From the Guidelines
The proper workup for a patient with defatting involves a comprehensive approach, starting with a detailed history and physical examination, including weighing the patient and quantifying eating and weight control behaviors, as recommended by the American Psychiatric Association 1. The initial evaluation should identify co-occurring health conditions, including co-occurring psychiatric disorders, and include a comprehensive review of systems 1. The physical examination should assess vital signs, including temperature, resting heart rate, blood pressure, orthostatic pulse, and orthostatic blood pressure, as well as height, weight, and BMI, and physical appearance, including signs of malnutrition or purging behaviors 1. Laboratory tests should include a complete blood count and a comprehensive metabolic panel, including electrolytes, liver enzymes, and renal function tests 1. An electrocardiogram should be considered in patients with a restrictive eating disorder, patients with severe purging behavior, and patients who are taking medications that are known to prolong QTc intervals 1. The patient should have a documented, comprehensive, culturally appropriate, and person-centered treatment plan that incorporates medical, psychiatric, psychological, and nutritional expertise, commonly via a coordinated multidisciplinary team 1. Key elements of the initial work-up for patients with obesity, which may be relevant in the context of defatting, include a comprehensive clinical assessment to identify obesity-related complications, health risks, and potential barriers to treatment, as well as exploring factors that may have contributed to the individual's unhealthy weight 1. This approach addresses both the immediate concerns and potential underlying causes, while preventing further damage to the patient's physical and mental health.
From the Research
Patient Workup for Defatting
There are no research papers directly related to the workup for a patient that is defatting. However, the following information may be relevant in a general medical workup:
- A thorough patient history is fundamental for the accurate diagnosis and effective management of health conditions 2
- Important communication skills for nurses when history taking include active listening, empathetic communication, and cultural sensitivity 2
- Evaluating a patient requires a careful assessment that includes a thorough history, examination, and workup 3
- A meticulous evaluation is necessary to determine the cause of a patient's symptoms, and a shotgun approach to evaluation can be costly and may expose the patient to unnecessary risk and concern 4
General Medical Workup
- A step-by-step process for taking a comprehensive patient history can help inform diagnosis and treatment 2
- Laboratory, encephalographic, and imaging studies may be necessary to support a diagnosis, but should only be used if they are necessary to answer questions raised by the initial evaluation 3, 4
- Patient compliance with therapy regimes is crucial, and pseudomalabsorption (poor compliance) can be a common cause of failure of therapy 5, 6