Definition and Overview

Patients who are diagnosed with eating disorders face a high risk of malnutrition or not getting the adequate amount of nutrients that their body requires to function properly. If this happens, the patient may suffer from serious health risks such as low blood pressure, anemia and an increased susceptibility to diseases caused by a compromised immune system, among several others. Thus, patients with eating disorders should consult a nutritionist or dietitian who can educate them on how they can receive proper nutrition despite their condition. This is an important part of the long-term management of eating disorders.

Who Should Undergo and Expected Results

Considered as the first step in seeking proper treatment, a nutrition consultation is highly important for all patients diagnosed with any of the following eating disorders:

  • Anorexia nervosa – Individuals with this condition have an intense fear of gaining weight that leads to low self-esteem and obsession with weight loss even if their weight is already too low.
  • Binge eating disorder – This causes a person to have frequent episodes of eating excessive amounts of food without control, followed by strong feelings of guilt or shame. Although it does not put a person in danger of low weight levels, this disorder may cause a person’s diet to become imbalanced.
  • Bulimia nervosa – A combination of anorexia and binge eating, bulimia causes an uncontrollable urge to eat excessive amounts of food followed by strong feelings of guilt and concern over gaining weight. One unique characteristic of bulimia that is not present in binge eating disorders is that it causes certain actions, such as self-induced vomiting, to prevent weight gain.
  • Avoidant or restrictive food intake disorder – Also known as a selective eating disorder, this prevents a person from consuming certain types of food. It is very common among children but is more easily overcome especially as they grow older.
    The goals of an eating disorder nutrition consultation are:

  • To assess the patient’s health and nutrition level

  • To check for signs of malnutrition
  • To educate the patient about proper nutrition and how it can be achieved in spite of an existing eating disorder

How the Procedure Works

An initial nutrition therapy assessment for patients with eating disorders may last up to 1 ½ hours. It is significantly longer than follow-up visits, which may last for about 20 to 45 minutes as the doctor or nutritionist must conduct a thorough assessment to better understand the patient’s condition.

The consultation involves:

  • A review of the patient’s medical history, focusing on the patient’s history of weight changes
  • A review of the information regarding the patient’s condition, which includes:
  • A comprehensive assessment of the patient’s typical food intake and eating patterns
  • A review of any treatment, therapy, medication or supplementation the patient has been through as part of the treatment plan for eating disorders
  • An evaluation of the patient’s health, which may also include a physical examination
    During the physical examination, the doctor or nutritionist will watch out for the physical effects of malnutrition caused by the eating disorder. These include:

  • Dry skin

  • Dry or chapped lips
  • Frail body
  • Easy bruising
  • Brittle nails
  • Sunken eyes
  • Pallid complexion
  • Slow heart rate
    The above symptoms are just some of the possible effects of not having enough nutrients in the body.

The doctor or nutritionist will then prescribe a nutritional or structured meal plan, which has to be incorporated into any other existing treatment plan the patient may have. The doctor will explain how the treatment plan will work so the patient can assess whether it is a good option for him/her. The plan will be tailored to the specifics of the patient’s case.

To help patients understand how a nutritional plan works and how they can stick to it, the doctor may also explain about:

  • How much and what kinds of carbohydrates, fats and proteins the body requires
  • The metabolic rate and how it is affected by abnormal eating patterns
  • External factors that may influence the patient’s eating habits; these include fear foods, social-eating and so on
  • Correct portion sizes
  • The difference between physical and emotional hunger
  • The dangers of chronic/severe dieting
  • The role of exercise in a nutritional plan
  • The need for and limitations of nutritional supplements
    Along with the other details of the nutritional plan, the doctor may also create a schedule of follow-up visits, which will help ensure that the patient will receive optimum nutrition for as long as he/she is suffering from an eating disorder.

Possible Risks and Complications

Patients are typically not asked to undergo any tests during the consultation, so the said appointment with the doctor pose little to no risk to the patient.

A nutritional consult makes up just one part of the complex treatment that eating disorders require, but it is one of the most important parts, which is why patients are strongly advised to seek a consultation, usually upon the referral of their primary physician. The nutritionist will work in collaboration with the physician as well as with a psychiatrist and psychotherapist, who may also be involved in the treatment of eating disorders. By receiving proper advice regarding the nutritional aspect of eating disorders, patients will be protected from the following health risks associated with malnutrition:

  • Frequent headaches
  • Low blood pressure
  • Hypotension
  • Anemia
  • Endocrine disorders
  • Amenorrhea
  • Edema
  • Decreased libido
  • Feeling cold often
  • Thinning of hair
  • Frequent illnesses, which may indicate a compromised immune system
  • Osteoporosis
  • Constipation
  • Diarrhea
  • Tooth decay

References:

  • Academy for Eating Disorders -- www.aedweb.org
  • Overeaters Anonymous -- www.oa.org
  • National Eating Disorders Association -- www.nationaleatingdisorders.org
  • National Institute of Mental Health -- www.nimh.nih.gov/health/publications/eating-disorders
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