“Doctor, I just can’t eat!” A Patient-Centered Approach to Diagnosing and Managing Disordered Eating in the Medically Complex Patient. Co-Sponsored by the Pediatrics SIG and the Psych Onc/Pall Med SIG

Abstract:
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Background: Patients with complex medical illnesses including cancer, diabetes, and ‎neurocognitive disorders often develop disordered eating, which can impact treatment or ‎potentiate serious medical consequences. Although there are overlapping symptoms with ‎current DSM-classified eating disorders, the etiology of disordered eating in patients with ‎complex medical illnesses is often distinct with contributions from the underlying medical ‎illness itself, side effects of medical treatments or procedures, and/or unhealthy coping ‎mechanisms employed to manage medical stress (1,2). This interactive session will ‎present updates from the literature and provide a framework for diagnosing and managing ‎disordered eating in patients with complex medical illnesses.
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Approach: This interactive session will engage participants using didactic presentation ‎and group discussion. First, Dr. Brown will review the current literature and offer a ‎recommended framework for the assessment and management of disordered eating in ‎medically complex patients. Next, Dr. Miran, Dr. Ort and Dr. Ramirez will each utilize this ‎framework to discuss three distinct clinical cases of disordered eating in patients with ‎medical complexity. These cases will serve to demonstrate the varied manifestations of ‎disordered eating across different disease-specific contexts. Finally, Dr. Brown will ‎highlight common themes and provide a roadmap towards future research and ‎interventions.‎

Format:‎
‎10 min: Dr. Brown will provide an overview of disordered eating among medically ill ‎patients and outline a framework for the assessment and management of this population.

‎15 min: Dr. Miran will present a case of disordered eating in an adult with advanced cancer ‎admitted to oncology.

‎15 min: Dr. Ort will present a case of disordered eating in a pediatric patient with diabetes ‎in the outpatient setting.

‎15 min: Dr. Ramirez will present a case of disordered eating in a medically admitted patient ‎with HIV/AIDS and neurocognitive deficits.

‎5 min: Dr. Brown will emphasize key themes and outline directions for future interventions.‎
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‎15 min: Interactive Q&A

Conclusion: Disordered eating is a common clinical challenge among medically complex ‎patients across the lifespan and in varying disease processes. The approach for these ‎patients fundamentally differs from those typically used for primary eating disorders like ‎anorexia nervosa and bulimia nervosa. Addressing disordered eating is crucial to the care ‎of the whole patient as it can disrupt treatment and lead to significant medical ‎consequences. This session will employ multiple learning techniques to prepare audience ‎members to recognize disordered eating, identify contributing factors, and develop a ‎management approach at their home institutions.‎