A Wish List from a Mental Health Dietitian for People Living with Eating Disorders

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As a dietitian at a specialized regional mental health care hospital, I am often working with some patients who have formally diagnosed eating disorders. Many others have disordered eating or have the potential to meet eating disorder criteria if they were to be screened. Up to 94% of people living with an eating disorder also have a co-existing mental health condition such as depression or an anxiety disorder. (1) However, even within a mental health care hospital setting, it is common that eating disorders are not routinely screened for or directly addressed.
I have many wishes for the future. Eating disorders remain a primarily hidden disease, with 9 out 10 people never receiving treatment (2). I wish all mental health professionals would receive thorough education about eating disorders, especially as anorexia nervosa is the mental health condition with the highest mortality rate. Misconceptions among health care professionals about eating disorders remain prevalent (3).
I have heard many stories from patients living with eating disorders who have felt misunderstood or dismissed by health care professionals, and/or friends and family. Every person who finds the courage to share their struggles deserves to receive understanding and compassionate support. If they have reached out to a health professional, I hope they will be taken seriously and listened to carefully. I wish no one would ever hear “you don’t look like you have an eating disorder”. Only one of the types of eating disorders is associated with low weight, and all types of eating disorders are potentially life threatening (4). People who experience eating disorders are diverse. Everyone is equally deserving of treatment and support.
Eating disorders tend to progress down a slippery slope. I wish more people could access help before they experience severe symptoms, such as becoming fully preoccupied with eating disorder thoughts and habits. There are many benefits of looking at the whole person. Addressing just one component of physical or mental health does not promote reaching ones best self. I hope the collaboration between physical and mental health care services will continue to grow, and that available eating disorder services will be expanded. Also, I strongly wish that no person should ever be made to feel they have less value related to their weight or appearance. Everyone deserves to feel amazing about themselves.
I am passionate about advocating for people living with eating disorders. I share the following ideas in case they are of interest to other health professionals. I give a presentation about eating disorders to new mental health nursing staff several times a year. I have shared my eating disorders presentation with the psychiatrists at my facility. I am working to set up an education session by our local treatment program for mental health care staff to enhance their knowledge. I am pursing a goal of having a few screening questions for eating disorders added to the nursing admission assessment. Where appropriate, I provide information to patients about how a referral to the eating disorders program may help them in their recovery journey. I am advocating for more dietitian hours, as mental health care tends to have a lower staffing level of dietitians, and often no outpatient dietitian services.
In conclusion, I wish all individuals living with eating disorders hope and best wishes for their futures. I hope for improved access to eating disorder screening and treatment. If we all continue to wish hard, work hard, and join forces, great things can happen.

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Christina Seely, BSc RD CDE, is a full time clinical inpatient dietitian in London ON at Parkwood Institute, part of St. Joseph’s Health Care London,. She supports mental health care patients ranging from adolescents to geriatrics. She was the 2017 recipient of a professional practice award for Excellence in Innovation and Evidence-Based Care from St Joseph’s Health Care London. She received a 2018 Dietitians of Canada Member Recognition Award for Leadership.
Christina is a regular presenter on the topic of nutrition and mental health. She was interviewed for the spring 2017 issue of Chatelaine and the upcoming December 2018 issue of Canadian Living. Christina is a contributing author to two Dietitians of Canada position papers, “Promoting Mental Health through Healthy Eating and Nutritional Care” and “Addressing Household Food Insecurity in Canada”. She is known as a passionate advocate for the health and wellbeing of people living with mental illness.
She can be reached at Christina.Seely@sjhc.london.on.ca

(1)https://www.nationaleatingdisorders.org/eating-disorders-co-occurring-co...
(2)http://eatingdisorderscoalition.org.s208556.gridserver.com/couch/uploads...
(3) https://www.theglobeandmail.com/life/health-and-fitness/health/canadas-h...
(4) https://www.nationaleatingdisorders.org/health-consequences