As one of the most complicated sets of illnesses to treat, eating disorders have mental health, as well as medical and nutritional, aspects. While treatment by a multidisciplinary health-care team is considered the best practice, there is considerable debate over how to most effectively treat eating disorders and who should be on a treatment team.
In a newly updated position paper, the American Dietetic Association says nutrition counseling by a registered dietitian is an "essential component" of successful care for people diagnosed with eating disorders. ADA's position paper on "Nutrition Intervention in the Treatment of Eating Disorders" has been published in the August issue of the Journal of the American Dietetic Association:
It is the position of the American Dietetic Association that nutrition intervention, including nutrition counseling by a registered dietitian, is an essential component of the team treatment of patients with anorexia nervosa, bulimia nervosa and other eating disorders during assessment and treatment across the continuum of care.
Eating disorders are serious illnesses affecting approximately 8 million Americans at any given time. While anyone can suffer from an eating disorder, affecting all cultures, ages and genders, they are most common in teen and young adult women. All forms of eating disorders can be fatal. It is critical for anyone with symptoms of an eating disorder to seek professional help. Early treatment gives the greatest chance for a full recovery.
More information about eating disorders is available on ADA's website.
ADA's position paper was written by registered dietitians Amy D. Ozier, PhD, RD, LDN, assistant professor of family, consumer and nutrition sciences at Northern Illinois University; and Beverly W. Henry, PhD, RD, LDN, associate professor of family, consumer and nutrition sciences at NIU.
In addition, ADA's has produced its first practice paper on eating disorders, providing up-to-date information for registered dietitians on current research and controversies in the field; offers guidance on diagnostic criteria, symptoms, assessment and treatment of eating disorders; and delineates concrete ideas about the role of RDs.
ADA's position paper is designed to:
•Increase awareness of the types of disordered eating and eating disorders
•Detail emerging issues including associations between binge eating disorder and overweight and obesity
•Focus on special populations such as athletes, adolescents and those considering bariatric surgery
•Address other challenging issues encountered in treatment of eating disorders such as insurance coverage.
"The complexities of EDs, such as epidemiologic factors, treatment guidelines, special populations and emerging trends highlight the nature of EDs, which require a collaborative approach by an interdisciplinary team of mental health, nutrition and medical specialists," the authors of ADA's position paper write.
"RDs are integral members of treatment teams and are uniquely qualified to provide medical nutrition therapy for the normalization of eating patterns and nutritional status. However, this role requires understanding of the psychologic and neurobiologic aspects of EDs. Advanced training is needed to work effectively with this population. Further efforts with evidence-based research must continue for improved treatment outcomes related to EDs, along with identification of effective primary and secondary interventions."
The authors note that a registered dietitian's role in the nutritional care of individuals with eating disorders "is supported by the American Psychological Association, the Academy for Eating Disorders and the American Academy of Pediatrics....An RD may be the first to recognize an individual's ED symptoms or be the first health-care professional consulted by a patient for this condition," and registered dietitians can facilitate the referral process and help the patient understand the effectiveness of a full treatment team. "Multiple components of nutrition assessment performed by RDs can contribute to treatment plans."
The purpose of the practice paper is to provide registered dietitians with updated information about the development of eating disorders and to bridge the gap across multidisciplinary health-care teams by describing unique contributions of registered dietitians in treating the full spectrum of eating disorders in a variety of settings.
The practice paper also addresses such issues as:
•Registered dietitians' unique contributions to multidisciplinary teams treating eating disorders
•Evidence why leading researchers are calling eating disorders "brain disorders" (since physical symptoms of eating disorders may be caused or worsened by malnutrition or under-nutrition)
•How RDs treat this spectrum of disorders
•Controversial subjects related to eating disorders
•Encouragement to RDs to become more literate about eating disorders and work to improve understanding and treatment.
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