Medical monitoring and provision of psychoeducation about what is happening with the body is an important component of eating disorder treatment. As the RD, I often find myself as the liaison between the therapeutic and medical setting since nutrition therapy combines aspects of both. I am able to “speak the language” of both the therapist and doctor, so my work often becomes a hybrid of the two.
Sometimes it is the “proof” from the medical tests that helps us break through the barrier of denial seen in so many of our patients. When they see that their body is NOT okay it can help motivate behavior change. For others, they will perpetually toe the line of medical stability, and the medical monitoring becomes ever more important. Either way, the medical aspect of ED treatment is not to be overlooked in this complicated and dangerous disease.
It is essential that patients are seeing a medical doctor who understands the nuances of eating disorders. In just the past week I have encountered a handful of instances where non-ED docs either missed the ED diagnosis or told a patient who already has the ED diagnosis that they are "fine" even in the presence of abnormal medical test results.
One of the strongest pieces of advice I give patients is to see a medical specialist (doctor, nurse practitioner, physician's assistant, etc.) who understands ED's. The trouble is, there aren't that many of these specialists out there, not even in the Kansas City metro area where I practice. So what do we as clinicians do? We keep ourselves informed about what to look out for, team closely with the medical providers, and make the referral to higher level of care at an ED-specialized inpatient treatment program when necessary. It just might save your life.