Eating disorders are a type of mental illness characterised by obsessive concerns with weight and disturbances in eating behaviour such as an extreme reduction in food consumption or severe overeating. Types of eating disorders include Anorexia nervosa, and Bulimia nervosa which can be defined as follows:
Anorexia nervosa- involves self starvation where a person becomes preoccupied with dieting and thinless causing them to lose an excessive amount of weight.
Bulimia nervosa – involves recurrent episodes of binge eating, that is eating an excessive amount of food in a short period of time.
Medical diagnosis and treatment
Medical diagnosis of an eating disorder can be through a physical examination and through questions aimed at assessing a person’s weight history, dietary intake and any other related problems such as excessive exercise regimens, vomiting or laxative use.
Eating disorders are very complex psychological disorders and can result in mood swings, fertility problems, physical problems and even death where they are not managed appropriately. A person suffering from an eating disorder must be encouraged to seek professional advice and a specific care plan will be required to address and improve current eating patterns, to help restore a healthy weight and treat psychological issues such as poor self esteem, low mood and distortions in a person’s body image.
Nutritional management of an eating disorder
Again it is essential for patients to received tailored nutritional advice from a qualified professional ideally a registered dietitian, who works alongside other members of a multidisciplinary team including psychologists, physicians and other members of a mental health team such as nurses who have specialised in this area.
Specific roles of a dietitian include:
1) Taking a thorough dietetic Assessment- this will help to determine a patient’s current and previous dietary intake and weight history. A dietitian will also check for disordered eating behaviour such as purging and use of laxatives and check for a patients willingness to change unhealthy habits. After completing their assessment a dietitian will then calculate a patient’s nutritional requirements which will be based on their current weight adding additional calories required for weight gain.
2) Providing Nutritional education- this education should help teach patients about any nutritional deficiency in their present diet and enable them to find solutions to move towards a more balanced diet. Dietitians will also work with a patient to set realistic weight goals and advise patients how to achieve these goals e.g. through a high protein/ calorie diet to gain weight with the possible addition of nutritional supplements. Nasogastric feeding may also be required in severe cases of anorexia where a patient’s weight and nutritional status has become severely compromised.
3) Providing support- this is a major component of effective dietetic advice. It is essential that a dietitian shows empathy to a client’s personal situation and also provides support to help clients move towards dietary change