Any provider in the field of eating disorders recognizes the voice. The caller on the other line sounds tired, frustrated, helpless, hopeless, and in need of a friendly voice.
The story sounds vaguely familiar. A young child, who at first was a picky eater, delves into the world of dieting. The amount of weight loss is significant enough to catch the attention of the parents, the school and the pediatrician. A plan is devised and there is progress until relapse happens. Then the parents’ worst fear becomes reality – outpatient level of care is not enough. They must send their child to an inpatient eating disorder facility. The parents scour the country in search of the best hospital that will offer their child the greatest opportunity to achieve recovery. Cost is not a concern, only the child’s health.
But what happens if the care the child is receiving does not match up with parents’ expectations? What if the old way of treating eating disorders no longer works?
That call I received was a reminder that providers in the field of eating disorders continue to be unwilling to alter current treatment models to better serve our patients. The end results are often an extended treatment stay, higher rate of relapse and an even more discouraged family.
The call in question concerned the use of multivitamins. Those small, chewable or swallowable tablets and capsules that many doctors today encourage children and adults to take regularly, was the tipping point for one family.
After months of self-starvation, a young boy’s medical and emotional health was greatly compromised. After much research his parents sent him to a prestigious and highly reputable medical center in the Midwest to be treated for anorexia nervosa. Once there doctors found that he was deficient in a number of essential vitamins and nutrients. When his parents asked the hospital staff to provide their son with a daily multivitamin they were told No. His nutrients were to come from food only, not through supplements.
Why would a hospital take such a hard stance on what most would consider a relatively harmless request?
Most Americans are not consuming a varied enough diet to meet their vitamin needs through food. The U.S. diet, especially the diet of adolescents, often lacks fruits and vegetables, which contain many vitamins and nutrients. Certain populations likely to be vitamin deficient include pregnant women, the elderly, vegans and patients with malabsorption problems (often patients with eating disorders).
Low vitamin and nutrient intake can be risk factors for diseases. In a scientific review published in the Journal of the American Medical Association, the authors discussed how vitamin deficiency and “suboptimal vitamin status” can be risk factors for chronic diseases such as, cardiovascular disease, neural tube defects, colon and breast cancer, and osteopenia which can lead to increased risk of fractures.
There is little harm associated with taking a multivitamin, as long as it’s taken appropriately. Like any supplement, a multivitamin serves the needs of an individual who lacks proper nutrition. Taking a multivitamin or any supplement helps the body adjust to receiving nutrients and move from a state of deficiency to full health. As the brain becomes well nourished, more stable thought processes occur.
While in an ideal world all individuals would be able to have their nutrient needs met through food, the fact is that in today’s world this is not a possibility for most people. In light of this, it is especially important for a patient battling an eating disorder to be given a multivitamin in addition to food.
Until the eating disorder field recognizes there is no one way to recover and encourages more eclectic treatment plans, calls like the one above will continue.
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