By Kristen Quann, MS, RD
As a registered dietitian, working in the eating disorder field is both challenging and rewarding. Eating disorder treatment consists of levels of care ranging from inpatient or residential, to partial-hospitalization, to intensive outpatient. At inpatient level, the patient is residing in a treatment facility with round-the-clock care, and is seen by a dietitian multiple times per week, whereas in intensive outpatient care, a patient may be in programming for a few hours a day for 3 to 5 days per week, and typically has one individual session with a dietitian per week.
Dietitians work closely with an interdisciplinary team comprised of primary therapists, family therapists, psychologists, medical doctors, nurses, and case managers. Strong counseling skills are essential for dietitians working with patients struggling with eating disorders, as there are often additional co-occurring mental illnesses or substance abuse issues that need to be addressed as well.
Eating disorders have the highest mortality rate of all mental illnesses. There is often a misconception that eating disorders are only “real” in emaciated women. However, a person of any sex and weight can be struggling from an eating disorder that is just as life threatening as someone who is very underweight.
The dietitian’s role in ED treatment involves looking at weights and vitals daily, and tailoring the patient’s meal plan to promote weight restoration or maintenance. Meal plans must also be tailored to take into account the patient’s specific eating disorder history, and what behaviors they engage in, such as restriction, purging, or laxative abuse.
Normalization of eating behaviors is a focus of dietitians as well, because eating disorders typically involve numerous food rules or rituals that function to serve the eating disorder, not the patient. A dietitian regularly works with a patient in ED treatment for 1 to 2 months, but that time frame can range from a week to over a year in some cases. Trust and a strong rapport between the patient and dietitian are necessary to ensure that the patient’s needs are being met and the appropriate dietary recommendations are being made.
Unfortunately, there is a high-risk of relapse with eating disorders. Treatment can be the difference between life and death, and the work of eating disorder dietitians is an essential part of treatment that can impact someone’s life and help them regain their life and happiness, once again.
For more information about National Eating Disorders Awareness Week, visit the National Eating Disorders Association website: http://nedawareness.org/
Kristen is a Registered Dietitian in Colorado. She worked for Dietitians On Demand at an eating disorder center in 2015 and has more than two years experience working exclusively with eating disorder patients.
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