University health professionals coordinate care through an eating disorder team

For more than 15 years, members of the medical, psychiatric, psychological, and nutritional departments of Michigan State University Health Services have worked together as an eating disorder team to coordinate multidisciplinary recovery care.

The current eating disorder team consists of a physician, physician, nurse, nutritionists, psychologist, psychiatrist and social worker. Olin Health Center physician Julia Popenoe said the team works primarily for the providers.

“Our team is really about providers coordinating their care,” Popenoe said. “If a student is seeing multiple different providers in different disciplines, there can be some communication.”

Because eating disorders are mental health disorders with significant health components, having a multidisciplinary treatment plan is essential to recovery, Popenoe said.

Ann Buffington, a registered dietitian and nutrition program coordinator at the university, said providers work together in a client-centered effort to address the complexity of eating disorders.

“(Eating disorders) are complex psychological conditions, so there’s no single cause,” Buffington said. “(Recovery) involves a support system from a team of multidisciplinary providers because eating disorders affect people medically, nutritionally, psychologically and sometimes psychiatrically.”

The team enables coordinated care for students with eating disorders, regardless of how they initially sought help. With so many facets of care needed, students can enter recovery through a variety of pathways.

Popenoe said she often has students come to her with health concerns such as fatigue, hair loss or feeling cold. After talking more with these students, she determined that the worries were symptoms of a disordered relationship with food.

In those cases, she said MSU’s program is helpful for students who are beginning to recover because they can focus on resolving their initial health issues.

Senior Dietitian and Spartans Empower Body Acceptance President Paige Helfen said that while she hasn’t heard of anyone recovering this way, she would guess it could be beneficial to the recovery process.

“I feel like it would almost make for a faster recovery because you go into it wanting your physical symptoms to get better and you haven’t even noticed the psychological symptoms that are causing your eating disorder,” Helfen said. “So I feel like keeping an open mind in that scenario is almost more helpful.”

Hair loss, extreme fatigue, and feeling cold are just some of the common physical symptoms of eating disorders. Physical symptoms can also include weight loss, mood swings and loss of menstrual periods, Popenoe said.

Eating disorders also include a range of behavioral symptoms such as restricting food, binge eating, purging and compulsive exercise, Buffington said. Buffington said understanding these behaviors as symptoms of a condition is important in combating the stigma surrounding eating disorders.

“(Eating) disorders are often misunderstood (as) someone’s choice, but they’re not,” Buffington said. “You would never say that someone chooses to have depression or someone chooses to have anxiety, right? So they revert back to this kind of psychiatric, psychological condition. These are just behaviors that are symptoms of the condition.”

It’s often difficult for people struggling with the psychological aspects of an eating disorder to recognize their eating behavior as problematic, Buffington said. This resistance can make it difficult for anyone trying to help and support a loved one they care about.

In cases like this, Buffington said it’s important to express concerns with specific “I statements.” She also said people need to remind themselves that it’s not their job to be the medical provider.

“Their role is not to be their friend’s nutritionist or their friend’s medical professional or their friend’s therapist, but just to be friends,” Buffington said. “It can become very distressing for the friend or loved one to take some level of responsibility for that person’s behavior that they really shouldn’t.”

Helfen suggested encouraging positive behavior and joining a friend you may be concerned about in positive activities.

“One of my favorite comments is just the suggestion that we go together,” Helfen said. “If you notice someone not eating, invite them to the dining room with you or just be inclusive.”

Students can access eating disorder care through a variety of pathways depending on where they feel most comfortable starting, Buffington said. Students can schedule an intake appointment through MSU Counseling and Psychiatric Services, a nutritional counseling appointment through Student Health and Wellness, or an appointment with a medical provider through Campus Health Services.

“(Some) people hate going to the doctor and would rather maybe see a nutritionist or maybe see a therapist as the first thing they’re going to do, and that’s fine too,” Popenoe said. “That’s the nice thing, just whatever looks more comfortable is good to start with.”