Weight gain in psychiatric patients is a common clinical phenomenon in the course of specialty care. Many psychiatric patients experience obesity. How should we recognize the obesity problem of psychiatric patients?
A. Why should psychiatric patients pay attention to weight control?
1. Excess weight tends to cause heart. Bone. Increased burden on the joints, easy to complicate hypertension diabetes. Coronary heart disease and so on.
Medical experts after a long period of research and exploration, found the following common pathogenesis pattern of metabolic syndrome: abdominal obesity – high blood pressure – hypertension – hyperglycemia –cardiovascular diseases, etc.
2, due to the characteristics of the psychiatric patient’s own disease, weight is easy to cause loss of control therefore extra attention should be paid to the patient’s weight control.
3. Weight gain of psychiatric patients may affect their compliance with medication.
B. What factors lead to weight loss in psychiatric patients?
(A) Drug effects
Various antipsychotic drugs generally have different degrees of weight gain side effects.
(B) Improper diet
1. Irrational dietary structure: excessive intake of high-fat, high-salt and high-sugar foods, and too little fiber and essential nutrients.
2, irregular diet: psychiatric patients sometimes lack the ability to take care of themselves, and if the medical staff or family members do not take good care of them, it often leads to irregular diet of patients.
(iii) Lack of exercise
Lack of moderate physical activity is another important reason why psychiatric patients lose weight. Moreover, the lack of exercise is also detrimental to the recovery of psychiatric patients themselves.
To sum up: medication + more food + less movement, weight gain.
III. Dietary Guidelines for Psychiatric Patients
Dietary guidelines for psychiatric patients were developed to help patients make dietary choices to meet nutritional needs, promote health, support active living and reduce the risk of chronic disease. These guidelines can provide simple and effective recommendations for psychiatric patients in terms of diet.
1. Eat a variety of foods
Eating a varied diet can ensure a complete range of nutrients, including more than 40 essential nutrients.
2. Choose a diet with plenty of fruits, vegetables and grains
Fruits, vegetables and cereals are rich in vitamin C, E and minerals, and low in fat. Taking these foods will be beneficial to
a. reduce the risk of heart disease and stroke.
b. reduce the risk of cancer.
c. enhance immunity.
d. preventing oxidative stress and cellular damage in psychiatric patients.
e. Maintaining a slimmer body.
f. Lowering blood pressure.
g. Save on food costs (these foods are usually cheaper than meat and dairy products).
3, eating such foods can also increase fiber intake, a high-fiber diet has the following benefits.
a. Helps relieve constipation.
b, provide a sense of fullness, which helps to reduce food consumption.
c, reduce blood cholesterol levels.
d. Reduce the risk of gastrointestinal dysfunction and colon cancer.
3. choosing a low-fat, low-cell and fat, low-cholesterol diet.
a. Fat provides energy and facilitates the absorption of vitamins A, D, E and K.
b. Daily cholesterol intake is <300 mg (egg yolk, meat, poultry, high-fat dairy products, shellfish and pork all contain cholesterol).
4. Choose a diet with moderate sugar content
Excessive sugar intake will cause many problems.
a. Without the consumption of exercise, excess calories provided by sugar will be converted into fat.
b. Dietary monosaccharides can corrode teeth.
c. Diets high in sugar can mask or exacerbate diabetes.
5. Choose a diet with moderate salt and sodium
Sodium plays an important role in regulating body fluids and blood pressure. The human body needs 2400 mg of sodium daily, which is equivalent to 6 grams of salt, but the vast majority of people consume more than this.
a. Foods high in salt and sodium include snack foods, ham, bacon, and mustard.
b. Ways to reduce sodium intake include.
(1) Eating more fruits and vegetables to replenish potassium can help sodium excretion and maintain sodium-potassium balance. Foods with more potassium include kelp, nori, fungus, yams, bananas, potatoes, tomatoes, dried mushrooms, etc.
(2) Use herbs and salt-free seasonings, such as using the natural flavors of peppers, tomatoes and onions to cook with foods that taste light, using acidity to reduce the amount of salt, using sugar and vinegar to season, and using herbs and spices to season.
(3) Use cooking methods that maintain the original flavor of food such as steaming and stewing.
(4) Avoid pickled and packaged foods.
(5) Sprinkle a small amount of salt in the dish.
6.Avoid alcohol, should not use tobacco, tea, coffee
Alcohol is high in calories and lack of nutrition. Alcohol interacts with drugs used to treat psychiatric disorders and may aggravate certain side effects, such as drowsiness and sedation, and may also cause worsening of certain symptoms of psychiatric disorders, such as hallucinations, delusions and social isolation. Smoking can reduce the concentration of antipsychotic drugs, tea and coffee can cause anxiety and insomnia.
7, drink more water
It is recommended to drink 8 large glasses of water every day. If you participate in regular exercise, it is recommended to drink 9 – 13 cups. The body needs water to perform the following functions.
a, digest food, dissolve nutrient watts for absorption by the digestive system.
b. Carry waste products out of the body.
c, regulate body temperature.
8, psychiatric patients diet tips.
Three more: more vegetables, fruits, more vegetarian oils, more seafood.
Three less: less fatty meat, less sugar, less smoking.
One not: do not touch alcohol.
9, to improve the eating habits of the method
a. Clean up the food cupboard at home, resolve to get rid of food that is not good for health from the kitchen and start a new healthy lifestyle.
b. Avoid eating between meals.
c. If you want to snack, choose low-calorie, high-fiber foods such as carrots, celery and popcorn.
d. Chew well when eating.
e, avoid eating fast food.
10.Control hunger
Some medications for psychosis can enhance appetite, but there are ways to control hunger and appetite. Here are some useful tips.
a. Go for a walk when you feel hungry.
b. Drink a glass of water or other sugar-free beverage.
c. Eat a piece of rice cake / cookie or half a bowl of lettuce.
d. Chew sugar-free gum or take sugar-free mints.
e. Distinguish between “oral hunger” and “stomach hunger”.
Oral hunger: eating to soothe boredom, tension, anger, frustration or stress.
Stomach hunger: eating because the body needs to eat.
IV. Exercise guidelines for psychiatric patients
Exercise guidelines provide help for patients to perform moderate physical exercise and thus control their weight.
1. Soft Exercises.
Some simple soft exercises – exercises you can do anywhere.
2. Achilles tendon stretching exercises.
Sit on the floor and straighten both legs forward. Grasp the ends of a towel with both hands, put both feet in the middle of the towel, and then pull back from the ends of the towel to gently stretch the Achilles tendon. The Achilles tendon is located at the back of the ankle, just above the heel and below the calf belly.
3, groin stretching exercises.
Sit on the floor and bend your knees and feet so that the feet can be pressed against each other. Put your feet as close to the groin as possible. Hold this position and press the knee down until you feel a slight pain in the groin muscles. Hold this position for about 15 to 60 seconds. Repeat three times.
4. Posterior leg extension exercise.
Straighten one leg and lift it up on some kind of support, such as a ladder. Bend down from the waist and try to get the head as close to the leg as possible. Knees straight. Hold this position for 15-60 seconds.
5. Doorway stretching exercises.
Stand in the doorway, open the arms outward, like pushing the wall, put the second-hand on both sides of the wall of the doorway. Then gradually lean the body forward until the chest muscles feel tight and slightly painful. Hold this position for 15-60 seconds. Repeat three times.
6, Notes.
Stretch your muscles until you feel some slight muscle “tightness” or slight pain can be. If you are just starting your exercise program, then the number of seconds of muscle stretching first control in 15 seconds; when your flexibility becomes better, then gradually increase the number of seconds. Do not stretch to the point of excessive pain. Flexibility exercises must be performed at least 3-4 days per week to have an improvement effect. Incorporate flexibility into your warm-up and relaxation exercises. Stretching movements should be gentle, do not suddenly and violently shake up and down.
7, aerobic exercise
Aerobic exercise is the pursuit of the body’s ability to inhale, transport and use oxygen for the purpose of durability of exercise. Its characteristics are low intensity, rhythmic, uninterrupted, and long duration. Generally speaking, aerobic exercise does not require high skills, such as walking, running, swimming, cycling and so on.
Aerobic exercise increases the heart rate and the rate of inspiration for a sustained period of time, and it also delivers more oxygen and blood to all parts of the body. In order to improve your cardiovascular health, the exercise you do must reach an aerobic level. A moderate aerobic metabolism is exercising until your age plus heart rate equals 170.
Aerobic exercise increases the basal metabolic rate and allows for rapid fat burning in the body. After each exercise, the increase in the basal metabolic rate of the human body can last 24 hours, so two days of exercise once, each time more than half an hour, you can make the body’s basal metabolic rate does not slow down.
8, the classic example – walking
Walking and other aerobic exercise must include three component items.
These three items are: warm-up; exercise; relaxation.
9. Warm-up exercise (5 minutes).
The warm-up must consist of 5 to 10 minutes of slow, static stretches or exercises to prepare the body for the more strenuous exercise that follows. All stretches should be performed in a slow and smooth manner, do not do rapid jumping movements. The muscles at the back of the legs and the Achilles tendon at the back of the ankle need to be stretched in particular. Knee holds and pushing wall stretches are two good stretching exercises.
10. Exercise (30-40 minutes).
The exercise phase should consist of 30 to 40 minutes of steady, continuous activity, and the intensity of the exercise must be within the target heart rate range. Check your heart rate 10 minutes after you start exercising, and then check it again 10 minutes later so you know if you have reached your target heart rate and have maintained it. In order to obtain the aerobic benefits of exercise, it is important to maintain your target heart rate (generally greater than 130 beats per minute).
11. Relaxation exercise (5 minutes).
The intensity of exercise in this phase should be gradually reduced so that the body can return to a resting state. Relaxation exercises should last at least 5 minutes and can be done by walking slowly or with the same movements as the warm-up exercises.
V. Tasks of the patient and family
1.Arrange the patient’s diet according to the dietary guidelines and keep records.
2. Regularly measure the patient’s weight with appropriate exercises to control the weight gain.