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Understanding Eating Disorders

Understanding Eating Disorders. Alessandra Kershaw RD, CDN Outpatient 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.

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Understanding Eating Disorders

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  1. Understanding Eating Disorders Alessandra Kershaw RD, CDN Outpatient Dietitian Sodexo/Faxton St Lukes Healthcare

  2. 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

  3. 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.

  4. Types of Eating disorders • Anorexia nervosa (AN) • Bulimia nervosa (BN) • Eating disorders not otherwise specified (EDNOS) • Binge eating disorder (BED) • Pica

  5. Not currently recognized in standard medical manuals • Compulsive Overeating • Purging disorder • Rumination • Diabulimia • Night eating syndrome • Orthorexia nervosa • Drunkorexia • Pregorexia

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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.

  11. 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

  12. What is our role? What can we do?

  13. What are the treatment options • Inpatient/Hospitalization • Residential • Day program • Outpatient

  14. Our role in Inpatient • Meal plan • Tube feeding • Monitoring for re-feeding syndrome

  15. Our role in Residential/Day Program • Meal plan • One on one counseling • “After care” training/counseling • Possible cooking or shopping classes

  16. Outpatient: Anorexia • Meal plan • Weight gain monitoring/Weight maintenance • Fear foods • Fearful situations/Social situations • Normalization of eating • Portion control • Shopping/cooking

  17. Outpatient: Bulimia • Meal plan • Weight gain monitoring/Weight maintenance • Fear foods • Fearful situations/Social situations • Normalization of eating • Portion control • Shopping/cooking

  18. When is it time to say, I can not help you?

  19. 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

  20. 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.

  21. 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.

  22. Any Questions?

  23. References • http://en.wikipedia.org/wiki/Eating_disorder • http://www.nationaleatingdisorders.org/ • http://www.state.sc.us/dmh/anorexia/statistics.htm

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