1st Edition
Sick Enough A Guide to the Medical Complications of Eating Disorders
Patients with eating disorders frequently feel that they aren’t "sick enough" to merit treatment, despite medical problems that are both measurable and unmeasurable. They may struggle to accept rest, nutrition, and a team to help them move towards recovery. Sick Enough offers patients, their families, and clinicians a comprehensive, accessible review of the medical issues that arise from eating disorders by bringing relatable case presentations and a scientifically sound, engaging style to the topic. Using metaphor and patient-centered language, Dr. Gaudiani aims to improve medical diagnosis and treatment, motivate recovery, and validate the lived experiences of individuals of all body shapes and sizes, while firmly rejecting dieting culture.
Table of Contents
Acknowledgements
Introduction
Part One: Not Enough Calories
Chapter 1: 30,000 Foot View: What Happens When You Starve Yourself?
Box: The "Perfect Child"
Chapter 2: Going Into Hibernation
Box: The House on Fire, a.k.a. Combatting "I’m Fine"
Chapter 3: Hormones and Bones
Box: Exercise During Recovery
Chapter 4: The Empty Tank
Box: The Subterranean Aquifer, Checklists, and Reframing Expectations
Chapter 5: Extreme Presentations
Box: The Parables of The Fortress and the Nuclear Wasteland and The Perfectionist and the Appreciative Achiever
Chapter 6: Starting to Eat Again
Box: The Balloon Metaphor and "Fear Foods"
Part Two: Purging
Chapter 7: 30,000-Foot View: What is Purging? Why Does it Cause Medical Issues?
Box: The Two-Sided Coin
Chapter 8: How Does Purging Physically Affect the Body?
Box: Comparing Yourself to Your Sickest Day
Chapter 9: Electrolytes and Stopping Purging
Box: The Sponge Metaphor and Finding Self-Compassion
Part Three: Patients in Larger Bodies
Chapter 10: Binge Eating Disorder (BED) and Weight Stigma
Box: Naming Privilege and Challenging the Narrative
Part Four: The Unmeasurables (a.k.a. The Very Real Medical Problems that Modern Medicine Can’t Measure)
Chapter 11: Irritable Bowel Syndrome (IBS) and Associated Conditions
Box: The Dog in the Street
Chapter 12: Postural Orthostatic Tachycardia Syndrome (POTS) and Associated Conditions
Box: Bearing Witness
Part Five: Special Populations
Chapter 13: Type 1 Diabetes Mellitus and Concurrent Eating Disorders (ED-DMT1)
Chapter 14: Avoidant Restrictive Food Intake Disorder (ARFID)
Chapter 15: Orthorexia and Food Intolerances
Chapter 16: Elite Athletes
Chapter 17: Male Patients
Chapter 18: Gender and Sexual Minorities
Chapter 19: Women’s Sexual and Reproductive Health
Chapter 20: Older Patients
Chapter 21: Substance Use Disorder
Chapter 22: Caring for the Patient Who Declines Treatment: The Spectrum from Mandated Treatment to Hospice Care
Figure 1: Flow Chart for the Patient Declining Recommended Treatment
Conclusion: How We Can Each Make a Positive Contribution
Index
Biography
Jennifer L. Gaudiani, MD, CEDS, FAED is a Board-Certified internal medicine physician, known nationally and internationally for her work on the medical complications of eating disorders. Her outpatient medical practice, the Gaudiani Clinic, cares for individuals of all genders, shapes, and sizes, from around the United States.
