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Position of the American Dietetic Association: Nutrition Intervention in the Treatment of Eating Disorders

      Abstract

      It is the position of the American Dietetic Association that nutrition intervention, including nutritional counseling by a registered dietitian (RD), is an essential component of team treatment of patients with anorexia nervosa, bulimia nervosa, and other eating disorders (EDs) during assessment and treatment across the continuum of care. Diagnostic criteria for EDs provide important guidelines for identification and treatment. In addition, individuals may experience disordered eating that extends along a range from food restriction to partial conditions to diagnosed EDs. Understanding the roles and responsibilities of RDs is critical to the effective care of individuals with EDs. The complexities of EDs, such as epidemiologic factors, treatment guidelines, special populations, and emerging trends highlight the nature of EDs, which require a collaborative approach by an interdisciplinary team of mental health, nutrition, and medical specialists. RDs are integral members of treatment teams and are uniquely qualified to provide medical nutrition therapy for the normalization of eating patterns and nutritional status. However, this role requires understanding of the psychologic and neurobiologic aspects of EDs. Advanced training is needed to work effectively with this population. Further efforts with evidenced-based research must continue for improved treatment outcomes related to EDs, along with identification of effective primary and secondary interventions.
      This paper supports the “Practice Paper of the American Dietetic Association: Nutrition Intervention in the Treatment of Eating Disorders” published online at www.eatright.org/positions.
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      Linked Article

      • Binge Eating Disorder and Bariatric Surgery
        Journal of the Academy of Nutrition and DieteticsVol. 112Issue 4
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          I read with interest the “Position of the American Dietetic Association: Nutrition Intervention in the Treatment of Eating Disorders” (1). This is an exceedingly complex area for nutritional interventions, and I appreciated the inclusion of possible changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM) progressing from DSM IV to DSM V. My own expertise is limited in regard to the eating disorders; however, when I read that binge eating disorder was a contraindication for bariatric surgery, a red flag came up.
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      • Academy's Response
        Journal of the Academy of Nutrition and DieteticsVol. 112Issue 4
        • Preview
          We appreciate the personal insights from Gladys Witt Strain, PhD, that indicates binge eating disorder is frequently corrected by an appropriate surgical intervention. We hope this response provides clarification about binge eating disorder as a contraindication as stated in the Academy's position paper on “Nutrition Intervention in the Treatment of Eating Disorders” (1). We agree the research in this area is limited, and the reference used by the authors listed contraindications, including binge eating disorders, as a general statement (2).
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