Malnutrition in cystic fibrosis: A behavioral conceptualization of cause and treatment

The genetic mutation in cystic fibrosis causes a generalised dysfunction of the exocrine system. The subsequent increase in energy needs due to pulmonary infections, increased basal metabolic rate, and malabsorption are not compensated for by increased food intake, hence, malnutrition becomes a problem for most patients. Biological control mechanisms for body energy regulation may be impaired, causing anorexia directly and contributing to learned behaviors which further decrease intake. An interdisciplinary approach to treatment is suggested which would include behavioral, dietary, and medical components. Early and continuous assessment and modification of problematic eating behaviors and related environmental factors along with nutrition education may delay the need for artificial supplementation, and augment their use by increasing oral intake and compliance with procedures. Anxiety due to increasing disease severity may contribute to anorexia and treatment noncompliance. Behavioral training in identification of Stressors and relaxation techniques may be helpful in reducing stress.