MEDS 2148 Clinical Presentations Across The Lifespan

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Please read the case about Therapeutic Interventions for Mr. Versace, and answer the question

An orthopaedic doctor is concerned Mr Versace may have instability in his joints due to his past history of orthorexia.

It is a continuous risk after surgery.

Discuss, using current literature, the factors that increase this risk due to age-related physiological or psychosocial factors.

His medical team and allied health professionals could establish a therapeutic regimen that will lower this risk. They should also discuss any additional risks associated manual therapy.

The practitioner must prioritize these interventions to show that he is aware of the top concern for Mr Versace.

Also, talk about the potential benefits of using evidence-based adjunctive treatments at RMIT University clinic for Mr Versace.

Discuss the potential referral paths for Mr Versace as part of the adjunctive therapy discussion.


Therapeutic Interventions for Mr. Versace


Orthorexia (Baer 2015) is a condition that causes an individual to be obsessed with eating a certain diet and to avoid certain foods.

According to the WHO, Orthorexia is linked to poor nutrition and poor quality life.

However, the NHS suggests that this topic has received much less attention.

There is much debate about whether to categorize the condition as either a nutritional disease or a mental disorder. (Caudle, et al. 2015).

An assessment of neuropsychology literature suggests that orthorexic signs are often associated with Orthorexia.

The ideas presented in this paper aim to highlight the psychosocial and physiological factors that are responsible for the risk of Orthorexia in Mr. James Versace.

In addition, the article will discuss the treatment options available to reduce the risk.

In the paper, Mr. Versace will be discussing the benefits of evidence-based supplementsive therapies.

As an appendix, a letter will be sent to the GP.

Finally, the paper will summarize the ideas concerning the thesis statement.

Risk of disease: Psychosocial factors and pathophysiology

Orthorexia type is determined by biological factors. Men are reported to experience more cases of anorexia and women to be more susceptible to bulimia.

According to the NHS, Orthorexia sufferers have higher rates of substance abuse and alcoholism than those without it (Herpertz Dahlmann et. al., 2014).

Endogenous opioids are also believed to contribute to Orthorexia’s denial of hunger because they believe that dieting increases the risk.

The case of Mr. James Versace is a good example of an individual who experiences increased levels of endorphins that cause a feeling of well-being, but his body mass as a sportperson is not directly related to his age.

There is an increasing demand for antidepressants to support the pathophysiologic function serotonin and norepinephrine in patients like Mr. Versace.

Remember that starvation causes biochemical modifications such as the suppression or increase in thyroid function.

As such, it is possible for one to notice that obese people eat in order to increase their body activity. This makes Mr. Versace a victim.

Self-starvation is also a way to gain approval in the eyes the society.

It is essential to understand the physical risk factors for Orthorexia.

Understanding that physical factors are linked with emotional and psychological factors is also important.

These include losing interest in activities that you used to enjoy, spending too much time planning meals, and less effort in doing activities.

Therapeutic Interventions for Combating the Condition

Kristeller and colleagues (2014) concluded that Orthorexia is poorly understood.

Micali et al. (2015) propose alternative strategies to manage and reduce the negative effects.

Multifaceted group approaches, which include psychotherapists, physicians and dieticians, are recommended to implement cognitive-behavior therapy. They also advocate psychoeducation awareness to monitor and assess the condition of patients such a Mr. Versace.

Shanwal and Dasgapata (2014) believe that it is best to refer a patient to an Inpatient System with qualified physicians to refeed syndrome if they have severe orthorexic conditions.

In treating OCD and Orthorexia, serotonin synthesizer is a significant benefit.

Cognitive-behavior Therapy is also likely to lower the stress associated Orthorexia by creating a platform that allows nurses and patients to engage.

Additionally, body relaxation sessions may be a key component in Mr. Versace’s anxiety health.

Health professionals should implement strategies that allow patients to socially interact and give them the opportunity to share their ideas and health information.

Stice and colleagues (2013) explain the importance of establishing a patient-centered platform that promotes recovery from Orthorexia.

Orthorexia, if not understood, is a horrible disease.

For Mr. Versace to be treated, it is necessary to implement a treatment program that includes nutrition rehabilitation, medication, psychotherapy, and a plan for his recovery.

Mr. Versace’s weight and cardiac metabolism determine the severity of the condition and the type and location of the hospital.

American Psychiatric Association provides guidelines to help Mr. Versace regain his nutritional status and establish healthy habits (ThompsonBrenrer, 2013).

A clinician should be able to treat medical problems, correct Mr. Versace’s Orthorexia thoughts, and include the family in promoting healthy eating habits.

In liaison with NICE, The National Collaborating Centre for Mental Health promotes evidence-based care for Orthorexia patients. It is essential for nurses working in acute nutrition to be aware of eating disorders and to provide care for patients at risk (Treasure und Schmidt, 2013).

This model promotes the well-being and recovery of patients using theory-based interventions, such as CFIR.

Nutritional Rehabilitation

His pathology results indicate that Mr. Versace’s normal controlled weight gain should be 2 pounds per semaine (Baer, 2015).

He should consume 30 Kcal/kg daily.

Given Mr. Versace’s medical findings, oral feeding is not effective in his nutritional rehabilitation program. This necessitates the addition of a nocturnal nasogastric feed pattern to ease the distress.

As Mr. Versace’s nurse, one must pay close attention to his weight, fluid intake, and any other vital signs and symptoms.

It is essential to have regular physical examinations to check for circulatory overload, refeeding edema, or monitor cases of bloat related to diet changes (Dunn, Bratman, 2016).

Inpatient care unit Mr. Versace should be checked for serum electrolyte levels.

If there is constipation, the doctor in charge should induce stool softener.

He should be praised for his positive attitude during the rehabilitation program.

A close watch on the patient means that he must be monitored after each meal and that he cannot use the washrooms for at least two hours.

The patient should not be allowed to engage in any activity at all during the first phase.

The patient can then be slowly introduced to a program of exercise, starting with stretching and jogging, before moving on to more vigorous aerobics.


Mr. Versace is able to maintain his body weight by taking medication.

Medication can be used to treat specific psychiatric symptoms and restore normal eating habits.

Tricyclic antidepressants such as tricyclic antidepressants can be used to treat the specific disorder being treated (Caudle, et al. 2015).

It is important to take care when allocating the drugs as abuse can cause hypotension and cardiac complications.

It is a good idea to give Mr. Versace a low dose of antipsychotics to improve his eating habits.

The treatment for anxiety can be continued with benzodiazepines.

For abdominal discomforts metoclopramide may be recommended.

It is important to mention that screening can help in the prevention of adverse Orthorexia conditions due to aged-related psychosocial or physiological factors.


Technology has made it easier to understand the advantages and disadvantages of eating.

Orthorexia is a growing problem among older teens.

Mr. Versace was 17 years old.

Furthermore, it is evident that Orthorexia can be a social construct. It is where environmental factors have an influence on the eating habits of people.

For example, Mr. Versace is obsessed about football and wants to be a great player. However, he does not want to eat a healthy diet.

According to reports, the patient has poor eating habits that are contrary to what his mentors do in his sport.

Orthorexia can also be a problem in older teens. However, health professionals have vowed to decrease the danger by providing patient-centered care within similar settings.

Additionally, Orthorexia sufferers need to be prescribed the correct medication to help them regain their normal weight and improve their appetite.

To that end, although severe Orthorexia can be a frightening condition, early detection of symptoms and signs is crucial in resolving it.

Refer to

Clinician’s guide for mindfulness-based treatments: The evidence base and application.

Academic Press.

Retrospective study on the impact of DSM-5 in diagnosing eating disorders, Victoria, Australia.

Journal of eating disorder, 3(1), 35.

The effectiveness of family-based treatment in treating adolescents with eating disorders: A systematic analysis and meta-analysis.

International Journal of Eating Disorders, 46(1): 3-11.

Orthorexia nervosa: An overview of the literature, and proposed diagnostic criteria.

DSM-5: The “new disorder” of restricted/avoidant food intake disorder in children and teens.

Journal of Adolescent Health. 55(1): 49–52.

Day-patient treatment with short-term inpatient care versus continued, inpatient treatment for adolescents suffering from anorexia. This is a multicentre, randomised open-label, noninferiority trial.

The Lancet 383(9924), 1222-1229.

World Health Organization World Mental Health Surveys. The prevalence and associated factors of binge eating disorder.

Biological psychotherapy, 73(9). 904-914.

New perspectives on orthorexia nervosa’s clinical basis.

Neuropsychiatric disorders and their treatment, 11, 385.

A clinical trial of mindfulness-based eating awareness training (MBEAT) for bingeing: Randomized clinical trial.

Adolescent eating disorder behavior and cognitions: gender-specific effects and consequences of maternal, child and family risk factors.

The British journal of psychotherapy, 207(4): 320-327.

Emotional intelligence is a management tool for orthorexia.

Indian Journal of Health and Wellbeing 5, 638.

A prospective 8-year community study of young females to determine the prevalence, incidence, impact, and course for DSM-5 eating disorders.

Journal of abnormal Psychology, 122(2): 445.


Journal of consulting clinical psychology, 81(4): 710.

Journal of eating disorders 1(1), 13.

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