Understanding Eating Disorders

Alessandra Kershaw RD, CDNOutpatient Dietitian

Sodexo/Faxton St Lukes Healthcare

Objectives

What is an eating disorder What are the types of eating disorders What are the treatment options What is an RD’s role in eating disorders

What is an eating disorder?

An eating disorder is a condition defined by abnormal eating habits that may involve either insufficient or excessive food intake to the detriment of an individual's physical and mental health.

Types of Eating disorders

Anorexia nervosa (AN) Bulimia nervosa (BN) Eating disorders not otherwise

specified (EDNOS) Binge eating disorder (BED) Pica

Not currently recognized in standard medical manuals

Compulsive Overeating Purging disorder Rumination Diabulimia Night eating syndrome Orthorexia nervosa Drunkorexia Pregorexia

PREVALENCE It is estimated that 8 million Americans have an

eating disorder – seven million women and one million men

One in 200 American women suffers from anorexia

Two to three in 100 American women suffers from bulimia

Nearly half of all Americans personally know someone with an eating disorder (Note: One in five Americans suffers from mental illnesses.)

An estimated 10 – 15% of people with anorexia or bulimia are males

MORTALITY RATES Eating disorders have the highest mortality rate of

any mental illness A study by the National Association of Anorexia

Nervosa and Associated Disorders reported that 5 – 10% of anorexics die within 10 years after contracting the disease; 18-20% of anorexics will be dead after 20 years and only 30 – 40% ever fully recover

The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of ALL causes of death for females 15 – 24 years old.

20% of people suffering from anorexia will prematurely die from complications related to their eating disorder, including suicide and heart problems

ACCESS TO TREATMENT

Only 1 in 10 people with eating disorders receive treatment About 80% of the girls/women who have accessed care for

their eating disorders do not get the intensity of treatment they need to stay in recovery – they are often sent home weeks earlier than the recommended stay

Treatment of an eating disorder in the US ranges from $500 per day to $2,000 per day. The average cost for a month of inpatient treatment is $30,000. It is estimated that individuals with eating disorders need anywhere from 3 – 6 months of inpatient care. Health insurance companies for several reasons do not typically cover the cost of treating eating disorders

The cost of outpatient treatment, including therapy and medical monitoring, can extend to $100,000 or more

ADOLESCENTS

Anorexia is the 3rd most common chronic illness among adolescents

95% of those who have eating disorders are between the ages of 12 and 25

50% of girls between the ages of 11 and 13 see themselves as overweight

80% of 13-year-olds have attempted to lose weight

Causes of an eating disorder

The specific cause/causes of eating disorders are unknown. However, it is believed to be due to a combination of biological, psychological and/or environmental abnormalities.

Causes of an eating disorder

Cultural pressure PTSD, especially due to sexually

related trauma Peer pressure and idealized body-types Possible genetic causes Certain disease states Drug/Alcohol addictions

What is our role?

What can we do?

What are the treatment options

Inpatient/Hospitalization Residential Day program Outpatient

Our role in Inpatient

Meal plan Tube feeding Monitoring for re-feeding syndrome

Our role in Residential/Day Program

Meal plan One on one counseling “After care” training/counseling Possible cooking or shopping classes

Outpatient: Anorexia

Meal plan Weight gain monitoring/Weight

maintenance Fear foods Fearful situations/Social situations Normalization of eating Portion control Shopping/cooking

Outpatient: Bulimia

Meal plan Weight gain monitoring/Weight

maintenance Fear foods Fearful situations/Social situations Normalization of eating Portion control Shopping/cooking

When is it time to say, I can not

help you?

My Criteria

Intake below 1000 calories on a daily basis with no improvement

Severely low BMI with very low intake Continued weight loss Under reporting or dishonest answers Unusual behaviors

Number one rule: if you do not feel comfortable refer them to a Doctor. We are not Doctors and can not diagnosis an eating disorder but can assess disordered eating patterns.

A Team Sport

The number one key to treatment for any kind of eating disorder is collaboration!!!

We need to work with the Doctors, Therapist, Counselors and Treatment center when applicable.

Any Questions?

References http://en.wikipedia.org/wiki/Eating_diso

rder http://www.nationaleatingdisorders.org/ http://www.state.sc.us/dmh/anorexia/st

atistics.htm