Posts Tagged ‘For Providers’

According to the Centers for Disease Control (CDC), approximately 22 million individuals are living with either Type 1 or Type 2 diabetes. These individuals are also at significantly higher risk for eating disorders. When this dual diagnosis exists, treatment and recovery are often complicated by the complexity and conflicting demands of the two conditions.

Although the approach to treatment can vary among those with Type 1 (DMT1), Type 2 (DMT2) and latent autoimmune diabetes in adults (LADA), it is important to be aware of the increased risk these individuals carry for disordered eating and eating disorders. It is estimated that the risk for ED behaviors is three times higher in individuals with DMT1 (1) and that up to 40% of individuals with DMT2 are affected by ED behaviors (2). There are numerous factors that increase the risk for disordered eating for those with diabetes. Several common challenges include:

If you are experiencing suicidal thoughts, there are resources that can help. Contact the National Suicide Prevention Lifeline at 1-800-273-8255.

In the United States alone, over 30 million individuals struggle with an eating disorder. Eating disorders are complex and biologically-based illnesses that can affect anyone, regardless of age, gender, size, or any other demographic categorization. Sadly, eating disorders are often severe and may become life-threatening. Among adolescents, eating disorders are the third most common chronic illness, and the rate of children living with eating disorders is on the rise.

What Are Eating Disorders?

Eating disorders are characterized by a disturbance in an individual’s eating habits and self-perception. Due to the complex nature of eating disorders, the DSM-5 has broken eating disorders up into the following categories:

When a client has a history of an eating disorder, it’s essential to be aware of the signs of eating disorder relapse. If a client states they are struggling with relapse, a provider has one job: to get them to an eating disorder assessment. Healthcare providers shouldn’t feel like they have to make the patient feel better on their own, and they certainly shouldn’t tell the client they should wait to see what happens.

If a client communicates concerns about eating, they’ve probably had concerns for quite some time. This isn’t something people often share in the first month that it is happening. Once noticed, the provider needs to treat the eating disorder the same way that they would treat any other disease–connecting their client with the best person to treat the illness.

A common mistake made in primary care offices is a medical provider saying, “Maybe you’ll snap out of it, come back to see me in a month and we can see what happened.” Two or three things are likely to occur in this scenario. The client may hear that what is happening to them is not that serious, perhaps thinking, “My doctor doesn’t think it’s a big deal, so maybe it’s not.” Another outcome may be that the person will get worse over the next month. And if the eating disorder gets worse, it becomes increasingly less likely that they will seek treatment. So, telling someone to wait should be avoided at all costs.

Eating disorders are hard to spot, especially when disordered eating behaviors are extremely common. From the prevalence of dieting to the glorification of excessive exercise, it can be tricky to understand when disordered behaviors spiral into a full-blown eating disorder.

What is Disordered Eating?

Disordered eating includes unhealthy food and body behaviors, usually undertaken for the purpose of weight loss or health promotion, but that may put the person at risk for significant harm.  Disordered eating is serious and can lead to severe complications in one’s life, so it is important to stay vigilant of the warning signs and symptoms. Unfortunately, disordered eating is extremely common due to the normalization of many disordered behaviors in primarily Western cultures. Common examples of disordered eating include:

• Fad diets
• Cleanses
• Heightened focus on appearance
• Skipping meals
• Supplement misuse
• Diet pills
• Extreme social media focused on appearance or food
• Undereating or overeating

As a medical provider, you may be the first person to recognize that a patient has an eating disorder. That’s because eating disorder behaviors often occur in secret, and those struggling are typically very good at keeping their eating disorder a secret from the people in their lives.

Eating disorders are often apparent in a medical setting because we check weight, assess vital signs, and spend time discussing physical symptoms with patients. Signs of eating disorders that could be recognized even in a routine check-up may include dramatic changes in weight, menstrual irregularity, dizziness, dry skin, leg cramps, hair loss, and bruising. If you’re lucky, your patient may view an appointment as a natural time to share that they are experiencing eating disorder thoughts and behaviors. However, many patients are not forthcoming and the medical system is very poorly designed to talk to people about food and body issues.

Usually, the first thing that happens when a patient walks into a provider’s office is that they are asked to step on the scale. Patients are usually told their weight or it is written on a piece of paper.  After that, patients are taken into an office and asked several questions about medications, habits and health concerns. The patient may see one or two providers before seeing their primary medical provider.

As a field, we are beginning to understand that males are at a high-risk for eating disorders and that it is crucial to understand how males present with eating disorders and how we can treat them. Realizing that men have eating disorders is extraordinarily important. Eating disorders are serious and potentially life-threatening and unfortunately, they are often overlooked and trivialized.

The reality of the eating disorder world is that the diagnoses of eating disorders have historically been based on women. Studies to define what eating disorders are have been done primarily with women. The criteria used to describe eating disorders has been normed to women. The professional field is primarily women and treatment is often designed with a gender bias.  However, we are very aware that men (and people of all genders) can get eating disorders and that more men are presenting with symptoms and entering treatment. As a result, we have a lot of work to do to truly understand how males present with eating disorders.

To give an example of how eating disorder treatment is normed to women, we can look at current eating disorder screening tests. Typically, there are statements such as these where a client can answer yes or no.