The characteristic changes that follow a major operation or moderate to severe injury do not include the following:

D. Hyperphagia.

DISCUSSION: The characteristic metabolic response to injury includes hypermetabolism, fever, accelerated gluconeogenesis, and increased proteolysis (creating a negative nitrogen balance). Food intake is generally impossible because of abdominal injury or ileus. With time, food intake increases, but the patient generally experiences anorexia, not hyperphagia.