Position of the American Dietetic

Association:

Nutrition Intervention in the

Treatment of Eating Disorders
Amy D. Ozier, PhD, RD, LDN
Beverly W. Henry, PhD, RD, LDN
Northern Illinois University, DeKalb, IL

Presentation by Samantha Daily

Position Statement
It is the position of the American Dietetic Association that
nutrition intervention, including nutritional counseling by
a registered dietitian, is an essential component of team
treatment of patients with anorexia nervosa, bulimia
nervosa, and other eating disorders during assessment
and treatment across the continuum of care.
Adopted by the House of Delegates on October 18, 1987.
Reaffirmed on September 12, 1998; May 25, 2005; and May 28, 2009.
Effective until December 31, 2014.

Position Statement: A summary

Registered dietitians play a vital role in the multidisciplinary treatment of

eating disorders

To be more effective, registered dietitians should have exceptional

communication and collaboration skills as well as advanced training for a
better understanding of, and use in, the following:

Roles and Responsibilities of RDs

Complexity of EDs

Treatment of EDs

What are Eating Disorders (EDs)?

Psychiatric disorders

Diagnostic criteria based on the following characteristics

Psychological

Behavioral

Physiological

What are Eating Disorders (EDs)?

Anorexia nervosa. Types: Restricting or binge-eating/purging
Diagnostic and Statistical Manual of Mental Disorders (DSM) IV
Exaggerated drive for thinness
Refusal to maintain a body weight above the standard minimum
Intense fear of becoming fat with self-worth based on weight or shape
Evidence of an endocrine disorder
Bulimia nervosa
DSM IV
Overwhelming urges to overeat and inappropriate compensatory behaviors or purging that
follow the binge episodes (eg, vomiting, excessive
exercise, alternating periods of starvation, and abuse of laxatives or drugs)
Similar to anorexia nervosa, individuals with bulimia nervosa also display psychopathology,
including a fear of being overweight
Eating disorders not otherwise specified
DSM IV
Considered to be partial syndromes with frequency of symptoms that vary from above
diagnostic criteria
Distinguishing feature of binge eating disorder is binge eating, with a lack of self-control,
without inappropriate compensatory behaviors

Roles & Responsibilities of RDs

Nutrition Assessment

Identify nutritional problems relative to medical/physical condition

Nutrition Intervention

Normalize eating patterns, weight restoration

Nutritional Counseling

Educate nutritional needs at various stages of treatment

To be effective, RDs must:

Understand their own roles & responsibilities involved in the treatment plan

Recognize boundaries relative to other healthcare professionals on the treatment team

Communicate effectively and regularly with treatment team members

Have advanced training--specialized knowledge and skills to better educate, treat, and
prevent EDs.

Complexity of EDs

Concurrent psychiatric disorders common

Axis I psychiatric disorders: Depression, anxiety, chemical dependency, body dysmorphic disorder

Axis II personality disorders: Borderline personality disorder

Population

Greatest frequency of anorexia and bulimia nervosa in adolescence

Binge eating disorder occurs most often in adulthood

Understanding the complexity of eating disorders is

important for providing effective treatment, which requires
appropriately addressing all components and factors that
keep the eating disorder present in these individuals.

Treatment of EDs

Advanced training is necessary for more effective

treatment

The messages and communication style of registered

dietitians should match the patient's treatment plan

RDs should have specialized training in various counseling

techniques and therapies, including

Cognitive Behavioral Therapy (CBT)

Dialectical Behavioral Therapy (DBT)

Other psychotherapies--Interpersonal Therapy, Psychodynamic

Therapy, Family Therapy, and Group Therapy

Conclusion
RDs

play a vital role in the interdisciplinary treatment of

eating disorders

To

be more effective, RDs should:

Understand

their roles and responsibilities in the interdisciplinary

treatment plan
Boundaries,

Understand

the complexity of EDs

Concurrent
Have

communication, collaboration
disorders, population, challenges and sensitivities

advanced training in various counseling techniques and

therapies used in treating patients with eating disorders

My Opinion
I agree with the position of the article, in that:
RDs

play a vital role in interdisciplinary treatment of

eating disorders

For

optimization of treatment, RDs should have advanced

training and exceptional communication and collaboration
skills

Effective

treatment involves addressing all challenges and

disorders associated with individuals with an ED

Reference
1.

Ozier A, Henry B. Position of the American Dietetic Association: Nutrition

intervention in the treatment of eating disorders. J Am Diet Assoc. 2011; 111
(8): 1236-1241.