Lesson 18 — Nutrition

Body mass index, or B-M-I, is the relationship of weight and height. It also provides a good estimate of the degree of body fat. B-M-I can be a predictor of weight-related disease and risk classification. The physician may use the index to evaluate patient health and disease risk. The physician determines each patient's classification.

A body mass index range of eighteen-point-five to twenty-four-point-five is considered normal. The ideal B-M-I range is understood to be nineteen to twenty-two. Some may believe that those in this range live longer. An index under eighteen-point-five falls into the underweight range. A measurement in the twenty-five to thirty range is considered overweight. A body mass index over thirty can indicate obesity unless the patient has a higher-than-normal muscle mass.

As of twenty-twenty, approximately forty-two percent of adult Americans are classified as obese. The Centers for Disease Control and Prevention, or C-D-C, subdivides obesity into three classes. Class one is a B-M-I of thirty to less than thirty-five. Class two ranges from thirty-five to less than forty. Class three, also known as severe obesity, has a B-M-I of forty or higher.

Each category considers the potential for weight-related disease. For underweight and normal classifications, disease risk is low. Those classified as overweight have increased risk. For the obese indices, the disease risk is high and increases with each classification of obesity. Those with increased risk may require medications, bariatric surgery, or diet modifications.

B-M-I is measured by a mathematical formula that is often calculated within the E-H-R with entry of a patient's height and weight. Physicians may choose to replace or supplement the B-M-I with another formula that calculates a patient's waist to hip ratio. Some believe that the formula using waist and hip measurements is a better indicator of health and especially cardiac risk.

Anorexia nervosa is a common eating disorder, marked by self-induced starvation. This leads to extreme weight loss and severe malnourishment. Because the body is denied necessary nutrients, there are often significant health problems. Patients who struggle with this disorder are often sensitive to failure and criticism.

Bulimia nervosa is even more common than anorexia. This disorder is evidenced by periods of binging and purging. Binging refers to overeating. Purging happens by self-induced vomiting and overuse of laxatives or enemas. Excessive exercise or fasting may follow the binging period. There may be noticeable fluctuations in the patient's weight. There is often significant erosion on the back of the front teeth from excessive stomach acid. These patients believe their self-worth is related to being thin.

Binge eating disorder is like bulimia, without the purging. According to N-E-D-A, or National Eating Disorder Association, this is the most common eating disorder in the United States. Binge eating is characterized by eating excessive amounts of food within a certain time period. The person feels a lack of control and is unable to stop eating. These patients may also have noticeable fluctuations in weight.

Patients may experience a variety of health problems because of an eating disorder. They struggle with poor concentration, poor body image, and other mental health issues like anxiety or depression may result. Sleep problems, stomach issues, fainting or dizziness, dry skin, and feeling cold may occur. Poor wound healing and impaired immune systems are also serious considerations.