A specific dietary assessment is conducted when teens appear to be at risk of an eating disorder. I do this during a detailed conversation about dietary intake and include such questions as what, when and how much is eaten. A weight measurement is not usually a focus of this assessment, but weight history is important, including:
- When weight loss/gain started to be a problem
- Rate of weight loss/gain
- Body Mass Index
Similarly an indication of physical activity or excessive exercise together with other behaviours involved with controlling weight eg. smoking, taking laxatives, diuretics (water-loss pills), vomiting or purging.
Purging or getting rid of calories by vomiting to control weight leads to physically damaging cycles of starving and bingeing, with accompanying distressing thoughts and feelings. Completing a short questionnaire is requested before the appointment, and includes questions about:
- Weight history and current BMI
- Menstrual cycle in girls
- Thoughts and feelings about weight gain, eating, mealtimes and eating with others
A meal plan is often the best starting point to help a young person normalise their eating behaviour. Written information is also provided at the appointment on :
- Facts on Food restriction – help on how to stop
- Mealtime management – information for carers
- Re-establishing a normal health eating pattern
- Regular eating and regular weighing
Following this type of dietary assessment, a management plan is considered/provided alongside other support eg. through your GP as well as a systemic or family therapist or psychologist and when indicated a referral to the eating disorders service CAMHS – Childrens and Adolescents Mental Health Service. Issues of confidentiality, consent and safeguarding vulnerable children are discussed further in my teenage nutrition clinic and my Terms of Business.