PsychEd Episode 37: Treating Eating Disorders with Dr. Randy Staab

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Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This is the second of two episodes covering the topic of eating disorders. In this episode, we explore the treatment of these illnesses with Dr. Randy Staab, a psychiatrist at Trillium Health Partners and medical director of the eating disorders program at Credit Valley Hospital.

The learning objectives for the episode are as follows:

By the end of this episode, you should be able to…

  1. Outline the management of eating disorders using a biopsychosocial framework.
  2. Identify the indications for various levels of care (inpatient, residential, day hospital, outpatient, etc).
  3. Understand the ethical and medicolegal dilemmas (i.e. involuntary treatment) that may arise in treatment of eating disorders.
  4. Consider the treatment of special populations (i.e. children and adolescents, older adults, men, LGBTQ+ individuals).

Guest: Dr. Randolf “Randy” Staab

Hosts: Dr. Lucy Chen, Dr. Nikhita Singhal (PGY3), Dr. Vanessa Aversa (PGY4)

Audio editing by: Dr. Vanessa Aversa

Show notes by: Dr. Vanessa Aversa, Dr. Nikhita Singhal

Interview Content:

  • Introduction - 0:00
  • Learning objectives - 00:39
  • Biological approaches to treatment:
    • Nutritional rehabilitation - 03:47
    • Medications - 06:00
  • Psychological approaches to treatment -16:35
  • Treatment of comorbidities - 23:45
  • Levels of care - 26:00
  • Ethical dilemmas - 32:40
  • Special populations:
    • Children and adolescents - 35:35
    • Older adults - 36:45
    • Men - 37:55
    • LGBTQ+ - 40:23
  • Novel interventions - 42:48
  • Closing - 51:47

Resources:

  • The National Eating Disorder Information Centre (NEDIC) provides information, resources, referrals and support to Canadians affected by eating disorders: https://nedic.ca.
  • The National initiative for Eating Disorders (NIED) provides access to educational, informational, and other recovery-oriented resources related to eating disorder prevention and treatment: https://nied.ca.
  • Body Brave provides accessible eating disorder treatment and support, as well as community training and education: https://bodybrave.ca.

References:

  • American Psychiatric Association. Feeding and eating disorders. In Diagnostic and statistical manual of mental disorders. 5th ed. https://doi.org/10.1176/appi.books.9780890425596.dsm10
  • Gaudiani J. Sick Enough: A Guide to the Medical Complications of Eating Disorders. New York, NY: Routledge; 2019.
  • Mehler PS, Andersen AE. Eating Disorders: A Guide to Medical Care and Complications. 3rd ed. Baltimore, MD: Johns Hopkins University Press; 2017.
  • American Psychiatric Association. Practice Guideline for the Treatment of Patients with Eating Disorders. 3rd ed. 2006.
  • Geller J, Isserlin L, Seale E, et al. The short treatment allocation tool for eating disorders: current practices in assigning patients to level of care. J Eat Disord. 2018;6(45). https://doi.org/10.1186/s40337-018-0230-2
  • McClain Z, Peebles R. Body image and eating disorders among lesbian, gay, bisexual, and transgender youth. Pediatr Clin North Am. 2016 December; 63(6):1079–1090. https://doi.org/10.1016/j.pcl.2016.07.008
  • Mangweth-Matzek B, Hoek HW, Rupp CI, Lackner-Seifert K, Frey N, Whitworth AB, Pope HG, Kinzl J. Prevalence of eating disorders in middle-aged women. Int J Eat Disord. 2014 April; 47(3):320–324. https://doi.org/10.1002/eat.22232
  • Treasure J, Claudino AM, Zucker N. Eating disorders. Lancet. 2010;375(9714):583–593. https://doi.org/10.1016/S0140-6736(09)61748-7
  • Smink FR, van Hoeken D, Hoek HW. Epidemiology, course, and outcome of eating disorders. Curr Opin Psychiatry. 2013;26(6):543‐548. https://doi.org/10.1097/yco.0b013e328365a24f

CPA Note: The views expressed in this podcast do not necessarily reflect those of the Canadian Psychiatric Association.

For more PsychEd, follow us on Twitter (@psychedpodcast), Facebook (PsychEd Podcast), and Instagram (@psyched.podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

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