Wednesday, August 10, 2022

What Doctor To See For Eating Disorders

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Who Might Have An Eating Disorder

Ask a Doctor: Eating disorders

In adolescents, Dr. Myers said anorexia tends to start in the early teen years, while bulimia tends to begin in the late teen years. Those who treat adults tend to see a mixture of eating disorders.

Anxiety, obsessive-compulsive disorder and perfectionism can play a role in the development of anorexia, especially in younger ages. Being involved in activities that focus on body shape or weight or thinness could play a role, too. And societal pressure to look a certain way helps foster eating disorders in later adolescence.

Dr. Myers patients can be as young as 10, tending to struggle with restrictive eating. Dr. Nyayapati sees many adolescent and adult patients, with some as young as 10 as well.

Onset of an eating disorder can occur at any age. In some cases, patients may have struggled with an unidentified eating disorder for a few years before receiving help.

What Are The Risk Factors For Developing Anorexia

Anorexia can affect anyone, no matter their gender, age or race. However, certain factors put some people at greater risk for developing anorexia, including:

  • Age: Eating disorders, including anorexia, are more common in adolescents and young adults, but young children and older adults can still develop anorexia.
  • Gender: Women and girls are more likely to be diagnosed with anorexia. However, its important to know that men and boys can have anorexia and may be under-diagnosed due to differences in seeking treatment.
  • Family history: Having a parent or sibling with an eating disorder increases your risk of developing an eating disorder, such as anorexia.
  • Dieting: Dieting taken too far can develop into anorexia.
  • Changes and trauma: Big changes in your life, such as going to college, starting a new job or going through a divorce, and/or trauma, such as sexual assault or physical abuse, may trigger the development of anorexia.
  • Certain careers and sports: Eating disorders are especially common amongst models, gymnasts, runners, wrestlers and dancers.

Be Honest About The Kind Of Care You Need

Patients with eating disorders often struggle with feelings of shame or denial. But the only way to get quality care is to be completely honest with yourself and the provider. The problem I struggle with is that many people are in denial and they simultaneously want help but dont, says Elizabeth Maier, a San Francisco MD. Honesty on the part of the patient is important, and saying these are the things that do and dont work for me.’

If youre not sure how to start, the National Eating Disorder Association offers a free, confidential online screening tool that can help you determine if its time to seek help.

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How Is An Eating Disorder Diagnosed

Healthcare providers, such as physicians and mental health professionals, diagnose eating disorders. Your primary care provider may review symptoms, perform a physical examination and order blood tests. A mental health counselor, such as a psychologist or psychiatrist, conducts a psychological evaluation to learn more about your eating behaviors and beliefs.

Providers use the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders to make a diagnosis. The DSM outlines symptoms for each type of eating disorder. You dont have to have every symptom to receive an eating disorder diagnosis. And even if you dont have a specific DSM-listed eating disorder, you may still need help overcoming food-related issues.

The Eating Disorder Treatment Plan

Trauma and PTSD: Linkage to Eating Disorders

Patients can receive Medicare rebates for:

  • an eating disorder plan prepared by a GP, psychiatrist or paediatrician
  • up to 40 sessions of psychological treatment with a psychologist, GP or specially trained mental health practitioner
  • up to 20 visits to a dietitian over 12 months
  • regular GP reviews of their progress against the treatment plan and
  • a formal specialist review by a psychiatrist or paediatrician.

Previously, patients could only access up to ten Medicare-subsidised sessions of psychological treatment. Mental health experts and GPs felt this wasnt nearly enough to treat complex eating disorders.

Eating disorder therapists, paediatricians, and dietitians dont come cheap especially when a patient requires months or years of care. Research conducted by the Butterfly Foundation found that people experiencing eating disorders often go into debt due to the cost of treatment. Many cut treatment short due to the expense.

This rebated plan relieves much of the financial pressure. It also keeps patients in care for longer, giving them a much better chance of recovery.

To be eligible, patients need to meet certain diagnosis criteria. We dont base diagnosis on BMI measurement. Speak with your GP for more info.

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Finding A Provider Who Understands Your Eating Disorder

When 27-year-old Sandy* started struggling with bulimia several years ago, she was sure a doctor could help. But after a few appointments with various physicians, she realized she wasnt getting the right care. Most doctors dont know what to do when you tell them you have an eating disorder, she says. I know theyre well-intentioned, but a lot of times they miss the mark.

The Texas native says she experienced everything from dismissiveness to insensitivity. I had one doctor brush over it like its no big deal, she says. While another subjected me to a lecture about the harmful effects of bulimia, as if I didnt know. Ive had a nurse try to bully me into getting on the scale after I explicitly said I didnt want to be weighed.

Sandys experience speaks to a problem among people who need help finding a primary care provider to manage their care. Twenty million women and 10 million men in the United States suffer from an eating disorder like anorexia, bulimia, or binge eating disorder during their lifetime, and countless more are plagued with unhealthy thoughts around food, exercise, and their bodies.

What Kind Of Doctor Treats Eating Disorders

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How Do Health Care Professionals Diagnose Binge Eating Disorder

Most of us overeat from time to time. Some of us often feel we have eaten more than we should have. Eating a lot of food does not necessarily mean you have binge eating disorder.

To determine whether you have binge eating disorder, talk with a mental health specialist who focuses on eating disorders. The specialist will talk with you about your symptoms and eating patterns and will help you find the best treatment options if you are diagnosed with binge eating disorder.

Challenging Misconceptions About Eating Disorders

An Eating Disorder Specialist Explains How Trauma Creates Food Disorders

These kind of problems can cost lives and leave vulnerable people in very bad situations. To combat these problems, the researchers said that doctors, teachers and other front line workers have an important role in fighting eating disorders. They must challenge misconceptions about EDs or men will continue to be overlooked.

Men must also become better advocates for their own health. Many men fail to speak to their doctor or use an ED helpline, which leaves problems overlooked and allows eating disorders to become worse.

The longer an eating disorder is allowed to grow, the harder it is to treat. This makes it doubly important to catch them early. This could help reduce the estimated £70 million cost of eating disorders on the NHS.

To discuss how the Life Works team can help to support individuals and families dealing with an eating disorder or for further information on treatment programmes, please call: 01483 745 066 or click here to make an enquiry.

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What To Expect From Your Gp Consultation

Going to the doctor for concerns around an eating disorder can feel like a big step. Understanding what is likely to happen at your appointment can help ease your anxiety.

Talking to your doctor

Its important to speak as openly and honestly about your symptoms and concerns as possible. Your pre-filled out checklists will also give your doctor a good indication of whats going on for you. Your doctor may ask you a range of questions to help inform their assessment. You may feel more comfortable bringing a loved one or friend with you to help support you or explain things.

Physical check-up

The doctor will need to do a physical check-up to assess the stability of your medical health. This may also involve taking some blood for testing. If you are weighed, its important to know that you do not have to see the number on the scales you can ask to face the other way or not be told the number.

Its also important to note that the GP should not focus exclusively on physical measures to determine if you are experiencing an eating disorder. Eating disorders are serious mental illnesses that can have large variations in physical presentations.

Diagnosis and referrals

What happens if my GP isnt confident in referring me for further treatment?

Not all GPs are skilled in managing the treatment of eating disorders. If this is the case with your doctor, you can advise them that EDV recommends they read this information outlined by the National Eating Disorders Collaboration .

What Are The Symptoms Of Eating Disorders

It is not always easy to tell if someone has an eating disorder, since they may try to hide it because of shame or guilt. However, some of the behaviours associated with eating disorders include:

  • Dieting: this could mean calorie counting, fasting, skipping meals, avoiding certain food groups or having obsessive rituals related to eating.
  • Binge eating: including hoarding of food or the disappearance of large amounts of food from the kitchen.
  • Purging: vomiting or using laxatives to rid the body of food. People who purge often make trips to the bathroom during or after eating.
  • Excessive exercise: a person may refuse to disrupt their exercise routine for any reason, insist on doing a certain number of repetitive exercises or become distressed if unable to exercise.
  • Social withdrawal: the person may avoid social events and situations that involve eating, or they prefer to eat alone.
  • Body image: the person may focus on body shape and weight.
  • Change in clothing style: the person may start wearing baggy clothes, for example.

There are also physical signs that a person may have an eating disorder, such as:

  • Weight changes: fluctuations in weight or rapid weight loss.
  • Disturbed menstrual cycle: loss of or disrupted periods.
  • Being cold: sensitivity to cold weather.
  • Inability to concentrate .

Some of the emotional signs of an eating disorder include:

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When We Look At Eating Disorders As A Social Justice Issue The Focus Isnt Just On The Cause But Also On The Impact Of Sufferers And The Barriers To Recovery

Hunger is a biological cry for sustenance a feedback loop that shouts into the void of an empty stomach and gurgles and twists in discomfort, as a brilliant mind commands endless energy.

And in the face of a society gone mad, a brilliant mind tells hunger that it is a lie.

When we think of eating disorders, the primary thought is that they often stem from a diet gone wrong. Perhaps, they are even a dangerous cocktail of vanity and mental illness. Society pictures cheerleaders squeezing into size zero jeans with their hip bones visible over their waistbands, and think that the solution lies in inpatient programs with therapy, regimented meals, and supervision.

This image of eating disorders is symptom-based. It focuses on the effects of eating disorders, but not the macro scale that considers the cause and result of them. This view is clinical and ignores the truth of the matter, that eating disorders at their core, are a symptom of a broken society.

Eating disorders are allowed to fester in society because of two related afflictions: sizeism and diet culture.

Sizeism is the discrimination against a person because of their body fat percentage. It feeds the assumption that people in larger bodies are unhealthy. Sizeism also extends into other socioeconomic categories. According to the Council on Size and Weight Discrimination, overweight people make on average $1.25 per hour less than standard sized people.

How Is Anorexia Diagnosed

Eating Disorders in Children &  Adolescents

A healthcare provider can diagnose a person with anorexia based on the criteria for anorexia nervosa listed in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. The three criteria for anorexia nervosa under the DSM-5 include:

  • Restriction of calorie consumption leading to weight loss or a failure to gain weight resulting in a significantly low body weight based on that persons age, sex, height and stage of growth.
  • Intense fear of gaining weight or becoming fat.
  • Having a distorted view of themselves and their condition. In other words, the individual is unable to realistically assess their body weight and shape believes their appearance has a strong influence on their self-worth and denies the medical seriousness of their current low body weight and/or food restriction.

Even if all of the DSM-5 criteria for anorexia arent met, a person can still have a serious eating disorder. DSM-5 criteria classifies the severity of anorexia according to body mass index . Individuals who meet the criteria for anorexia but who arent underweight despite significant weight loss have whats known as atypical anorexia.

Diagnostic guidelines in the DSM-5 also allow healthcare providers to determine if a person is in partial remission or full remission as well as to specify the current severity of the condition based on body mass index .

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Hospitalization For Eating Disorders

Medical complications related to malnutrition, such as acute kidney injury and dehydration, can result in hospitalization. There, the focus is primarily to stabilize the patient, correct the patients fluid status and electrolytes, and observe for other potentially serious medical complications.

Another common scenario for hospitalization would be if a patient is not making progress at an outpatient level and continues to have symptoms.Then the goal is to help the patient restore nutrition in a medical setting, where providers can also monitor and treat any medical complications. This is usually a longer-term hospital stay.

A lot of what I tell my patients is, food is their medicine, Dr. Nyayapati said. It might not help every long-term medical complication, but generally, if they eat, then their symptoms of starvation do restore they do get better.

How Is Eating Disorders Diagnosed

Because eating disorders can be so serious, it is important to seek help if you or a loved one thinks that you might have a problem. Your health care provider may use many tools to make a diagnosis:

  • A medical history, which includes asking about your symptoms. It is important to be honest about your eating and exercise behaviors so your provider can help you.
  • A physical exam
  • Blood or urine tests to rule out other possible causes of your symptoms
  • Other tests to see whether you have any other health problems caused by the eating disorder. These can include kidney function tests and an electrocardiogram .

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How Do Health Care Professionals Treat Binge Eating Disorder

Treatment may include therapy to help you change your eating habits, thoughts, and feelings that have contributed to binge eating as well as other psychological symptoms. Types of therapy that have been shown to help people with binge eating disorder are called psychotherapies and include cognitive behavioral therapy, interpersonal psychotherapy, and dialectical behavior therapy.

Your psychiatrist or other health care professional may also prescribe medicine to help you with your binge eating, or to treat other medical or mental health problems.

Concerned About Eating Disorders

How To Talk To Your Doctor About Eating Disorders

Take one of our 2-minute eating disorder quizzes to see if you or a loved one could benefit from further diagnosis and treatment.

Common Types of Eating Disorders in Children

Avoidant/Restrictive Food Intake Disorder is a common eating disorder experienced by young children. Children with AFRID experience a disturbance in their eating which can include a lack of interest in food or a sensory aversion to certain foods. For example, a child might be averse to swallowing or the texture of foods they once enjoyed. They might also fear getting stomach aches or vomiting if they became sick because of a certain food. These aversions and restrictions can lead to weight loss and nutritional deficiency among young children.

Pica is a type of condition where a child might eat non-food or non-nutritional substances persistently. To be diagnosed with pica, the behavior must fall outside of the childs expected developmental level . These substances often include dirt, soap, chalk, sand, ice, and hair.

Anorexia nervosa can affect both young girls and boys. Children with anorexia think they are overweight when they seem very underweight to other people. Children might obsess about their food intake and with how to control their weight. They might exercise intensively or binge and then purge. Anorexia can cause significant damage to physical health and growth, so it is important to seek treatment as soon as possible for a child.

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Male Eating Disorders Under

A new report in BMJ Open found that men are not getting the help they need to deal with eating disorders. The study found that around a quarter of those suffering with an ED were men but very few of these men actually received treatment or even understood they had a problem.

The research, which came from Oxford and Glasgow Universities, shows that most men see eating disorders as a female problem. This means men overlook their own negative eating habits. This problem is compounded by the fact that men have just as much pressure from society to conform to an ideal standard of beauty.

“Our findings suggest that men may experience particular problems in recognising that they may have an eating disorder as a result of the continuing cultural construction of eating disorders as uniquely or predominantly a female problem,” said Dr Ulla Raisanen and Dr Kate Hunt.

This perception that eating disorders are a female issue does not just affect patents. Doctors and other healthcare workers may also believe that EDs can only occur in women. In the study, one man was even told by his doctor to man up. Other men reported long waiting times for help and misdiagnosis.

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