Scoping survey of dietetic resourcing for eating disorders: why is the dietitian’s role marginalised in community eating disorders?

Eating disorders (EDs) like anorexia nervosa (AN) and bulimia nervosa (BN) are conditions characterised by severe and persistent disruptions in eating behaviours. Nutritional rehabilitation is the main goal of many therapies, for example, family therapy for AN, enhanced cognitive–behavioural therapy and the Maudsley Model of AN Treatment for Adults. Dietitians should play an essential role in the multidisciplinary team that treats people with EDs, and dietetic intervention in ED has been associated with improved weight gain.1 Patients and their families often need advice around mealtime management and menu planning, as well as tailored advice on energy input and output. However, McMaster et al 2 reported that ED specialists were less likely than carers and those with lived experience of an ED to endorse dietetic involvement as a standard component of treatment. In particular, ED specialists were less likely to agree that ‘all patients should receive a multi-disciplinary assessment at the start of treatment, including nutritional assessment by a dietitian’ (53% agreed vs 100% with lived experience or caring for a person with an ED) and that ‘all patients diagnosed with an ED should be referred to a dietitian for assessment, education and guidance about nutrition’ (48% vs 87% patients/carers).