Individualized, multidisciplinary care at the heart of eating disorder treatment
Monday, January 13, 2014
By ANDY GOODELL
Associate Writer, Department of Psychiatry
Everyone’s relationship with food is different. For some, it’s deadly.
Eating disorders take many different forms, impacting lives in unique ways. Thankfully, the University of Iowa Hospitals and Clinics offers individualized care supporting the needs of anyone on the journey through their eating disorder struggle.
Dr. Wayne Bowers, Clinical Director of the Eating Disorders Program at UI Hospitals and Clinics and clinical professor of psychiatry, noted the differences in people who’ve had an eating disorder for different time periods. “You can’t really apply the same sort of treatment equally,” explained Bowers when talking of the difference between having an eating disorder for one year versus five years. “You really want to tailor what you do for treatment to what the person’s needs are.”
There is plenty to do when it comes to engaging inpatients being treated for eating disorders at UI Hospitals and Clinics. Daily activities in the inpatient unit include, but are not limited to, supervised meals and snacks, family and group therapy as well as recreational and occupational therapy. Outpatient services are also very active and include individual therapy, nutrition assessments and medication management.
Treating eating disorders through UI Hospitals and Clinics isn’t limited to just outpatient and inpatient care. Keeping with the idea of an individualized approach, there is also a partial hospital eating disorders track offered through the University of Iowa Hospitals and Clinics. This option engages patients five days a week, eight hours a day.
Bowers noted that this program helps people make decisions about meals and nutrition.
“Also, it helps them kind of try out new skills to help them cope effectively,” Bowers says.
It’s essential to make sure inpatients are made confident in their ability to re-join the greater community. That is a priority at UI Hospitals and Clinics and part of a continuum of care helping them cope with stress, as well as handling things that may contribute to anxiety.
The University of Iowa Hospitals and Clinics is world-renowned for their treatment of eating disorders for many reasons. Part of that is the program’s rich history. Our eating disorders program has been in operation since the mid-1970s, according to Bowers. We have operated a specialized inpatient treatment unit for eating disorders, which continues to be a resource for patients not only in Iowa, but all across the country.
“We have a long history of working with individuals with eating disorders,” Bowers noted. “We’ve had prominent professionals in the field of eating disorders that have worked here.” These prominent individuals include Dr. Katherine Halmi and Dr. Arnold Andersen, who are internationally recognized for their research and clinical work in Eating Disorders.
In coming to understand eating disorders, it is important to know that many times a patient’s eating disorder diagnosis comes with other mental health diagnoses.
“Depression is generally the one that you often see,” says Bowers. “The other one would be an anxiety disorder.”
Bowers noted that, for some dealing with anorexia, depression can arise once they reach a very low body weight. He said some find that when they do restore body weight, this depression can diminish. On the other hand, some people may have an anxiety or depression disorder prior to developing an eating disorder. The UIHC Eating Disorders Program is well-equipped with care team members and innovative approaches to treatment in either scenario, as well as any others.
Part of knowing where eating disorders come from involves extensive research. There is considerable, innovative research related to eating disorders conducted at the University of Iowa Hospitals and Clinics.
Dr. Michael Lutter, an assistant professor of psychiatry at the University of Iowa, conducts psychiatric research on the molecular level. Dr. Lutter was the senior author on a study published in October 2013 in the Journal of Clinical Investigation. The study focused on two genes, which are linked to an increased risk for eating disorders. This study was conducted over a period of about four years.
Lutter, a young researcher in the field of eating disorders, has recent accomplishments focused on identifying novel mutations that increase the risk of developing eating disorders. He also has the benefit of being trained as an MD psychiatrist and a PhD neuroscientist, affording him rare insight into eating disorders on a disordered neural chemistry level.
Learning from patients is a vital piece of the research puzzle. Patients who come in for treatment for eating disorders are given the opportunity to participate in a study by providing a sample of their DNA via saliva and filling out a short assessment packet, noted Lutter.
The biologic basis for eating disorders remains to be seen, Lutter said. He explained that current mainstays of treatment include medical nutrition therapy, which includes normalizing meal patterns and restoring body weight. Psychotherapy can also be a mainstay of treatment for eating disorders.
Lutter is keenly aware of the most dangerous and troubling eating disorders outcome. Lutter stressed that the mortality rate is the highest of any psychiatric illness.
“About 10 percent overall of people with eating disorders will die as a result of that eating disorder,” Lutter says.
But, there is hope.
Since the study was published, Lutter said he’s heard positive feedback from the patients he’s been treating, noting that they appreciate the work that has been done. This includes demonstrating that there are genetic and biological contributions toward eating disorders and that they are not simply behavioral in nature.
“So, I think that makes people feel better,” says Lutter.
If you are concerned about yourself or a loved one when it comes to eating disorders, call 319-356-2263.
To learn more about eating disorders, visit the following links:
Eating disorders resources
Atypical eating disorders