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University health professionals coordinate care through eating disorder team

October 29, 2023
The eating disorder team poses for a photo in front of Olin Health Center on Oct. 27, 2023.
The eating disorder team poses for a photo in front of Olin Health Center on Oct. 27, 2023.

For over 15 years, members of the medical, psychiatric, psychological and nutrition 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 is made up of a medical doctor, a physician, a nurse practitioner, dieticians, a psychologist, a psychiatrist and a social worker. Olin Health Center Physician Julia Popenoe said the team functions primarily for the providers.

"Our team is really for the providers to coordinate 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.

Registered dietician and university nutrition program coordinator Anne Buffington said providers work together with a client-centered effort to tackle the complexity of eating disorders.

"(Eating disorders) are complex psychological conditions, so there's no one single cause," Buffington said. "(Recovery) includes a support system from a team of multidisciplinary providers because eating disorders do impact individuals from a medical perspective, from a nutrition perspective, from a psychological perspective and sometimes a psychiatric perspective."

The team allows for coordinated care for students suffering from eating disorders regardless of how they originally sought out help. With so many aspects of needed care, students can enter recovery through multiple avenues.

Popenoe said she often has students reach out with health concerns like fatigue, hair loss or feeling cold. After talking more with these students, she determines the concerns are symptoms of a disordered relationship with food.

In these cases, she said MSU's program is helpful for the student entering recovery because they are able to focus on resolving their original health concerns.

Dietetic senior and president of Spartans Empower Body Acceptance Paige Helfen said although she hasn’t heard of anyone entering recovery in this way, she would guess it might be beneficial to the recovery process.

"I feel like it would almost make for a quicker recovery because you're going into it wanting your physical symptoms to get better, and didn't even notice the psychological symptoms that were causing your eating disorder," Helfen said. "So I feel like having an open mind in that scenario is almost more beneficial."

Hair loss, extreme fatigue and feeling cold are just a few of the common physical symptoms of eating disorders. Physical symptoms can also include weight loss, mood changes and a loss of menstrual period, Popenoe said.

Eating disorders also include a number of behavioral symptoms like food restriction, binging, 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 being) somebody's choice, but no," Buffington said. "You would never say somebody chooses to have depression or somebody chooses to have anxiety, right? So they are again, going back to that kind of psychiatric, psychological condition. These are just behaviors that are symptoms of the condition."

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

In cases like this, Buffington said it is important to express concerns with specific "I statements." She also said people should remind themselves that it is not their job to be the medical provider.

"Their role is not to be the dietician for their friend or a medical provider for their friend or a therapist for their friend but just to be a friend," Buffington said. "It can become very distressing for the friend or loved one to take on some level of responsibility for this person's behaviors that really they shouldn’t."

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

"One of my favorite comments is just suggesting to go together," Helfen said. "If you notice somebody's not eating, invite them to the dining hall with you or just kind of be inclusive."

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

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"(Some) people hate to go to the doctor and would much prefer to maybe see the 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, is just whichever seems more comfortable is fine to start with."

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