Updated: Sep 19, 2022
The Fallout: Underserved Populations Including Eating Disorder Patients and Patients in Larger Bodies Have Limited Support or Resources
This article originally published on March 22, 2022 in the Arizona Physician: A Digital Publication of the Maricopa County Medical Society.
The first thing we ask most patients to do when they come into a physician’s office is step on the scale. For patients with eating disorders, stepping on the scale can be detrimental to their recovery and treatment. Some common symptoms of eating disorders that people typically struggle with include:
An obsession, or preoccupation with the numbers tied to their weight
Manipulating their food intake in the name of the eating disorder
Variable symptoms like self-induced vomiting, laxative abuse, slowed heart rate, fainting, hair falling out, difficulty sleeping, depression, and anxiety amongst others that breakdown both mental and physical health
Physicians who fail to recognize and help treat their patients, exhibiting eating disorder behavior, are advertently or inadvertently failing to ensure they receive proper care. Today, eating disorders are prevalent in up to 9% of the population and rates have risen (with estimates stating that eating disorders are 400% more prevalent than we were even aware of) since the start of the pandemic.(1) In the greater-Phoenix Metropolitan area, there are not any physicians who specialize in eating disorders. Additionally, there is only one registered nurse practitioner in this area who practices in this specialty. Considering there are almost 300,000 individuals in the metro area who meet the diagnostic criteria for EDs. Whether you think you treat patients with eating disorders or not, you do. Eating disorders come in all shapes and sizes. We do not have enough support or training to deal with the demand of patients that need specialized help and doctors to recognize and treat them effectively.
What can we do to help patients exhibiting an eating disorder?
As a registered dietitian treating patients with eating disorders since 2017, I have seen, firsthand, the detriment of providers treating patients who are unfamiliar with identifying eating disorder symptoms.
Over these years, I’ve had many patients share disheartening anecdotes about the care they received from their providers that include:
Missing the eating disorder diagnosis entirely;
Clear and present weight bias in treatment, including ignoring the patient’s complaints by telling them to just, “change your diet, exercise more and you’ll feel better.” This is dangerous as it can delay treatment to the actual underlying issue that’s ailing them; and
An overall lack of understanding in the various eating disorder phenotypes and how to properly treat the patient.
Thankfully, there are some small changes we can make to show our patients that we care and hear them. And that starts with making our offices a safe place, not only for eating disorder patients, but all our patients.
Real-life Examples of Creating a Better Patient Experience
At the end of January, a story went viral on Twitter about a young woman who used “Don’t Weigh Me Cards” at her doctor’s office.(2,3) These cards are given to medical providers to help their patients decline to be weighed for their appointment, unless [absolutely] medically necessary.
Schedule an appointment with me today if you suffer from any of the following medical conditions:
Body Image Issues
Binge Eating Disorder
Avoidant Restrictive Food Intake Disorder