CLINICAL
ACUTE EATING DISORDERS
Elle Kelly RD
There’s much more to eating disorder (ED) treatment than simply ‘eating’. Affecting the mind as well as the body, EDs are complex conditions that require the input of a strong multidisciplinary team for optimal recovery. EDs have the highest mortality rates among any other psychiatric illness,1 emphasising the importance of early detection and commencement of treatment. It is estimated that between 1.25 and 3.4 million people in the UK are affected by an ED, with anorexia nervosa (AN) and bulimia nervosa (BN) accounting for 8% and almost 20% respectively.2 Interestingly, there is a greater incidence of EDs amongst athletes and people with Type 1 diabetes.3 Table 1 looks at the long-term risks of EDs. Potentially attributable to the world we live in now where diet culture is such a strong influence and where ‘bikini’ or ‘ripped’ bodies circulate social media, EDs can go unnoticed and can be easily disguised by trends that we now consider ‘normal’ such as: • labelling lifestyles or dietary choices – i.e. veganism could be a way to restrict food groups and control intake; • consistent dieting or overexercising – which could be excused by being involved in competitive sports;
• celebrity endorsed ‘skinny teas’ and shakes – although a marketing ploy, these can encourage the concept of skipping meals; • diet trends such as fasting, keto, juicing – which promote the avoidance of foods and food groups.
Elle is a Specialist Eating Disorder Dietitian. She currently works with young people with eating disorders and is completing her Master’s degree in Applied Sports Nutrition. ellekellynutrition
REFERENCES Please visit: nhdmag.com/ references.html
ACUTE MANAGEMENT OF EDS
EDs go miles deeper than simply weight and food. However, both of these factors majorly influence the acuity of one’s illness and are vital considerations when it comes to beginning treatment, which is why the input of a specialist dietitian remains important. The weight and BMI upon admission can indicate the severity of the patient’s condition and this, combined with the recent food intake, can highlight the risk of refeeding syndrome, which the patient may be at. As patients with AN or BN may falsely report their intake in order to please, hide their illness or appear healthier, electrolyte levels should be assessed in conjunction with these www.NHDmag.com February 2021 - Issue 160
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