What Working with Patients with Eating Disorders has Taught Me

Thursday, Sep 15  •  


Chad Speth
Primary Care Provider

For the past eleven years, my healthcare practice has been dedicated to the treatment of eating disorders. I have grown and learned much in that time. I have seen firsthand many of the ill effects of eating disorders (eating disorders) on the patients, their families and friends. Prior to treating eating disorder patients, I had worked in various other healthcare settings. I realize now that some of the signs and symptoms I was seeing in patients I treated earlier in my career, could have been subtle signs of a more sinister problem. From something as seemingly simple as a sore throat or canker sore in the mouth to abdominal pain and passing out in in otherwise “healthy” patients, could have been warning signs for those suffering from an eating disorder. Had I recognized the more subtle signs of an eating disorder, could I have made a difference and helped someone to receive the care they needed? Could an outcome have been better for that patient had I asked more questions or even knew what questions to ask? I’ll never know for sure. Sometimes I think, “oh, how I wish I knew then what I know now!” I was caught in the same position that much of the pediatricians and general practitioners are still in today-without the necessary knowledge for early identification of eating disorders. In non- eating disorder specialty settings, eating disorders are simply under-diagnosed and therefore under-treated. Our society and healthcare community in general lack education and awareness of the life-threatening nature of eating disorders. This needs to change!

Eating disorders are the deadliest of any of the psychiatric illnesses.

More deadly than depression!

More than schizophrenia!

No part of the body is spared the potentially fatal effects of this terrible disease. eating disorders have an effect on every organ system from the heart, brain and other internal organs to the bones, hair, skin and fingernails. The vast majority of deaths from eating disorders occur because of damage to heart and from suicide. eating disorders affect >500,000 adolescents in the US and this number is likely under-reported due to lack of awareness and recognition. In our collective quest for thinness, social acceptance and the now, en vogue “war on obesity”, we are inadvertently fostering increased numbers of adolescents and adults who engage in disordered eating, have increased anxiety and body image disturbance. Again, collectively as a medical community, we are neglecting these people who suffer and in many cases are losing a large number of them. This breaks my heart because I know how treatable eating disorders are.

There are many patients in our communities who are struggling with eating disorders whose symptoms often go unrecognized by their family, friends and even worse-by their healthcare professionals.

“The majority (73 to 88%) of adolescents with eating disorders reported some contact with service providers, such as mental health specialty care, school services, or general medical services. However, only a minority (3 to 28%) had specifically talked with a professional about their eating or weight problems.”1

Why is this happening in our society? In my experience, education and awareness of eating disorders and their severity as well as proper treatment are inadequate in many of our communities across the US and the globe. It’s also likely “…due to denial, shame or stigma, or a lack of recognition of eating symptoms by professionals treating other targeted problems, it shows that adolescents do use services. This suggests possible avenues for prevention and early intervention if recognition could be improved.”1

Of all of the things I have learned about those suffering with an eating disorder in the past eleven years, the most important is that healing IS possible. Recovery can be an uphill battle, especially when many things seemed to be barriers. I’ve seen patients recover whose insurance companies and even some providers had given up on them and chalked them up as being “chronic”. I’ve even heard insurance companies say the “revolving door” of visits in and out of emergency departments, hospital stays and outpatient treatment was an acceptable treatment outcome. The treatment team at Avalon Hills one hundred percent disagrees with this! I know firsthand that the “treat to outcome” philosophy WORKS! People do get better! They can go on to have productive and fulfilling lives, connect with others and have meaningful relationships I have seen many patients who have had multiple treatment failures, actually begin the road to recovery. I have seen them return to their families, school and careers. I’ve seen them marry and begin families or become the parent and spouse they had always hoped to be. I have witnessed those who were hopeless to recover begin to make peace with their bodies for the first time. Their bodies have begin to reward them with renewed energy, strength and vitality. In short they begin to experience an inner peace that wasn’t there before. Life becomes cherished again, or for the first time. This is what real recovery is all about. This is why we fight the fight and do what we do. Saving lives and helping others find the peace of recovery is the most rewarding work I’ve done.