Spring 2009

Volume 2 Issue 1

Nutrition Intervention in Eating Disorders

by Maiya Ingram, MS, MPH, RD, LD
Food, to the healthy body, functions Nutritional intervention and weight to nourish, restore, sustain, satisfy and restoration is typically the first step to heal. It is a basic, natural element of recovery of medical and psychological life that occurs without anguish. In health. Besides the many physical bencontrast, to someone with an eating efits, healthy nutrition restores the disorder, food brain to full is alien, somefunctioning, We are indeed much more than thing to conupon which trol, restrict, what we eat, but what we eat psychological abuse, purge, treatment can nevertheless help us to be distrust and depends. much more than what we are. even fear. Early interHelping to vention, close Adelle Davis, re-shape a to the onset of nutrition pioneer (1904-1974) patients pereating disorception of der symptoms, food is just one of many goals of eating can minimize damage and maximize disorder treatment. Eating disorders the recovery process. The urgency of are complex mental health disorders treatment in adolescents should be remarkable for their nutrition and underscored due to the potentially irremedical-related problems, some of versible effects of an eating disorder on which are life-threatening. Nutrition the young persons physical and psyintervention, including nutritional chological development. counseling by a registered dietitian is Nutritional rehabilitation is thus an essential component of the team essential not only to re-nourish the treatment of patients with anorexia body, but is critical to the patients nervosa, bulimia nervosa, and other ability to succeed in other facets of eating disorders during assessment and treatment. Specifically, nutrition intertreatment across the continuum of care. vention involving structured food (JADA, 2006) intake, attention to food perceptions, Physical manifestations of eating dismodification of eating behaviors and orders are numerous and can be liferegulation of weight are important elethreatening. These can include ments within a comprehensive treatchanges in cardiovascular response, ment program, such as our Eating heart mass, gastrointestinal tract, brain Disorders Intensive Outpatient mass, and bone mass. At the same Program (ED IOP). time, eating disorders have emotional, Nutritional components of the ED mental and behavioral components. IOP assist the patient to normalize eatFood restriction and starvation dramating patterns, plan meals in advance ically alter thought patterns, depress and practice with food items. The IOP mood, interfere with thinking, and can program includes utilization of the folpose a barrier to effective treatment. lowing:

1)A FOOD DIARY

The food diary is introduced to the patient on admission and serves as a Maiya Ingram multi-faceted tool that is used by all members of the treatment team. All IOP participants keep a food diary. Keeping a record of intake promotes accountability, awareness of actual intake and its associated feelings, and the identification of potential triggers to eating disordered behavior. The diary also serves as an assessment tool for the dietitian to gauge nutritional adequacy. Accurate diaries benefit both patient and clinician to assess progress toward goals.

THE INDIVIDUALIZED 2) MEAL PLAN

An individualized meal plan created by both the dietitian and patient provides a schedule to normalize eating. Following the plan enables the patient to restore nutrient and fluid balance, normalize eating, trust the bodys utilization of foods for nourishment and achieve weight goals. Within this plan, nutritional requirements are incorporated and made userfriendly by describing nutritional needs in terms of food groups and portion sizes.

3) THE THERAPEUTIC MEAL

The therapeutic meal session is a daily element of the IOP schedule.
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16216 Baxter Rd., Ste. 399 Chesterfield, MO 63017

For more information, call (636)532-9188 or www.slbmi.com

NEDA to Hold Walk on April 18

in Tower Grove Park
The National Eating Disorders Association (NEDA) will hold its first annual walk in St. Louis and in hundreds of other cities around the country to raise awareness and much needed funding to battle Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. The NEDA Walk in St. Louis will take place on April 18, 2009 at Tower Grove Park at the Sons of Rest Shelter. To find out how to register, sponsor a walker, or donate to NEDA, visit our website at www.slbmi.com/eating_disorders/index.htm. For additional information, contact Kate Evett 314-968-1900 ext. 13.

Eating Disorder Services

Intensive Outpatient Program
6-day (day/evening/weekend IOP) 4-day (evening/weekend IOP)

Weekly Therapy Groups

Anorexia Nervosa and Bulimia Nervosa Therapy Group Compulsive Eaters Group

Nutritional Counseling Individual Psychotherapy Expressive Therapy for Body Image Issues
All groups are facilitated by a licensed clinician. We accept many insurance plans.

Nutrition Intervention in Eating Disorders continued from front page

This meal includes a pre- and postmeal questionnaire for patients to identify current thoughts and emotions, acknowledge current food behaviors, determine barriers to eating goals, and assess adherence to their meal plan. The group setting enables patients to eat together, to process, and to communicate with each other and the clinician in a safe and monitored setting. Patients are supported and reinforced to practice with food items and adhere to the individualized meal plan. meal outing, e.g. eating at a restaurant, going on a picnic, grocery shopping and preparing a meal. These are activities that participants are likely to confront but may have been avoided in the past or represent a high risk situation for unhealthy eating. The goals of nutritional intervention in all phases of treatment are to provide strategies to normalize eating and to further the patients practical application of nutrition education. While patients can use the IOP to establish a solid nutritional foundation, ongoing consultation with a nutritionist is the best way to continue to progress towards full recovery.
Maiya Ingram, MS,MPH,RD,LD, provides nutrition intervention for eating disorder patients through SLBMIs Intensive Outpatient Treatment program. She also provides nutrition education for children through adults for weight management and medical needs. References:
Position of the American Dietetic Association: Nutrition Intervention in the Treatment of Anorexia Nervosa, Bulimia Nervosa, and Other Eating Disorders, Journal of the American Dietetic Association. December 2006 (Vol. 106, Issue 12, Pages 2073-2082). American Journal of Clinical Nutrition, Vol. 86, No. 1, 92-99, July 2007.

4) MEAL OUTINGS
Periodically, after progressing sufficiently, participants will participate in