MedEdPORTAL (Oct 2014)
Treating Taylor: Multidisciplinary Management of Eating Disorders
Abstract
Abstract Introduction Eating disorders (EDs) are a source of significant morbidity and mortality among youth in the United States. The lifetime prevalence rates of anorexia nervosa, bulimia nervosa, and binge eating disorder during adolescents are 0.3%, 0.9%, and 1.6%, respectively. Partial syndrome EDs affect up to 20% of the general adolescent population and many more adolescents engage in extreme weight control behaviors. EDs are associated with substantial psychiatric comorbidities and, because no organ system is spared the effects of EDs, the medical complications can be serious or even life-threatening. Treatment of such disorders requires a collaborative approach by a multidisciplinary team of mental health, nutrition, and medical specialists. This evolving case allows trainees to develop skills in the assessment, treatment, and management of EDs with an emphasis on the role of the multidisciplinary team. Methods Students review, discuss, and ultimately develop a treatment plan for Taylor, a 13 year-old girl diagnosed with an ED. The students review the case over five sessions that cover ED assessment, diagnosis, and treatment modalities. During the final session students are encouraged to design a hypothetical eating disorder screening program. Results This case has been used successful with a multidisciplinary group of postgraduate health care professionals training in adolescent health in 2 consecutive years. Learners reported on standard pre- and postcase 4-point Likert-type scales (4 = very confident) that the case experience improved their confidence in their ability to assess adolescents with eating disorders (pre = 3.0, post = 3.6), to diagnose eating disorders in adolescents (pre = 2.7, post = 3.4), to counsel adolescents with eating disorders (pre = 2.4, post = 3.1), and to devise a treatment plan for these youth (pre = 2.6, post = 3.3). Discussion This case provides an opportunity for trainees to explore barriers and challenges common to the clinical management of EDs while also providing exposure to current trends and evidence in the prevention and treatment of EDs. The case introduces trainees to aspects of program development and allows trainees to identify opportunities for advocacy and leadership.
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