Search Results (3)

Background: Although dietitians possess expert knowledge on the interplay between nutrition and health, their specific role in family therapy for anorexia nervosa (FT-AN) remains a topic of debate. Some of the literature indicates insufficient evidence to affirm the impact of dietetic interventions, emphasising variability in outcomes and a need for standardised research. This study aimed to identify the clinical characteristics of adolescents requiring dietetic intervention during FT-AN and to assess differences in clinical outcomes between those receiving dietetic support and those who did not. Methods: A retrospective cohort study was conducted at the Maudsley Centre for Child and Adolescent Eating Disorders in London. Patients were selected from electronic records. Inclusion criteria were ICD-10 diagnosis of AN and completion of FT-AN treatment between January 2020 and December 2022. Collected data included weight (kg and %mBMI), eating disorder symptom severity, pre-assessment anxiety (patient and parent), and details of FT-AN sessions (i.e., frequency and amount). The sample was divided into two groups: those who received dietetic input and those who did not. Statistical analyses included Mann–Whitney U tests, χ² tests, independent t-tests, and a logistic regression to examine differences at baseline, 4–6 weeks post-assessment, and discharge. Results: The study included 92 participants (dietetic group = 33 participants; non-dietetic group = 59 participants). Baseline characteristics were comparable between groups. The logistic regression showed no significant predictors for dietetic input. At 4–6 weeks, those requiring dietetic input exhibited lower %mBMI (83.3% vs. 87.3%, p = 0.027) and poorer weight gain (+2.3 kg vs. +3.1 kg, p = 0.04). By discharge, weight restoration was similar (92% vs. 93% mBMI, p = 0.64), although the dietetic group had more therapeutic treatment sessions (24 vs. 19, p = 0.04). Discussion: This study found no specific predictors for prioritising dietetic input in young people during FT-AN treatment. While those receiving dietetic support struggled with weight gain early and attended more sessions, both groups achieved similar weight outcomes by the end of treatment. Future research should focus on the timing and content of dietetic interventions, as well as perspectives from patients and caregivers, to better understand their role and impact on cognitive and emotional recovery aspects. Full article

Background: Despite dietitians being important members of the multidisciplinary team delivering family therapy for anorexia nervosa (FT-AN), their specific responsibilities and roles are unclear and their involvement in the treatment can be a contentious issue. Methodology: Clinicians (n = 20) experienced in the delivery of FT-AN who were working at a specialist child and adolescent eating disorder service responded to an online survey about their experience of including a dietitian in FT-AN and how they understand the role. Both categorical and open-ended questions were used. Reflexive thematic analysis was used to analyse the qualitative free-text responses of clinician perspectives on the role of the dietitian in FT-AN. Results: All clinicians agreed that dietetics had a role within FT-AN and most frequently sought dietetic involvement in the early phases of FT-AN. Reflexive thematic analysis of responses identified three main themes. These were (1) collaboration is key, (2) confidence as a core consideration and (3) case-by-case approach. These themes evidenced the role of the dietitian within FT-AN and highlighted both the benefits and concerns of this involvement. Conclusions: This study demonstrated that dietitians can take a core role as collaborators within therapy-led teams that facilitate joint working and sharing of expertise. However, dietetic input should be considered on a case-by-case basis, given its potential for creating an over-focus on nutrition and potentially diminishing parental confidence in feeding. When indicated for selected cases, nutritional counselling should be offered in joint sessions with the therapist rather than separately. The findings of the study were limited by the small sample size of participants recruited from a single centre and heterogeneity in the professional background of respondents. Although the integration of dietetics within the multidisciplinary team and the ability of dietitians to individualise patient care can enhance FT-AN treatment, potential benefits and disbenefits should be considered for each case. Full article

Despite advances in treatment of anorexia nervosa (AN), current therapeutic approaches do not fully consider gastrointestinal disturbances (GID), often present in AN. Addressing GID, both symptoms and disorders, is likely to improve treatment adherence and outcomes in people with AN. GID are complex and are linked to a range of factors related to eating disorder symptomology and can be impacted by nutritional treatment. It is not known which dietetic practices are currently used to address GID in AN. Therefore, this survey aimed to explore the perceived knowledge, attitudes, and practices (KAP) of Australian dietitians treating AN and co-occurring GID. Seventy dietitians participated by completing an online survey. Knowledge scores were calculated based on correct responses to knowledge items (total: 12 points); and two groups were generated: higher knowledge (≥10 points, n = 31) and lower knowledge (≤9 points, n = 39). A greater proportion of dietitians with higher knowledge recognized the role of GID in pathogenesis of AN (p = 0.002) and its impact on quality of life (p = 0.013) and screened for GID (p ≤ 0.001), compared with those with lower knowledge. These results suggest that attitudes and practices toward patients presenting with AN and GID differ depending on level of knowledge. This may have important implications for treatment outcomes for individuals with AN and GID. Full article