Carolyn Hodges Chaffee, Annika Kahm say testing
is simple and invaluable way to improve patient care.
Carolyn
Hodges Chaffee and Annika Kahm are co-authors of a new book that explains the
importance of using two simple measurement techniques that are invaluable tools
in helping to assess and treat eating disorder patients.
Carolyn,
MS, RDN, CEDRD, the owner and director of Upstate
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| Carolyn Hodges Chaffee |
New York Eating Disorder
Service in Elmira, and Annika, MS, an eating disorder therapist and
nutritionist in private practice in Stamford, Conn., wrote “Measuring Health
From The Inside: Nutrition, Metabolism and Body Composition” to help
clinicians, patients and their families.
“Both
Metabolic Testing and Body Composition Analysis are being used in research, but
very few clinicians are using them to help treat those struggling with an
eating disorder,” said Carolyn, a certified eating disorder specialist. “It is
our hope that by writing this book, clinicians will become more familiar with
the testing and incorporate it as part of their standard of care.”
Body
Composition Analysis, done by electrical impedance, is a measurement of the
body’s lean mass, fat mass, hydration status, and phase angle (which helps
assess how healthy an individual is at the cellular level). The results also
help determine the long-term impact malnutrition has had on the body.
Metabolic
Testing, or indirect calorimetry, is an actual
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| Annika Kahm |
measurement of the body’s
resting energy expenditure. The results are used to accurately assess the
current nutritional status of the patient. The test results show how the body
adapts to being underfed. Metabolic Testing determines how many calories a body
is burning at rest with no activity. It also shows if the body is breaking down
excessive protein stores.
The
book is receiving national attention.
“Carolyn
and Annika bring decades
of
expertise in the care of patients with anorexia, bulimia, binge eating
disorder, and the many related atypical and subsyndromal variants,” said Dr.
Diane Mickley, director of the Wilkins Center for Eating Disorders in
Greenwich, Conn. “Their clinical wisdom, understanding of the experience of sufferers
and those who love them, and understanding of these illnesses and the recovery
process infuse these pages.”
Mary
Ellen Clausen, the founder of Ophelia’s Place, an eating disorder prevention
and advocacy center in Liverpool, N.Y., said “Measuring Health From The Inside”
reveals the truth about our bodies’ needs and invites us to be part of the
healing and recovery process.
“It
is a profound book that will forever change how we see and treat this devastating
disease,” Clausen said.
Dr. Mickley, writing in the Foreword, said “Measuring Health From The
Inside” shines a light on a valuable addition to the treatment of eating
disorders: Metabolic Testing and Body Composition Analysis.
“These are noninvasive assessments with immediate results. The results
show patients numerically and graphically if they have slowed their metabolism
and if they are burning off muscle for lack of fuel. The testing provides
objective data on how many calories the patient needs, as well as what is an
accurate ideal weight.”
Question: Are you and Annika writing the book for treatment professionals?
Carolyn: Yes, but it is also for patients and their family members. The use of
these two tests encourages patients to become a partner in their recovery
process. The more knowledge patients have about why their body responds the way
it does, or why they physically feel the way they do, the easier it is to make
changes in their intake or behaviors. There are educational sections about the
different disorders and behaviors and how to effectively use and apply the
testing in the treatment process. The book opens with chapters on malnutrition
and the eating disorder “voice,” followed by an explanation of the Metabolic
Testing and Body Composition Analysis.
We dedicated chapters to Anorexia Nervosa, Bulimia Nervosa, Binge
Eating Disorder, Compulsive Exercise, and Other Specified Feeding and Eating
Disorders.
We also have chapters explaining healthy eating, treatment protocols,
and how and when to access higher levels of care. We conclude with a look at
why recovery is not a linear process and how patients can sustain long-term
recovery.
Annika: It’s important to have other clinicians on a patient’s treatment team
who are not familiar with Body Composition Analysis and Metabolic Testing
understand why I push for higher weight based on the numbers. So frequently when I work with other clinicians, they
settle for too low discharge weight and let the patient think that that is
their goal weight. This becomes hard for the patient, so the book is needed for
other clinicians on the team to respect, accept and support the patient to
reach a healthy weight goal range.
Question: Why is this book important in
your practice?
Annika: When I see a patient for the
first time, I go over and explain all the numbers from the tests, and make sure
they understand the concept. What frequently happens is that a couple of days
later, they are back to their own (eating disorder) thinking and don’t trust
the concept. With the book, they and their support team can be reassured that
what we initially planned is the right treatment. In other words, with the
book, they can trust the treatment sooner and it becomes a time-saver for the
patient and me as well.
Question: Will patients and their families understand?
Carolyn: We wrote this for everyone affected by eating disorders. It is
written in a way to make it accessible for all readers. We had many editors and
readers help us find the right balance for professionals and non-professionals.
It is our hope that clinicians incorporate the testing as part of
their practice, and patients seek clinicians who use these treatment methods.
Patients and their families need to know there are resources available they may
not be aware of.
Question: Have your patients requested more information about testing?
Annika: Patients frequently struggle with the treatment based on the test results,
especially when they need to eat more in order to, for example, lose weight.
The message may seem counterintuitive and not only they but their
loved ones may question it as well. As an example: “You went to the
nutritionist in order to lose 30 pounds, and she wants you to eat more?” With
the book, they and their loved ones can read why they need to eat more
initially in order to lose weight.
Question: Why did you write this book?
Carolyn:
Colleagues, patients, and family members are
always saying: Why don’t you write a
book? Or they would ask me to suggest a book they can read that will provide
more information about metabolism, malnutrition, and the testing. This book
fills that gap. It helps everyone better understand the how and why the body
works the way it does.
> Go to measuringhealthfromtheinside.com to learn more about the book and read excerpts.
