How to help someone with anorexia: a guide for nutritionists
Anorexia is a complex eating disorder and can have negative health consequences if it’s not addressed. As a dietitian, you play a critical role in your client’s treatment and recovery plan so here is how to help someone with anorexia.
As a dietitian, how to help someone with anorexia through nutrition can be challenging. While your client’s friends and family may encourage them to seek out help, they might be resistant to your treatment options or changes to their eating patterns.
If your client is struggling with an eating disorder (like anorexia) or other disordered eating patterns, it’s important that you tread carefully and work with other health professionals on how to help anorexia clients. However, as a dietitian, you can work with your client to repair their relationship with food and ensure they get the right amount of calories and nutrients through customized meal plans.
While anorexia can be challenging for both client and dietitian alike, recovery is possible with the right guidance and support from health professionals, as well as your client’s an outside support system, such as a friend or family member. But how can you help your clients on their road to recovery? Here’s what you as a dietitian need to know about how to help someone with anorexia.
Disclaimer: Anorexia is a serious and potentially life-threatening illness. If you feel it’s necessary, refer your client to other specialists like psychologists, psychiatrists, or physicians who specialize in behavioral health. Do not try to treat a client on your own if you are not skilled in this area.
Anorexia nervosa: what it is, symptoms and diagnosis
Anorexia is one of the most common types of eating disorders and affects approximately 1% to 2% of the population, as well as 0.3% of adolescents. But what is anorexia, and what should you look for in a client? Let’s start by uncovering the different types of anorexia and how this condition is diagnosed.
What causes anorexia?
Anorexia nervosa is a complex eating disorder where someone may avoid food, severely restrict food, or eat very small quantities of only certain foods. Oftentimes, it is driven by an intense fear of gaining weight or becoming fat. Unfortunately, this condition can lead to severe weight loss and malnutrition, as well as a host of physical and psychological complications.
There are two types of anorexia nervosa:
- Restricting: weight loss through excessive dieting, fasting or exercise.
- Binge-eating/purging: someone displays intermittent binge eating and/or purging behaviors.
The level of intervention treatment can depend on which type of anorexia your client has.
Sadly, anorexia nervosa can be fatal and has an extremely high death rate caused by suicide or complications associated with starvation. Other serious complications include irregular heart rhythms, kidney problems, or seizures.
Is anorexia a mental health disorder?
Anorexia is considered a mental health disorder. People suffering from this may have difficulty regulating their emotions and experience feelings of low self-esteem, shame, and guilt. They also may have other mental health conditions such as depression, anxiety, or OCD.
What are the signs and symptoms of anorexia?
The signs and symptoms of anorexia nervosa can vary, but may include:
- Extremely restricted eating
- Extreme thinness
- A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
- Intense fear of gaining weight
- Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight
- Menstrual periods cease
- Dizziness or fainting from dehydration
- Brittle hair/nails
- Cold intolerance
- Muscle weakness and wasting
- Heartburn and reflux (in those who vomit)
- Severe constipation, bloating, and fullness after meals
- Stress fractures from compulsive exercise
- Bone loss
- Depression, anxiety, poor concentration, and fatigue
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How is anorexia diagnosed?
Anorexia is typically diagnosed by a health professional, and can often include:
- Restriction of energy intake leads to a significantly low body weight
- Intense fear of gaining weight or becoming fat, even though underweight
- Body dysmorphia
- BMI of less than 18.5
If signs and symptoms of anorexia are present, you can further evaluate by asking certain questions on the following topics:
- Dietary history, including attitudes about food and dietary restriction
- Exercise history
- Psychological history
- Body image (this includes behaviors such as weighing oneself).
- Bingeing and purging frequency and use of diet pills, laxatives, and supplements
- Family history of eating disorders
- Menstrual status
- Medication history
- Prior treatment
How to help someone with anorexia through nutrition
As a dietitian, you can help your client heal from anorexia by helping them explore hunger/fullness cues and addressing body image and weight concerns. You can also challenge irrational thinking about food, and provide your client with a targeted meal plan to restore nutrient imbalances.
Some of the main goals for how to help someone with anorexia include:
- Stabilizing weight loss
- Beginning nutrition rehabilitation to restore weight
- Identifying problematic eating patterns
- Treating psychological issues such as low self-esteem and distorted thinking patterns
- Developing long-term behavioral changes
Tip: anorexia will present differently for each client, so be sure to work with each person individually. This will allow you to provide personalized nutrition recommendations that fit their needs and goals.
What nutrients and vitamins do anorexics lack?
Those struggling with anorexia nervosa often lack a variety of essential nutrients and vitamins due to their restrictive eating patterns. Here are some of the most common nutrient deficiencies in people with eating disorders (like anorexia).
- Low micronutrients: Anorexics may have low levels of vitamins and minerals such as zinc, vitamin D, copper, selenium, vitamin B1, vitamin B12, and vitamin B9. Because studies have found over 50% of anorexics have at least one micronutrient deficiency, it’s recommended that micronutrient status should be closely monitored in anorexic treatments.
- Low electrolytes: Anorexics may have low levels of potassium, sodium, and calcium, which can lead to many negative health consequences if left untreated.
You can help your clients address these deficiencies with a targeted meal plan and certain supplements.
How personalized and systematic nutritional monitoring can make a difference
To help your client heal from anorexia, it’s important to ensure that they are receiving adequate nutrition to support their recovery. This can include regular weigh-ins, examining their food intake, and monitoring nutrient levels through blood tests.
You can also help your clients develop healthy eating habits and learn how to make balanced food choices. This will not only help your clients during treatment, but it will set them up for success once they have recovered.
With Nutrium, you can create customized meal plans, monitor your client’s weight, schedule appointments, have frequent communication, and encourage them along their recovery journey.
Learn more about how you can use Nutrium in your nutrition practice today!
Summary
Recovery from an eating disorder such as anorexia requires a collaborative effort from mental health professionals, dietitians, and the client’s friends and family. Specifically, seeking professional care from a dietitian can help someone overcome anorexia by improving their relationship with food and addressing nutrient deficiencies.
You can do this by creating targeted meal plans (such as on Nutrium’s platform), monitoring your client’s weight, providing nutrition education, and encouraging them along the way.
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References
Eating disorders. Retrieved January 20, 2023 from https://www.nimh.nih.gov
Anorexia nervosa. Retrieved January 20, 2023 from https://my.clevelandclinic.org
What are eating disorders? Retrieved January 20, 2023 from https://www.psychiatry.org
Anorexia nervosa. Retrieved January 20, 2023 from https://www.ncbi.nlm.nih.gov
Anxiety, depression, and obsessive-compulsive disorder. Retrieved January 20, 2023 from https://www.nationaleatingdisorders.org
Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa. Retrieved January 20, 2023 from https://www.aafp.org
Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients. Retrieved January 20, 2023 from https://www.ncbi.nlm.nih.gov
Micronutrient Status in 153 Patients with Anorexia Nervosa. Retrieved January 20, 2023 from https://www.ncbi.nlm.nih.gov
The clinical biochemistry of anorexia nervosa. Retrieved January 20, 2023 from https://pubmed.ncbi.nlm.nih.gov
Effects of Anorexia Nervosa on Bone Metabolism. Retrieved January 20, 2023 from https://academic.oup.com
