Background: All medications have benefits and side effects. Clients with eating disorders are often hyper-aware of even small changes to their bodies which if include weight gain, constipation, or other side effects can lead to noncompliance. Partnering with a dietitian is an invaluable resource. Psychotropic medication side effects with nutrition interventions
Will That Medication Make Me Fat or Constipated or.....
Dietitians and Doctors Working Together To Care for Our Clients
Kevin Wandler, MD
Alice Baker, RD
I. Eating Disorders
a) Diagnosis
b) Level of care available
c) Co-occurring issues
II. Medications that treat eating disorders and co-occurring disorders
a) Antidepressants
b) Antipsychotics
c) Benzodiazepines
d) Anticonvulsants
e) Stimulants
f) Laxatives/ Diuretics/ Diet Pills
III. Side effects of medications that treat eating disorders
a) Weight gain
b) Constipation
c) Drug-nutrient interaction
IV. Physicians role
a) Good Doc—coach, encourager, lab monitoring, medication monitoring
b) Really Good “Bad” Doc—“Come to Jesus talks”, “Death is not an option on my watch”, “Tubes Happen”, Hospitalization
V. Dietitians role
a) Refeeding
b) Weight goals
c) Healthy relationship with food. Is that possible?
d) Trust. Is that possible?
VI. How the dietitian and physician work together-without splitting!
a) Constant contact
b) United front
c) Same goal; recovery for the patient
In the ideal setting, every client with an eating disorder has a treatment team made up minimally of a therapist, dietitian and medical provider. In all of psychiatry, there are no diagnoses with this many clusters of symptoms that affect a client both medically and mentally. In an inpatient setting, the standard of care is that there is a multidisciplinary treatment team. Over 90 percent of the patients that are treated in an inpatient/ residential treatment center for an eating disorder have a co-occurring diagnosis such as depression, anxiety, PTSD or substance abuse. The majority of these clients will be placed on a psychotropic medication to assist with the recovery process. All medications have benefits and side effects. Clients with eating disorders are often hyperaware of even small changes to their bodies which if include weight gain, constipation, or other side effects can lead to noncompliance. Partnering with a dietitian is an invaluable resource. The psychotropic medication side effects which can include weight gain and constipation can be minimized often with nutrition interventions. This workshop will review the indications and common side effects seen with the psychotropic medications including antidepressants, anticonvulsants, antipsychotics, benzodiazepines and stimulants. The role of the physician and dietitian partnering together for a positive outcome will be discussed. Finally, case studies will be used to illustrate throughout the presentation.
Dr. Kevin Wandler has been the Vice President of Medical Services/Medical Director of Remuda Ranch Treatment Centers for thirteen years. He specializes in the treatment of women with eating disorders and co-occurring conditions. He is Board Certified in Psychiatry; has added qualification from the American Board of Psychiatry and Neurology in Addiction Medicine; and has certification from the American Society of Addiction Medicine. Before Remuda Ranch, he was in private practice, specializing in treating adolescents and adults with substance use disorders and attention deficit/hyperactivity disorder. Dr. Wandler presents frequently at national eating disorder and chemical dependency conferences.
Alice Baker RD LD/N has 16 years’ experience in the field of Eating Disorders. She was passionate about eating disorders from the beginning; therefore did her fieldwork in eating disorders and presented her internship case study on Anorexia Nervosa. Alice has served clients with eating disorders through the full spectrum of care from inpatient to outpatient. Throughout her passion grew into creating structure for her clients to heal. This includes creating nutrition protocols for multiple eating disorder programs. Alice currently sees clients in private practice, facilitates support groups and trains new dietitians in the eating disorder field.
