The Role of the Dietitian in Eating Disorder Treatment

Chat Leave a comment April 16, 2018 nutritionadsa

Eating disorders are complex illnesses with both psychological and physical aspects that require treatment. For this reason, over the past few decades, it has become more common for the treatment of people with eating disorders to be managed by multi-disciplinary teams which can deliver the necessary medical, psychological and nutritional help. As society’s foremost expert on nutrition, the dietitian has an important role on the treatment team for a person suffering from an eating disorder, and more opportunities are opening up for dietitians to develop as experts in this role.

Julie Deane-Williams, a registered dietitian and ADSA (Association for Dietetics in South Africa) spokesperson who has a special interest in treating people with eating disorders, points out that in some cases, the dietitian may also be the first port of call for help.

“Even though there are high levels of denial associated with disorders such as anorexia nervosa or bulimia nervosa, the dietitian is often the health care professional on call, especially when it comes to a person struggling with emotional/comfort eating or binge eating disorder. Typically, in the first session, a sufferer, usually female, confides that she is desperate to lose weight; reveals disgust at her body, even if she is within a healthy BMI (Body Mass Index) and feels shame that she has been unable to stick to a diet. The dietitian soon discovers that the emotional eater has tried many different diets. Patients commonly are keenly aware of the energy content of different foods but that doesn’t mean that they know much about nutrition. Often the patient hopes that the dietitian can provide a ‘miracle’ diet that is finally going to help her lose weight and keep it off.”

In combination, these are the warning signs for the dietitian who can recognise the symptoms of disordered eating. It is important that the dietitian doesn’t play into the patient’s scenario but instead helps them to acknowledge disordered eating and address it appropriately.

Deane-Williams makes it clear that the dietitian who works with people with eating disorders needs to acquire particular expertise and skills.

“It is important for the dietitian to understand how the different eating disorders develop and are maintained by patients, as well as to have sound knowledge of the medical, psychological and physiological aspects of the range of eating disorders. In order to play their role effectively on a multi-disciplinary team, they also need to have a general understanding of the mental health issues as well as the various psychological interventions and their applications. It would be an advantage to the dietitian to have expert communication, counselling and behaviour change skills. This is a relatively new role for dietitians, and the complexity of eating disorders demands education and training that goes beyond the minimum required to simply qualify as a registered dietitian.”

The dietitian who works with people with eating disorders plays an important role in the assessment, treatment, monitoring, support and education of the patient. As advocates of evidenced-based science, they serve as important resources of nutrition knowledge for the patient, the patient’s family and the other health care professionals on the treatment team. They need to be skilled at determining a patient’s nutritional status, eating patterns and behaviour, food rules and beliefs. It is the dietitian who takes into account the patient’s meal planning, food shopping and cooking skills. The dietitian works closely with other team members to understand how the patient’s underlying psychological and emotional issues impacts on their eating behaviours, as well as their motivation and capacity for behaviour change. The dietitian will work collaboratively with the patient to develop the nutrition aspect of the treatment plan, and to support the patient and the rest of the team throughout its implementation.

In the light of recent research in the UK that has attributed more deaths to eating disorders than any other psychiatric disease, Deane-Williams urges people with unhealthy relationships with food to seek help sooner rather than later.

“Using food, or the lack of it, to cope with distressing emotions and situations is a maladaptive way of managing life,” she says. “All eating disorders are addictions, and it is the nature of an addiction to further and further alienate a person from their own inner truth. Addictions also usually drastically stunt emotional growth. Once a person accepts that they have an eating disorder, and they seek good medical help, the healing journey is one that is difficult yet immensely rewarding. Not only can they recover, but they find out who they really are – bright and exceptionally intuitive people who had developed a coping mechanism to keep their ‘heads above water’ during extremely challenging times in their lives. Once they develop healthy ways of managing difficult emotions, they can go on to thrive, and create healthy and very happy lives.“

If you think you or a loved one might be struggling with an eating disorder, consider visiting a registered dietitian for expert guidance and advice. If you are looking for a dietitian in your area, please visit www.adsa.org.za

Dietitians urge South Africans to ‘Eat Fact Not Fiction’

Chat 2 Comments June 12, 2017 nutritionadsa

Nutrition advice promising all sorts, from weight loss to healthier living and even cures for diseases, spread like wildfire across social media. In the era of ‘alternative facts’ and post-truth, ‘the latest, greatest nutrition advice’ from dubious sources can unfortunately tempt many away from accepted dietary guidelines and recommendations based on years of evidence.

‘Evidence and Expertise’ is the theme of Dietitian’s Week 2017, highlighting the important role of dietitians who are able to interpret nutrition science and dietary guidelines in order to customise nutrition advice for each individual. This is vital because from weight loss to a disease like diabetes, there is no ‘one size fits all’ best eating plan. Dietitians happen to be health professionals trained and qualified to do this.

Dietitians and Evidence

In the course of earning their degrees in the science of dietetics, dietitians are specifically taught the skills required to interpret scientific evidence. In order to maintain their professional registration with the Health Professions Council of South Africa (HPCSA), all practising SA dietitians also have to undertake ongoing studies that ensure they keep up with the latest knowledge provided by new and emerging evidence, in accordance with the Continuing Professional Development (CPD) programme. This means they have the latest evidence-based food, health and disease expertise at their fingertips – and you won’t find a registered dietitian in the country basing any recommendations on the long outdated food pyramid.

Dietitians and the Food-Based Dietary Guidelines

The country’s broad strokes dietary guidelines, on which public health messages are based, and which were developed according to the process recommended by the Food and Agricultural Organisation of the United Nations (FAO), have also evolved over the years, featuring a notable shift from the emphasis on nutrients to the focus on actual foods, which by nature contain a variety of nutrients. ADSA, the Association for Dietetics in South Africa, provides further clarity on the guidelines with its statement on the Optimal Nutrition for South Africans. The latest visual Food Guide from the Department of Health provides a very different picture from older models such as the Food Pyramid and represents the latest FAO recommendations.

Dietitians and Patients

But the reality remains that diet is highly personal. What we eat is rooted in our culture and tradition, shaped by affordability and accessibility, and inextricably intertwined with highly variable lifestyle factors such as weight, physical activity, emotional connection to food and our consumption of non-food substances, as well as various physiological differences and genetics.

“This is where the dietitian comes to the fore,” says ADSA President and Registered Dietitian, Maryke Gallagher. “If you take a disease such as diabetes, which is a prevalent lifestyle disease in the country, and is a condition that can be managed through diet, each patient needs a tailor-made plan and focused support to make their individualised diet work towards their well-being and health. When the situation demands change around something as fundamental to life as food, then broad strokes are not necessarily sustainable solutions.”

Dietitians and Sustainability

The role that the dietitian can play in helping the communities in which they work to secure healthy food systems that are good for both people and the planet is an emerging responsibility in the profession. Dietitans are increasingly involved in facets of our modern food systems including agriculture and alternative food production methods, natural resources and ecosystems, social justice and community health issues, as well as developing food policy and food systems research that takes sustainability into account.

Dietitians and Diseases

Some may associate dietitians with merely giving advice and support to someone who wants to lose weight, but dietitians work across a range of industries. They are also experts in providing nutritional advice with regard to serious diseases and conditions such as diabetes, heart disease, hypertension, liver disease, kidney disease, cancers, HIV/AIDS, TB, throat, stomach and intestinal disorders, as well as food allergies and intolerances, eating disorders, sports nutrition and life-stage nutrition (including the protection, promotion and support of breastfeeding as the best start in life). Apart from dietitians in private practice, they work in hospitals and communities, academia and industries. In addition to consulting with patients, dietitians are also involved in research, nutrition training and development of provincial and national policies.

Dietitians and Malnutrition

In South Africa, where the health issues that arise from the obesity epidemic stand side by side with those resulting from undernutrition, our dietitians’ work literally spans from one extreme to another. The South African Society for Parenteral and Enteral Nutrition (SASPEN), a supporter of Dietitian’s Week, highlights the essential role the dietitian plays in providing nutritional support to promote optimal nutrition to people in hospitals, where malnutrition is a common cause of the exacerbation of disease, delayed healing and prolonged hospital stays.

The Dietitian and You

It’s clear, that as a country, our need for dietitians is multi-fold, which explains why there’s a lot more than just dietary guidelines on the mind of a registered dietitian. In consultation, your dietitian is going to be taking in many factors unique to you to work towards helping you make optimal food choices. This includes your age and gender; your genetics, body size and body image; your environment, culture, spiritual beliefs and family life; physical activity level, mental well-being and general abilities; your work life and patterns; your budget; food preferences, eating tastes and cooking skills; as well as your existing health conditions and prescribed meds.

In the hopes of steering us clear of the latest trumped up ‘diets’ and promoting a return to genuine expertise and evidence, dietitians countrywide are suggesting that we ‘Eat Facts Not Fiction’.

In collaboration with the British Dietetics Association, Dietitian’s Week is held in SA from 12th to 16th June, with the 2017 theme ‘Evidence and Expertise’.

To find a dietitian in your area, please visit the ADSA website.

 

The facts about ADSA

Chat Leave a comment February 21, 2017 nutritionadsa

Have you ever wondered who ADSA is or why you should become a member? Read on to find out more about what ADSA does and how you can get involved.

The Association for Dietetics in South Africa, or ADSA, is the professional organisation for registered dietitians, and has been committed to serving the interests of dietitians in South Africa for the past 29 years. The Association is made up of a variety of members, from registered dietitians and nutritionists, to community service and student dietitians, international, retired and honorary members.

ADSA’s VISION: To represent and develop the dietetic profession to contribute towards achieving optimal nutrition for all South Africans.

ADSA’s MISSION: As the registered professionals in the field of dietetics and nutrition we support and promote the continued growth of the profession of dietetics in South Africa.

ADSA is a registered not-for-profit organisation (NPO) and unlike counterparts abroad, it is mainly driven by passionate and dedicated volunteers, most of whom are not remunerated for their time and services. The Executive (national) and Branch (provincial) Committee members serve for a 2-year term. Here are some of the many functions and activities the various portfolios are responsible for.

• President: directs, manages and guides the Association, oversees all its activities on a strategic level and builds strategic partnerships
• Communications: coordinates all internal communication with members, via the weekly bulletin and quarterly newsletters, managing ADSA’s website, and ADSA’s inputs into other scientific journals or newsletters, as well as co-ordinating a mentorship programme and bursary fund and being a member of the biannual national nutrition congress organising committee
• Public Relations: handles all aspects related to public relations, including planning and implementing nutrition and health-related awareness days, formulating and publicising statements based on evidence, acting as the official contact person for input into media content, monitoring of nutrition information communicated to the public and creating content to promote the profession in the public space, assisted by a team of spokespeople
• Sponsorship: recruits and manages suitable sponsors in line with ADSA’s updated rigorous sponsorship policy
• Representation: coordinates ADSA representatives on eight different official scientific or government groups or committees, as well as other interest groups, and manages the submission of comments to government on nutrition-related draft legislation
• Private Practicing Dietitians (PPDs): manages all professional issues relating PPDs, including the PPD database, addressing billing practices and providing assistance to PPDs on issues they may experience in private practice
• Continuous Professional Development (CPD): manages the accreditation of CPD events and online activities to create opportunities for continued education and upskilling of dietitians. Each year the 10 ADSA branches across the country are encouraged to host one CPD event per quarter and there has been on average 3 to 4 CPD-accredited events per branch per year. This portfolio also provides dietitians with access to latest scientific evidence, guidelines and resources through PEN.
• Membership: manages membership applications and coordinates member benefits. Liaises with members and non-members to establish needs to enhance membership benefits.
• Public Sector: establishes a support network and line of communication between dietitians in the public sector and ADSA, and communicates relevant developments, such as employer/labour negotiations to ADSA members
• Branch Liaison: acts as the communication link between ADSA branch chairpersons and the national Executive Committee to ensure consistency in operations
• Secretary: assists with organisational tasks for the Executive Committee, such as taking meeting minutes and record keeping
• Chief Operating Officer: part-time employed dietitian to assist with public relations, attend meetings on behalf of ADSA, and assist with other executive portfolios as and when required

The ADSA Executive and Branch Committee portfolio holders strive to meet the needs of the members they serve, by being in constant communication with members. This means that ADSA policy and strategic direction is continuously evolving to meet the changing needs of nutrition professionals in South Africa. Recent significant changes include an updated sponsorship policy, that includes a stricter process of selection and is based on international standards, as well as a review of membership benefits to determine the most appropriate fee structure. ADSA’s Constitution was also recently reviewed and updated to reflect the growth of the nutrition profession.

If you are a registered dietitian, nutritionist with a recognised nutrition degree, community service or student dietitian, we invite you to join us today. As your professional organisation, the more members we have, the stronger our collective voice, and the more we can do to achieve our vision and mission to grow the profession and to promote the nutritional well-being of our country.

To find out more about the benefits of joining ADSA or to find a registered dietitian in your area, visit http://www.adsa.org.za.

ADSA represents registered dietitians working in various spheres of nutrition and dietetics in South Africa

Leave a comment May 18, 2015 nutritionadsa

The Association for Dietetics is the professional organisation for registered dietitians in South Africa. The activities of the organisation are centred around representing and developing the dietetic profession to contribute to optimal nutrition for all South Africans.

Registered Dietitians are qualified health professionals registered with the Health Professions Council of South Africa (HPCSA) who have a minimum qualification of a four year scientific degree with training in all aspects and fields of nutrition and dietetics. Whether they consult privately to one client, work within a community or as part of the food supply chain, they have to adhere to best practice guidelines delivering sound dietary advice based on the latest scientific evidence.

ADSA members nominate and vote for members to serve on branch committees regionally or on the ADSA executive committee nationally, once every two years. These elected members serve on a voluntary basis, in their own time, without remuneration.

All committee members are registered dietitians working in different areas within nutrition and dietetics. The current executive committee has representatives from private practice, academia, government and the food industry.

As an association working in South Africa, we know South Africans eat a wide variety of foods from the entire food supply. We can’t ignore entire sections of the food industry, because they’re part of the daily diet of many South Africans.

We agree that while there are lot of nutritious, high quality foods on the market in South Africa, there’s a lot that can and needs to be improved when it comes to nutritional value and quality of some of foods sold in both the informal and formal food supply.

It’s therefore important that there are registered dietitians working in various sectors within the food industry, to influence changes that will benefit all South Africans.

Furthermore, registered dietitians working within the food industry have numerous important roles such as ensuring that foods are labelled correctly, as well as for ensuring compliance to various nutrition-related regulations, which provides the consumer with the information they require to make informed food purchasing decisions. They are also involved in managing nutrition-related queries about products, including ingredient queries, and can also be involved in corporate wellness programmes within the respective organisations, to name a few of their roles.

ADSA will continue to represent registered dietitians working in various spheres of nutrition and dietetics in South Africa, at all levels of the association, to ensure that the association is able to effectively represent and develop the dietetic profession to contribute to optimal nutrition for all South Africans.