This article is by student dietitian, Kim Mathews
Eating disorders are serious psychological conditions with severe clinical implications, including physiological, psychological, and social impairment. They are frequently associated with other disorders such as depression, anxiety or personality disorders, and substance abuse.1 Eating disorders negatively impact the person’s quality of life, with extreme cases resulting in poor health outcomes and potentially death.1 Distress is placed on the individual through manifestations in mood and self-esteem, social isolation, psychiatric and behavioural effects. Eating disorders not only affect the individual, but impact relationships with partners, family, and friends due to stress and changes to relationship dynamics.1
Associated medical complications vary between eating disorders due to variance in the behaviours involved. In general, medical issues associated with eating disorders include: chronic fluid and electrolyte imbalances, cardiac abnormalities, kidney failure, compromised immune function, gastrointestinal problems, osteoporosis, nutrient deficiencies, anaemia, and endocrine irregularities.1 Due to the severity of these complications, eating disorders are associated with increased risk of death. Anorexia Nervosa has the highest mortality rate of any psychiatric disorder, with death occurring in 20% of all cases.2
Eating Disorders have a significant and underestimated impact on Australian society. The prevalence of disordered eating and body-image issues have increased dramatically over the past three decades.1 In Australia, it is estimated that eating disorders affect approximately 9% of the population and that up to 20% of females may have an undiagnosed eating disorder.1 Research conducted in 2010 indicates that most young people in Australia (84.3%) know at least one other young person who may have an eating disorder.1
Despite the high prevalence and severe implications of these disorders, inpatient treatment options in Australia are relatively limited. The wait lists for treatment facilities are also typically exceedingly long; and in the absence of treatment, the eating disorder patient deteriorates, placing his or her life at risk.
In an out-patient setting, clinical psychology sessions are generally recommended. Eating disorder patients are entitled to a maximum of 16 Medicare-rebated sessions per year with a clinical psychologist.3 Typically, an eating disorder patient will require appointments weekly or fortnightly, and treatment of these complex conditions often takes years.1 Treatment requirements far exceed Medicare coverage and results in a cost of thousands of dollars to the patient or their family.
Due to their secretive nature, eating disorders are typically under-diagnosed. They may be mistakenly labelled as a dieting attempt gone awry, vanity, or simply a ‘phase.’ Health professionals and the general public must be aware of eating disorders and their signs to reduce stigma and provide early interventions when required. Warning signs and symptoms of eating disorders can be found on the Eating Disorders website. Dietitians are often working with a segment of the high-risk population; in addition to being able to identify the warning signs, dietitians should know how to intervene, refer on for appropriate care, and support people with eating disorders under their duty of care.
If you are interested in increasing your knowledge and skills in this area, the National Eating Disorders Collaboration offers a number of professional development opportunities across Australia; see http://member.nedc.com.au/events/event_list.asp for opportunities in your area. Reputable online resources for health professionals, parents, teachers, and the general public include: http://nedc.com.au/, https://thebutterflyfoundation.org.au/ , and https://www.eatingdisorders.org.au/
1. National Eating Disorders Collaboration. Eating Disorders Explained: ‘Eating disorders in Australia’ and ‘Fact sheets.’ Canberra: Australian Government Department of Health and Ageing; 2013 [accessed 08/10/13]. Available from: http://www.nedc.com.au/eating-disorders-explained
2. Australian Government Department of Health and Ageing. Anorexia nervosa: Australian treatment guide for consumers and carers, 2005. Canberra: Australian Government Department of Health and Ageing and the New Zealand Ministry of Health; 2005 [accessed 10/10/13]. Available from: http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-a-anorex-toc~mental-pubs-a-anorex-1
3. Australian Psychological Society. Medicare rebates for mental health services provided by psychologists: Information for clients; 2013. Melbourne: The Australian Psychological Society; 2013 [accessed 10/10/13]. Available from: http://www.psychology.org.au/medicare/fact_sheet/