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Food intake problems like severe or frequently vomiting may not only affect growth and development, but may also influence the process of learning how to eat and can have a great impact on the whole family. In addition to food intake problems, there is growing evidence that patients with a Noonan syndrome spectrum disorder may have a lower body mass index (BMI) due to a high energy expenditure, although little is known about the actual energy intake patients with a Noonan syndrome spectrum disorder need to maintain a healthy BMI. This article illustrates the challenge to recognise a high energy expenditure especially when a patient frequently vomits. Multidisciplinary attention is needed to manage food intake, vomiting and energy expenditure problems in patients with a Noonan syndrome spectrum disorder.<\/jats:p>","DOI":"10.1136\/bcr-2021-247513","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T11:50:47Z","timestamp":1647949847000},"page":"e247513","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["High energy expenditure in a patient with feeding problems and Noonan syndrome spectrum disorder"],"prefix":"10.1136","volume":"15","author":[{"given":"Dagmar","family":"Tiemens","sequence":"first","affiliation":[{"name":"Department of Paediatrics, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemiek van","family":"Wegberg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology - Dietetics, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debbie van","family":"Druten","sequence":"additional","affiliation":[{"name":"Day Treatment, SeysCentra Foundation, Malden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4829-6173","authenticated-orcid":false,"given":"Jos","family":"Draaisma","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"2025082722030468000_15.3.e247513.1","doi-asserted-by":"publisher","DOI":"10.1002\/humu.23624"},{"key":"2025082722030468000_15.3.e247513.2","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association . 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