1. diet, body weight & mental
wellbeing in adolescents
DIANE EDWARDS & ED FRESHWATER
04/12 BSC MENTAL HEALTH NURSING

2. a straw poll
Psychiatric medication causes
weight gain - true or false?

3. mental illness
& weight change
Weight change as a
cause of mental ill health
vs.
Mental ill health as a
cause of weight change

4. outlining the problem
Overweight
Poor nutrition
Higher mortality
Physical health problems
Inactivity
Maladaptive coping strategies

5. mental illness
& weight change
Delusions about food
Social withdrawal
Somnolence
Lack of motivation
Cognitive impairment
Hospital admission
Obesogenic environment
Comfort eating

6. energy requirements
Age Males Females
Kcal (kcal)
11-14
2220 (1845)
15-18
2755 (2110)
COMA, 1991

7. energy requirements
Age Males Females
kcal kcal
11 years 2127 2032
12 years 2247 2103
13 years 2414 2223
14 years 2629 2342
15 years 2820 2390
16 years 2964 2414
17 years 3083 2462
18 years 3155 2462
SACN, 2011

8. diet routine
Breakfast 0800
Snack 1030
Lunch 1200
Snack 1515
Dinner 1730
Supper 2030

9. diet routine
Day Breakfast Lunch Dinner Snacks Calories /
sugar
Mon
Cereal,
Squash x2
¼ cheese baguette
Ice cream
2 x Squash
Pasta & Tomato
sauce
Black forest Gateau
2 x Squash
4 chocolate bourbons,
Crisps x 2
Cake
3 x hot Chocolate
Tue Declined Declined
Pasta & Cheese
Ice Cream
2 x Squash
Giant cookie
Crisps
Kit Kat
Haribo (x4)
3x Squash
Wed
4 toast with
jam
2 x squash
Refused Refused
Aero
Crisps
Chocolate cake
2 x Squash

10. diet routine
Day Breakfast Lunch Dinner Snacks Calories /
sugar
Mon
Cereal,
Squash x2
¼ cheese baguette
Ice cream
2 x Squash
Pasta & Tomato
sauce
Black forest Gateau
2 x Squash
4 chocolate bourbons,
Crisps x 2
Cake
3 x hot Chocolate
2948
226
Tue Declined Declined
Pasta & Cheese
Ice Cream
2 x Squash
Giant cookie
Crisps
Kit Kat
Haribo (x4)
3x Squash
1785
169
Wed
4 toast with
jam
2 x squash
Refused Refused
Aero
Crisps
Chocolate cake
2 x Squash
1614
89

11. nutrition & mental health
Symptom May be lacking…
Anxiety Folic acid, magnesium
Poor concentration or attention Vitamin B1
Depression Vitamins B3, B6 & C, Folic acid, magnesium, selenium, zinc,
Omega3 fatty acids, tryptophan, tyrosine, GABA
Loss of appetite Zinc
Irritability Vitamin B6, magnesium, selenium
Stress Vitamins B6 & B3, magnesium
Lack of motivation Zinc, tyrosine
Insomnia Magnesium

12. what sugar does

13. barriers
Fixed timetable
Kitchen - food production
- lack of creativity
- teenager-friendly
food
- awareness
Involving the young people
Policy
Monitoring bodies
Infection control
Inedible gloop
Apathy

14. clinical procedures
Food & fluid charts
Food and mood diaries
CCBT
CPA
MDT

15. challenges for nurses
Advocacy
Sustaining lifestyle change
Maladaptive strategies
Cultural or religious needs
Challenging practice
Systemic issue

16. any ideas?
Avery, A (2012) Managing obesity in young adults. Practice Nursing 23:6
pp291-294
Avery, A., Pallister, C., Allan, J., Stubbs, J. & Lavin, J. (2012) An initial
evaluation of a family-based approach to weight management in
adolescents attending a community weight management group. Journal of
Human Nutrition and Dietetics 25, pp469-476
Barker, P. (2009) Psychiatric & Mental Health Nursing: The craft of caring.
London, Hodder
Bottomley, A. & McKeown, J. (2008) Promoting nutrition for people with
mental health problems. Nursing Standard 22:49, pp48-55
Chen et al (2013) Association between psychiatric disorders and iron
deficiency anaemia among children and adolescents: a nationwide
population study. BioMed Central Psychiatry 13, pp161-169
COMA (1991) Committee on the Medical Aspects of Food and Nutrition
Policy Available from Nutrition.org.uk Accessed 17.Mar.2014
Compton, M.T., Daumit, G.L. & Druss , B.G. (2006) Cigarette smoking &
overweight / obesity among individuals with serious mental illnesses: a
preventive perspective. Harv Rev Psychiatry Jul-Aug 14(4), pp212-222
DH (2013) Reducing obesity and improving diet. London, DH
Goodman, E. (2003) The public health impact of socioeconomic status on
adolescent depression and obesity. American Journal of Public Health
93:11, pp1844-1850
Hamel, L. & Robbins, L. (2012) Computer- and web-based interventions to
promote healthy eating among children and adolescents: a systematic
review. Journal of Advanced Nursing 69:1, pp16-30
Maayan, L. & Correll, C.U. (2011) Weight gain and metabolic risks
associated with antipsychotic medications in children and adolescents.
Journal of Child & Adolescent Pharmacology 21(6), pp517-535
Mulrooney, H. (2012) The effect of weight on mental health. Practice
Nursing 23:7, pp339-343
NMC (2008) The code: standards of practice for nurses and midwives.
London, NMC
Park, E. (2009) Gender as a moderator in the association of body weight to
smoking and mental health. American Journal of Public Health 99:1,
pp146-151
Rees, R., Oliver, K., Woodman, J. & Thomas, J. (2009) Children’s views
about obesity, body size, shape and weight. Journal of Advanced Nursing
67:5, pp954-960
SACN (2011) Scientific Advisory Commission on Nutrition Available from
Nutrition.org.uk Accessed 17.Mar.2014
Tosh, G., Clifton, A.V., Xia, J. & White, M.M. (2014) Physical health care
monitoring for people with serious mental illness. Cochrane Database of
Systematic Reviews 2014