RE: RE: 17 yr old female bulimic

[Guest guest]

excellent answer - also may want to find out if there is something

that precipitates the binge - fight at work, stress, anxiety.

Learning to anticipate a binge is a good step, and then they can try

some CBT to try and prevent the binge.

I also send them to the dentist to get plastic coatings or resins on

their molars. At least this will save the enamel on their teeth.

Plus a daily multivitamin

Marg

>

>

> Date: 2008/04/25 Fri AM 10:25:10 EDT

> To: <rd-usa >

> Subject: RE: 17 yr old female bulimic

>

> Good luck!! Bulimics are the hardest to educate in my opinion. I

work with

> eating disorders and they certainly can be a challenge. I usually

start out

> with a history and really listen for any myths/concerns/issues

that they

> have with food. Then, I try to discuss these

myths/concerns/issues. Then,

> I give a meal plan (usually an exchange list type of meal plan)

and go over

> how it can be achieved (with concerns to her eating disorder).

Then we

> discuss how to make sure to not binge/purge.

>

> What has worked best for me is try to establish a good

relationship in the

> beginning. This can be a challenge b/c of their distrust.

>

> Make sure she is seeing a therapist/psychiatrist. Recovery is

very likely

> to not happen without a team approach.

>

> Good luck!

>

> Lawson, RD, LD

>

> From: rd-usa [mailto:rd-

usa ] On Behalf Of

> Collier

> Sent: Friday, April 25, 2008 10:17 AM

> To: NEdpg ; rd-usa

> Subject: 17 yr old female bulimic

>

> Hey guys...TGIF!

>

> I am seeing a 17 yr old Monday who is bulimic. Her weight

appears OK.

> I don't see many of these patients and would like any guidance

folks

> would like to give! Thanks a bunch!

>

> Collier, RD

>

> Clinical Nutrition Manager

>

> 9507 Hospital Avenue

>

> PO Box 17

>

> Nassawadox, VA 23413

>

>

>

> fax

>

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[Guest guest]

When I give the meal plan and we go over food choices, I emphasize that 3

meals and regular snacks each day with protein and fiber help keep them

physically full and can help decrease the starve/binge/purge cycle.

Typically what I've found in my clients is their history is to go without

eating or eat very little for weight control. Then they get so hungry they

binge, feel guilty and purge. If you can get them eating consistently, then

they can deal more effectively with the emotional, stress stuff. Hope this

helps!

17 yr old female bulimic

>

> Hey guys...TGIF!

>

> I am seeing a 17 yr old Monday who is bulimic. Her weight

appears OK.

> I don't see many of these patients and would like any guidance

folks

> would like to give! Thanks a bunch!

>

> Collier, RD

>

> Clinical Nutrition Manager

>

> 9507 Hospital Avenue

>

> PO Box 17

>

> Nassawadox, VA 23413

>

>

>

> fax

>

> This e-mail and any attachments may be confidential or legally

privileged.

> If you received this message in error or are not the intended

recipient,

> immediately destroy the e-mail message and any attachments or

copies. You

> are prohibited from retaining, distributing, or disclosing any

information

> contained herein. Please inform us of the erroneous delivery by

return

> e-mail. Please note that any views or opinions presented in this

email are

> solely those of the author and do not necessarily represent those

of the

> company. Thank you for your cooperation.

>

>

[Guest guest]

Hello,

Kitty, you're taking the words out of my mouth (I don't know if it's the

good sentence)

I'm very pleased to read this kind of message and your experience. I

totally agree with you when you show how some patients with bulimia can eat

so little and that this element can worsen their eating disorders. I've also

notices this with these patients.

In a word, I'm glad to see that RD who are working with bulimic patients can

also consider the organic part of this pathology ; the psychological part is

also very important, but diet is often underestimated.

Thanks for sharing this Kitty.

A nice sunday to all of you.

--

Frederic Courtois, RD, PhD

RE: RE: 17 yr old female bulimic

> When I give the meal plan and we go over food choices, I emphasize that 3

> meals and regular snacks each day with protein and fiber help keep them

> physically full and can help decrease the starve/binge/purge cycle.

> Typically what I've found in my clients is their history is to go without

> eating or eat very little for weight control. Then they get so hungry they

> binge, feel guilty and purge. If you can get them eating consistently,

> then

> they can deal more effectively with the emotional, stress stuff. Hope this

> helps!