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The Gut-Brain Connection in Eating Disorders: How do we treat based on what we know (and don’t know)?


Friday, February 8, 2019: 4:00 PM-5:30 PM
Desert Ballroom (JW Marriott Desert Springs Resort and Spa)

Background: The gut-brain axis is a bi-directional system involving the brain and gastrointestinal tract, which connects intestinal functions with emotional, hormonal and cognitive centers of the brain. There is growing research examining the role of gut-brain axis dysfunction in the causes and symptoms of eating disorders. We will summarize current research as it may inform current practice in treating these concomitant disorders. We will then present the current evidence for dietary and therapeutic interventions to treat this dysfunction. Finally we will invite the audience to discuss and debate the use of these interventions in this population.

Objectives:

    1. Understand the current evidence for the role of the gut-brain axis in the etiology and symptomatology of eating disorders
    2. Identify dietary interventions with current and emerging evidence in the treatment of gut-brain disorders
    3. Discuss issues in clinical practice of treating gut-brain dysfunction in patients with eating disorders

Content Outline:
  1. The gut-brain-(microbiota) axis: current models
    1. Interaction between gastrointestinal, endocrine and nervous systems
      1. HPA axis
      2. Inflammatory proteins
      3. Neurotransmitters
      4. Vagus nerve
    2. Microbiome in eating disorders with regards to etiology of EDs
      1. Malnutrition + microbiota
      2. Over-nutrition + microbiota
      3. Epigenetics involved with
  2. Gastrointestinal disorders co-occurring with eating disorders
    1. Functional GI and motility disorders
      1. Gastroparesis, dysphagia, slow transit constipation, pelvic floor dysfunction, IBS-D/C/M
      2. Prevalence
      3. Proposed mechanisms
    2. Inflammatory and autoimmune GI disorders
      1. Celiac, Crohn’s, ulcerative colitis,
      2. Prevalence
      3. Proposed mechanisms
    3. Structural GI disorders
      1. SMA syndrome, outlet obstructions
  3. Therapies for GI disorders concomitant with EDs
    1. Antispasmodics
    2. Antidepressants
    3. Low FODMAP diet
    4. Specific carbohydrate diet
    5. Fiber interventions
    6. Pelvic floor therapies
    7. Cognitive behavioral therapy
    8. Mindfulness-based stress reduction
    9. Gut-directed hypnotherapy
  4. Discussion and Debate

The gut-brain axis is a bi-directional system involving the brain and gastrointestinal tract, which connects intestinal functions with emotional, hormonal and cognitive centers of the brain. There is a growing research examining the role of gut-brain axis dysfunction in the causes and symptoms of eating disorders. We will present a current summary of this research as it may inform current practice in treating these concomitant disorders. We will then present the current evidence for dietary and therapeutic interventions to treat this dysfunction. Finally we will invite the audience to discuss and debate the use of these interventions in this population with the intent to heal gastrointestinal dysfunction.
Primary Presenter:
Janelle Smith, MS, RD, CEDRD

Janelle Smith is a Registered Dietitian Nutritionist (RDN) based in Los Angeles, CA , specializing in gastrointestinal disorders, food allergies, eating disorders, intuitive eating, and other challenges to living with restricted diets. Her professional specialty is to integrate psychology, behavioral change, and nutrition therapy to help others understand and be at peace with the role that food plays one's life, while finding a least-restrictive diet that improves both physical and mental health. Janelle has recently joined the UCLA Health team in the Division of Digestive Diseases working with patients struggling with GI and digestives issues, as well as the Division of Adolescent and Young Adult Medicine, working with those struggling with eating disorders.



Co-Presenter:
Michele Christopher, MS, RD

Michele Christopher is Manager of Dietary Services at Rosewood Santa Monica. Michele graduated from California State University, Northridge with a bachelor’s degree in Chemistry and went on to earn her Master of Science in Nutrition and Dietetics. Michele received the Dean's Award for Outstanding Graduate Student in California State Northridge's Department of Health and Human Development and completed her dietetic internship at the Veteran’s Affairs Medical Center in West Los Angeles. Prior to joining Rosewood, Michele spent two years as a dietitian working with adults struggling with eating disorders, substance abuse and mental health at the residential level. Michele also participated as the lead research assistant and project coordinator in a research study investigating the relationship between dietary intake, exercise behaviors and body composition among college freshman.



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