Selection of Patients and Timing of Nutritional Support

The process of nutritional support should be an integrated continuum from normal diet to EN based on a plan. This plan should be developed at the moment of each patient's entry and implemented with modifications until discharge. It is undesirable to have to make an urgent decision on a weekend after realizing that the patient has been starving for the previous 2 weeks. I favor an approach in which the nutritionist examines the needs of each patient at entry and follows the algorithm given in Figure 1.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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