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Adolescent Anorexia: Guiding Principles and Skills for the Dietetic Support of Family-Based Treatment

Published:December 24, 2017DOI:https://doi.org/10.1016/j.jand.2017.09.003
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      Registered dietitian nutritionists (RDNs) play a significant role in the treatment of adolescent eating disorders; however, there are limited clinical practice parameters to guide providers. Anorexia nervosa (AN) is a life-threatening illness that typically begins in early- to mid-adolescence and can be associated with a chronic lifetime course of illness. The importance of renourishment efforts during the first 5 years of illness is critical.
      • Lock J.
      • Le Grange D.
      Treatment Manual for Anorexia Nervosa: A Family-Based Approach.
      Family-based treatment (FBT) is an empirically supported psychotherapy approach designed as a first-line treatment that empowers families to address and reverse the factors maintaining AN.
      • Waterhouse T.
      • Jacob M.
      Practice Paper of the American Dietetic Association: Nutritional Intervention in the Treatment of Eating Disorders.
      FBT studies have not utilized RDNs, despite their central involvement as a member of the eating disorder treatment team in standard clinical practice. RDNs can help families with home-based refeeding, as they can help to facilitate greater energy density and food variety, sooner rather than later, which are associated with best prognosis.
      • Waterhouse T.
      • Jacob M.
      Practice Paper of the American Dietetic Association: Nutritional Intervention in the Treatment of Eating Disorders.
      The goal of this paper is to propose initial guidelines for the integration of nutrition services in the provision of FBT using FBT-informed principles.
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