By: Natasha Hakim, MD Dept of Family Medicine Loyola- Cook County- Provident

Objectives: 1. Identify Eating Disorders 2. List at least three questions to ask your patient if you suspect eating disorder 3. Different types of treatments available 4. Know the resources available for your patients

Different Types of Eating Disorder --Two main types of eating disorder --Anorexia nervosa & Bulimia nervosa --Several variations --This third category is "not otherwise specified" --Not exactly fit either of the criteria

Different Types of Eating Disorder --Binge eating is under the third category --Most common form of eating disorder

Anorexia

--Distorted image of their bodies --Believe they are fat --Constant diet and Starve themselves --See themselves as fat --Irrational fear of becoming fat --Go to any extent in an effort to loose weight or stay thin --BMI of below 17.5

Bulimia --Cycle of binge eating and purging --First engage consuming huge amounts of food --Second engage in purging

Bulimia --Binge followed by guilt --Purge to get rid of the excessive calories Vomit Laxatives use Exercising excessively

Bulimia --Not underweight --Obsessed and unhappy with their weight --Want to lose weight --Unable to control the urge to eat --Binge eat and then purge --Don't eat in public --Don't starve themselves or restrict eating --Binge eat secretly either at night or in a private place

Purging Type --Don't overeat --They purged to prevent weight gain

Binge Eating Disorder --Compulsive overeating --Consume large amounts of food in a short period --Unable to stop eating even when uncomfortably full --Lack of control when it comes to eating --Regular basis – everyday or night

Binge Eating Disorder --Unable to control their eating --Usually overweight --Do not purge every time they overeat

Eating disorder recovery --Admitting you have a problem --Can be tough --Especially if still clinging to the belief --Weight loss is the key to happiness? confidence? and success? --Old habits are still hard to break!

Eating disorder recovery --Can be unlearned --Motivated to change --Willing to ask for help --Is about more than giving up unhealthy eating behaviors --Rediscovering who they are beyond eating habits, weight, and body image

How to talk to your patients about eating disorders When did you begin having different thoughts regarding food, weight, or exercise? What were the thoughts? When did the different behaviors start? What did you hope to accomplish (lose weight, gain control of something, get someone’s attention)? Have you noticed any physical health effects (fatigue, loss of hair, digestive problems, loss of menstrual cycle, heart palpitations, etc.)? Or any emotional effects?

How to talk to your patients about eating disorders How are you currently feeling physically? Emotionally? Do you feel ready to stop the disordered eating behaviors? How can the people in your life best support you? Do you want them to monitor your behavior? Do you want them to ask you how you are doing with your recovery or would you rather tell them?

Treatment Plans: Inpatient treatment Individual therapy Group therapy Family therapy Eating disorder education Nutritional counseling Medical monitoring

An Effective Treatment Program for Eating Disorders to address Symptoms and destructive eating habits. --The root causes of the problem --The emotional triggers that lead to disordered eating --Difficulty coping with stress anxiety, fear, sadness....

Therapy for eating disorders --Therapy is crucial --Addressing any feelings of shame --Isolation caused by eating disorder --Discussing goals in working towards recovery

Cognitive-Behavioral Therapy --The most common therapy --Targets the unhealthy eating behaviors --Unrealistic, negative thoughts --Goals, self-aware of the use food to deal with emotions --Helps recognize emotional triggers --Learn how to avoid or combat them --Involves education about nutrition --Healthy weight management --Relaxation techniques

Nutritional counseling for eating disorders --Help incorporate healthy eating behaviors --Develop a healthier relationship with the food

Inpatient Criteria: --Severe Malnutrition --Dehydration --Electrolyte Imbalances --Cardiac Arrhymthmias --Failure of Outpatient Treatment --24hour a day skilled nursing observation --Medical, Nutritional and Psychiatric

Resources to offer your Patients Local hospitals Medical centers Social workers School counselor or nurses National Eating Disorders Association Local Resources

Is not the mountain we conquer but ourselves. ~Edmund Hillary