological outcomes and reduce long-term, potentially irreversible medical complications, like linear growth impairment.
While the impact of malnutrition on linear growth is widely recognized, emerging data highlight consensus in several key areas: the time from onset to time of diagnosis, age at illness onset, pubertal stage at illness onset, and adequacy of weight restoration to achieve catch-up growth. This review provides concrete and actionable steps to help providers identify and explore deviations in expected growth and development while prioritizing early and aggressive weight restoration to provide the best opportunity for catch-up linear growth in patients with eating disorders.
The impact of restrictive eating disorders on growth and development cannot be overstated, particularly in pre- and peripubertal patients. While many consequences of malnutrition are reversible, the loss of genetic height potential may prove irreversible without early and aggressive weight restoration.
虽然对饮食失调患者的急性医疗稳定性评估绝不能轻视,但对营养不良的其他与年龄相关的特定后果予以密切关注,可以改善心理结局,并减少长期的、可能不可逆转的医疗并发症,如线性生长障碍。
虽然营养不良对线性生长的影响已得到广泛认可,但新出现的数据凸显了几个关键领域的共识:从发病到诊断的时间、发病年龄、发病时的青春期阶段,以及体重恢复以实现追赶生长的充足程度。本综述提供了具体且可操作的步骤,以帮助医疗服务提供者识别和探究预期生长发育中的偏差,同时优先进行早期积极的体重恢复,为饮食失调患者提供实现追赶性线性生长的最佳机会。
限制性饮食失调对生长发育的影响再怎么强调都不为过,尤其是在青春期前和青春期前后的患者中。虽然营养不良的许多后果是可逆的,但如果不及早进行积极的体重恢复,遗传身高潜力的丧失可能是不可逆转的。