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Treating the Chronically Ill Anorexic Patient


Thursday, March 23, 2017: 8:30 AM-9:45 AM

Background: Participants will learn how to define, conceptualize and treat chronic anorexia. Chronic illness requires the treatment team to have a different approach and realistic treatment goals than a more typical case. Due to the poor prognosis for this illness, therapists and dietitians must understand the medical issues facing this population.

Objectives: 1) the main treatment goals for chronic anorexia nervosa 2) specific medical tests and monitoring that is critical for proper care 3) how to differentiate between the typical patient with AN vs. the chronically ill

Content Outline

The presentation will begin with providing definitions for chronically ill patients from the literature of peer-reviewed journals.  We will define treatment resistance and explain what differentiates a chronically ill patient from a typical patient.  The cliniciansÕ therapeutic stance will be examined.

Next, we will focus on the concept of palliative care when working with the chronically ill patient. Palliative care will be defined and specific goals will be stated.  A medical treatment plan will be laid out, complete with a checklist of lab work that needs to be done for the initial appointment.  Specific minerals, enzymes and hormones will be examined.

The next section will highlight dietetic recommendations for fueling the mind and body.  Nutrition goals as well as common mistakes clinicians make will be addressed.  In addition, focus will be given to the importance of working with a nutrition therapist and why remaining with the same treatment team is critical due to this populationsÕ tendency to fall in and out of treatment.  In conclusion, a case study will be presented and the realistic treatment outcomes and sobering statistics will be discussed.

Proposal Abstract

This presentation will educate participants on how to work with chronically ill anorexic patients. Clinicians who work in an outpatient setting will find the information most relevant but clinicians in residential or day treatment programs will also benefit. Participants will learn how to conceptualize a case, which medical and nutritional issues to pay careful attention to and how to change therapeutic goals and treatment perspectives as compared to other (more typical) patients. The presentation will be given by a seasoned therapist and dietitian who work as a team in day to day life in a private practice setting. They will demonstrate through the use of a case study the immense importance of collaboration and communication that is required when working with chronically ill patients. Important elements such as how lab work results can help or hurt the treatment team in dealing with the patient will be addressed as well as incorporating the concept of palliative care in long term treatment. Dietitians will learn how to provide structure and guidance given the limitations of these fragile patients. Additionally, treatment goals will be presented that significantly differ from expected goals when working with this challenging population.

Primary Presenter:
Robyn Goldberg, RDN, CEDRD

Robyn began her career at Cedars-Sinai Medical Center in Los Angeles and was the Nutritional Counselor for the Susan Krevoy Eating Disorders Program at the Wright Institute. She is the Director of Nutrition Service for The Control Center an Addiction IOP. She has been a contributing author, appeared on national television as the eating disorder expert on The Insider and quoted in The New York Times, Shape, Fitness, Diabetes Forecast and other publications. Robyn teaches nutrition classes for the Motion Picture Industry and has a practice specializing in medical conditions, and eating disorders in Beverly Hills, CA since 1997



Co-Presenter:
Greta Angert, LMFT

Greta Angert is in private practice in Beverly Hills, CA for the past 15 years. She is an EMDR level 3 certified and TRM trained clinician. She has worked at every level of care program throughout Southern California and is a consultant for eating disorder treatment placement nationwide. Greta is an MFT Intern Supervisor, a Consultant & Media Expert on Eating Disorders, a consultant to many of Southern California’s most highly respected drug and alcohol treatment programs and provides eating disorder education, staff training and in-services to drug and alcohol treatment programs.



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