Tuesday, 13 August 2013

Getting your doc to understand

Although ED is more common than we think or see in daily life, there is sadly a lack of healthcare professionals who truly 'get it'. Many doctors/nurses think that ED is a problem with the patient and is thus to blame. Others do not know how to help their patients, so they tell them to 'eat higher calorie foods' and to stop 'moving around so much'. Still others think that ED is a phase that people go through.

Why is it so hard to find someone who understands ED and how to treat them? First, ED is not really spoken about in medical school. Sure, they may hear about ED, but students do not really get an opportunity to understand how ED works. They also simply hear that 'food is medicine', but they do not get taught how to deal with a patient who is suffering and desperately needs assistance. Furthermore, many theories about ED are still (sadly) prevelant in today's society, such as the idea that ED results from a bad relationship with one's mother. Because of all this information (which, by the way, is wrong), medical professionals usually do not know how to treat EDs.

But what is a patient to do? Can you leave your doctor and look for one who understands ED? In the perfect world, this would be the solution. But, unforuantely, this is not practical. First, it is unlikely that you will find an ED professional close to your area who can help. Next, you will likely be placed on a long waiting list. Third, these professionals can sometimes be costly if they are not covered by insurance. So what do you do? Well, if possible, educate your doctor. Refer them to resources that can help them understand what ED is and what they can do to help you. If your healthcare professional is willing to do this, then GREAT! If not, they may be able to help you locate other resources or professionals who can help you.

There are a lot of resources out there, so be careful. Some good sites are FEAST, NEDIC, NEDA, etc. (Note: I am not endorsing any of these. They are simply suggestions). Some of the top things that doctors/nurses who work with patients with ED are:

1) It is not the patient's fault. Do not blame them for their illness.
2) Patients need a lot of help. This may include dietary consultation, therapy, or family intervention. Do not think that this will be a temporary 'phase'. It takes a lot of time to help patients recover.
3) Sometimes, patients need hospitalization. There are guidelines that specify what conditions must be met for this to be true. Know what the guidelines are for your province/location.
4) Food is medicine, but patients need more than food. They need care, time, motivation, and hope.
5) Let the patient know that this is a serious illness, but that it can be treated. They will need to work hard, and they might not like (actually, they will probably hate it) treatment. But it will get better.
6) Recovery is not a straight road. It may have good times and bad times. Relapses or mistakes do not mean failure. It simply means that the patient has learned a lesson and will be stronger.
7) Families and friends can be helpful, but make sure that they are supportive and educated about ED.
8) Not all ED patients have comorbid disorders. Medication is not always necessary, so do not assume that you need to medicate your patient for depression simply because they have ED.
9) Patients do not mean to be hard to deal with or difficult. They are scared and frustrated. They will not be excited about eating and gaining weight, so be gentle but firm. Patients need to trust you before they are willing to work with you to get better.
10) Educate yourself. When you get an opportunity to learn about ED, take it. ED is more common than you think. Learn to screen for ED in patients, to recognize warning signs, and to help paients get treatment as soon as possible. You just might be saving lives.


  1. I can not believe that is true ,
    How doctors not able to diagnose and treat patients while We are in North America have the best evidenced medicine???!!!


  2. As I told you before .I fired my family doctor as he was completely idiot and not only was not helpful but was hurtful to my feelings. He blamed me for trying being a model and made me ashamed of my self in front of my family. He was nuts.
    I like the ten tips
    Thanks Marina


  3. I have to admit that not that much training in med school for certain area as pain management and ED and that is why many family doctors have no clue how to early pick up on ED and when they do ,they do not know how to address the issue ,however they should be able to teach themselves, go to workshops and conferences and above all they should be aware of the resources available to help their clients.

    I also like the ten tips

    Medical student

  4. I do not have a family doctor but my parents do and they are bitterly complaining and frustrated from the lack of knowledge and inaction when they consulted him several times about my illness.I am still under the age but I refused to see any doctor and I thought I did not have any major problem ,just mild issue till I met you over this blog

    I like your tips and I am keeping them in my heart and mind for protection.


  5. So Marina ,
    Can We trust our family doctor?
    I think best way is We do exactly like you did, We all need to look after our own health. Thanks to internet ,we can always search and consult caring people like You Marina


  6. We can not generalize .
    I have complete trust in my doctor and he she does not know ,she always search and come back to me later or refer me


  7. I completely agree with you. Most family doctors do not know how to diagnose (at least early) ED or how to investigate and manage .I do know that therapists who treat ED rely on few doctors with special interest in ED and so they refer their clients to them.
    I agree also it is not hard to educate yourself ,not necessary going faraway ,just you can get CDs or ,attend webinars or read a book.
    I also know some inpatient programs rely on patient's compliance and they kick them out if not improving blaming them for non-compliance and that is wrong as you said in a previous post .

    I also like your 10 tips that summarizes ED disease and how to help self and others

    Good post Marina

    Kelly W

  8. I have no problem if my family doctor does not know what to do with my medical issue as long as she is supportive,undersatnding and guiding me how to proceed.
    I am sure if doctors guide and support and be honest telling their clients what they know and what they do not know and work things out,people will be satisfied and can meet their needs.
    Good post and tips I agree


  9. I am an RN and I am learning every day not only from seniors nurses or docs or books etc. but also from patients too. You may wonder when your patients comes to you and requesting certain meds they learn about on the net or from their friends etc. .Some of them bring me copy of articles they read about their illness and I do take and read it and also I do some of my search and discuss with them next visit.
    Medicine is an ocean. The more you know ,the more you feel you do not know .There is no end to the knowledge especially when it comes to medicine .
    It is nor surprizing to me that doctors are not knowledgeable about ED .Once I asked one doctors about anorexia N and she shrugged her shoulders saying this is not my turf!!.


  10. I am for one and many of my family and friends search the web first before seeing doctors about any issue .
    I hear lots of complains about doctors who either incompetent or lazy to help clients.
    I can understand how idiots they are when it comes to difficult issue as ED.
    It is not a bad idea that we can teach our docs.


  11. If you remember me I had long struggle addiction to pain meds and thankfully fully recovered.
    I was told it was my choice and my decision and flatly I was told to back off of my own .Thankfully now I read an article about addiction saying yes addiction is a disorder of the brain that make people make wrong decision and wrong choice and therapist need to work with them to help their brain recover so that they can make the wright decision and make the appropriate change.
    I believe ED is same ,victims with ED need to be supported and helped so that they can make the right choice.
    I never seen a doctor twice who said to me once just stop your pain medicine without listening to me and helping me to understand my feelings .


  12. I have come across friends who exactly told me that one famous family doctor told a teenager and his parents that the problem with anorexia is in you ,it is you who choose not to eat ,just go and eat .No kidding this add fuels to the fire already in their house and things got worse with kid.
    I agree with you Marina,if this doctor knew how to talk to ED victims and their family and as simple as this not to blame victims ,he would have helped them.
    I am glad that I will be therapist here to support and comfort.

    With my humble respect


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