Page 17 - Today's Dietitian (February 2020)

• Don’t use scare tactics. In the vein is it in the best interest of the patient for they work with patients, RDs need to “be
of language to avoid, both Setnick and me to refer them out of my care?’” on the constant lookout for misunder-
Weiner vehemently disagree with using Setnick says that a strong working standing” about diabetes, food, insulin,
scare tactics such as telling patients relationship with a patient and family and other aspects of disease manage-
the worst possible complications. Set- sometimes can be equally or more ment. At diagnosis, let families know not
nick says scare tactics are harmful for important than eating disorder exper- only what highs and lows feel like but
any patient—those with type 1 diabetes, tise, but if your discomfort or uncer- that they may experience fear, defeat,
eating disorders, and beyond—but they’re tainty hampers your ability to provide and other “emotional complications.”
especially damaging to patients who nutrition care, it’s better to refer the Setnick tells new patients, “‘Some people
already suffer from depression or anxiety. patient to an expert who can then con- might have a temptation to give up and
“For example, if [a patient] is anxious, sult with you or other members of say this is too hard, and if you start to
telling them, ‘If you do this wrong, you the patient’s diabetes care team. (She feel that way, please let me know. Some
could die,’ will just make them more anx- doesn’t recommend a patient work con- people start to feel like they have to shut
ious. If [a patient] is depressed, telling currently with two different RDs.) If a their whole life down in order to take
them [the same thing] might make them patient’s eating issues have progressed care of this, and if you start to feel like
say, ‘Well, it’s all over anyway, so I might beyond outpatient management, an that, please let me know.’
as well give up.’ Everyone interprets evaluation for an eating disorder pro- “I think if we can prepare someone for
information through their own lens, and gram may be more helpful than general the potential extremes of what they might
you don’t know how the person is going medical or psychiatric hospitalization. experience, we can help them feel not as
to take that information,” she says. Weiner recommends the eating disor- shameful or shocked if and when it does
• Know when to seek help and make der treatment center Melrose Center, happen,” she continues. “And even more
referrals. While Setnick believes all with locations throughout Minnesota, importantly, they’ll know where to turn.”
RDs should have a toolbox equipped to which boasts a program specifically
help patients with dysfunctional eating for ED-DMT1. As of early 2020, Alsana, Hadley Turner is associate editor of Today’s
behaviors, she says, “If you feel like which comprises five eating recovery Dietitian and RDLounge.com, the blog
you’re out of your league, call an eating centers in California, Missouri, and written for RDs by RDs.
disorder RD for a professional consulta- Alabama, offers a treatment plan for
tion. Your main question is essentially, ED-DMT1 patients as well. For references, view this article on our
‘Can I provide what this patient needs Setnick reminds RDs there’s no “once- website at www.TodaysDietitian.com.
with some coaching from an expert? Or and-done” screening for ED-DMT1. As