Diets Health Article

Definition

Special diets are designed to help individuals make changes in their usual eating habits or food selection. Some special diets involve changes in the overall diet, such as diets for people needing to gain or lose weight or eat more healthfully. Other special diets are designed to help a person limit or avoid certain foods or dietary components that could interfere with the activity of a medication. Still other special diets are designed to counter nutritional effects of certain medications.

Purpose

Special diets are used in the treatment of persons with certain mental disorders to:

• identify and correct disordered eating patterns
• prevent or correct nutritional deficiencies or excesses
• prevent interactions between foods or nutrients and medications

Special types of diets or changes in eating habits have been suggested for persons with certain mental disorders. In some disorders, such as eating disorders or substance abuse, dietary changes are an integral part of therapy. In other disorders, such as attention-deficit/hyperactivity disorder, various proposed diets have questionable therapeutic value.

Many medications for mental disorders can affect a person's appetite or nutrition-related functions such as saliva production, ability to swallow, bowel function, and activity level. Changes in diet or food choices may be required to help prevent negative effects of medications.

Finally, interactions can occur between some medications used to treat persons with mental disorders and certain foods or nutritional components of the diet. For example, grapefruit and apple juice can interact with some specific psychotropic drugs (medications taken for psychiatric conditions) and should be avoided by individuals taking those medicines. Tyramine, a natural substance found in aged or fermented foods, can interfere with the functioning of monoamine oxidase inhibitors and must be restricted in individuals using these types of medications. A person's pre-existing medical condition and nutritional needs should be taken into account when designing any special diet.

Eating disorders

The two main types of eating disorders are anorexia nervosa and bulimia nervosa. Individuals with anorexia nervosa starve themselves, while individuals with bulimia nervosa usually have a normal or slightly above normal body weight but engage in binge eatingfollowed by purging with laxatives, vomiting, or exercise.

Special diets for individuals with eating disorders focus on restoration of a normal body weight and control of bingeing and purging. These diets are usually carried out under the supervision of a multidisciplinary team, including a physician, psychologist, and dietitian.

The overall dietary goal for individuals with anorexia nervosa is to restore a healthy body weight. An initial goal might be to stop weight loss and improve food choices. Energy intake is then increased gradually until normal weight is restored. Because individuals with anorexia nervosa have an intense fear of gaining weight and becoming fat, quantities of foods eaten are increased very slowly so that the patient will continue treatments and therapy.

The overall dietary goal for individuals with bulimia nervosa is to gain control over eating behavior and to achieve a healthy body weight. An initial goal is to stabilize weight and eating patterns to help the individual gain control over the binge-purge cycle. Meals and snacks are eaten at regular intervals to lessen the possibility that hunger and fasting will trigger a binge. Once eating behaviors have been stabilized, energy intake can be gradually adjusted to allow the individual to reach a normal body weight healthfully.

For individuals with either anorexia nervosa and bulimia, continued follow-up and support are required even after normal weight and eating behaviors are restored, particularly since the rate of relapse is quite high. (Relapse occurs when a patient returns to the old behaviors that he or she was trying to change or eliminate.) In addition to dietary changes, psychotherapyis an essential part of the treatment of eating disorders and helps the individual deal with fears and misconceptions about body weight and eating behavior.