Summary: <p>Eating Disorders Assessment<br> Part 2<br> Instructor: Dr. Dawn-Elise Snipes, PhD, LPC, LMHC<br> Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery<br> Objectives<br> ~ Review the prevalence of eating disorders<br> ~ Identify assessment areas<br> ~ Identify risk and protective factors<br> ~ Explore complications<br> ~ Explore potential guidelines for treatment</p> <p>~ Based on APA Guidelines for Eating Disorders and the NICE Guidelines for Eating Disorder Recognition and Treatment<br> Goals for Treating Anorexia<br> ~ Restore patients to a healthy weight (associated with the return of menses and normal ovulation in female patients, normal sexual drive and hormone levels in male patients, and normal physical and sexual growth and development in children and adolescents)<br> ~ Treat physical complications<br> ~ Enhance patients’ motivation to cooperate in the restoration of healthy eating patterns and participate in treatment<br> ~ Provide education regarding healthy nutrition and eating patterns<br> ~ Help patients reassess and change core dysfunctional cognitions, attitudes, motives, conflicts, and feelings related to the eating disorder<br> Goals for Treating Anorexia<br> ~ Treat associated psychiatric conditions, including deficits in mood and impulse regulation and self-esteem and behavioral problems<br> ~ Enlist family support and provide family counseling and therapy where appropriate<br> ~ Prevent relapse.<br> Anorexia Nutritional Rehabilitation<br> ~ Establish expected rates of controlled weight gain.<br> ~ Realistic targets are 2–3 lb/week for hospitalized patients and 0.5–1 lb/week for individuals in outpatient<br> ~ Registered dietitians can help patients choose their own meals and can provide a structured meal plan that ensures nutritional adequacy and that none of the major food groups are avoided.<br> ~ Formula feeding may have to be added to the patient’s diet to achieve large caloric intake.<br> ~ Encourage patients with anorexia nervosa to expand their food choices to minimize the severely restricted range of foods initially acceptable to them.<br> ~ Caloric intake levels should usually start at ~1,000–1,600 kcal/day.<br> ~ Weight gain results in improvements in most of the physiological and psychological complications of semistarvation.</p> <p>Anorexia Nutritional Rehabilitation<br> ~ It is important to warn patients about the following aspects of early recovery:<br> ~ As they start to feel their bodies getting larger, they may experience a resurgence of mood symptoms, irritability, and suicidal thoughts.<br> ~ Mood symptoms, non-food-related obsessional thoughts, and compulsive behaviors, although often not eradicated, usually decrease with sustained weight gain and weight maintenance.<br> ~ Patients who abruptly stop taking laxatives or diuretics may experience marked rebound fluid retention for several weeks.<br> ~ As weight gain progresses, many patients also develop acne and breast tenderness and become unhappy and demoralized about resulting changes in body shape.<br> ~ Patients may experience abdominal pain and bloating with meals from the delayed gastric emptying that accompanies malnutrition. This may respond to pro-motility agents.<br> ~ Constipation may be ameliorated with stool softeners; if unaddressed, it can progress to obstipation and, rarely, to acute bowel obstruction<br> Anorexia Psychoeducation<br> ~ The goals of psychosocial interventions are to help patients with anorexia nervosa<br> ~ Understand and cooperate with their nutritional and physical rehabilitation<br> ~ Understand and change the behaviors and dysfunctional attitudes related to their eating disorder<br> ~ Improve their interpersonal and social functioning<br> ~ Address comorbid psychopathology and psychological conflicts that reinforce or maintain eating disorder behaviors.<br> ~ During acute refeeding and while weight gain is o</p>
