NEDC e-Bulletin

Editor’s Note

In our work and training across the country, the National Eating Disorders Collaboration has seen an increasing interest in the topic of eating disorders and co-occurring diabetes. In this edition, we take a look at this significant comorbidity. We discuss the importance of screening and assessment within this high-risk group and explore the resources available to support professionals working in this space.

Additionally, as we welcome the commencement of a new funding and activity period for the NEDC, we look back on the achievements of the past activity period. Highlights have included building the foundations to strengthen our workforce, increasing knowledge of eating disorders, improving treatment access pathways across primary health networks, and continued engagement with NEDC’s stakeholder group and membership base.

We look forward to equally important activities in the coming period. A significant focus will be supporting the eating disorders sector and primary health networks alongside the introduction of the new Medicare item for eating disorders.

If you are interested in collaborating with the NEDC, we encourage you to join and become an NEDC member. 

Contents

1. Feature Article: Comorbid diabetes and eating disorders 

2. Discussing comorbid diabetes and eating disorders in practice.

3. Looking Back: NEDC Achievements in 2018 – 2019

4. ANZAED Conference 2019

5. Save the Date: NEDC Members' Meeting 2020

6. Training, Workshops and Professional Development

Diabetes and Eating Disorders – What does this look like?

In 2015, 16,400 Australians lost their lives to diabetes, with over half of these deaths caused by Type 2 Diabetes Mellitus (T2DM) (Australian Institute of Health and Welfare, 2018).

Prevalence of diabetes is increasing, worldwide. Over 400 million people are now living with T2DM (Abbott S, Dindol N, 2007). In Australia, there were around 41,800 new cases of Type 1 Diabetes Mellitus (T1DM) diagnosed between 2000 and 2016, equalling around 2,500 new cases of T1DM each year—an average of seven new cases per day (Australian Government Institute of Health and Welfare, 2018).
Typically, eating disorders develop after a diagnosis of Type 1 Diabetes, and before diagnosis of Type 2 diabetes (Gagnon, Aimé, & Bélanger, 2017). Factors that influence the development of an eating disorder differ based on the diabetes diagnosis, body mass index, coping styles and depressive symptoms experienced by an individual (Gagnon et al., 2017).

What is the relationship between eating disorders, type 1 and type 2 diabetes?

The onset of T1DM occurs most frequently in people under 30 years, a high-risk age group for eating disorders (Diabetes Australia, 2015). Further, young adults with diabetes are at higher risk of developing an eating disorder, particularly bulimia nervosa and binge eating, compared with their peers without diabetes. Research indicates that anorexia nervosa, binge eating disorder (BED), bulimia nervosa and EDNOS are common in individuals with T1DM, while BED, night eating syndrome (NES) and EDNOS also occur in individuals with T2DM (PEN: Practice-based Evidence in Nutrition, 2018).

Type 1 diabetes and eating disorders

Women with T1DM have close to 2.5 times the risk of developing an eating disorder compared to women without T1DM (Goebel-fabbri, Copeland, Touyz, & Hay, 2019) and the risk of a young adult with T1DM developing an eating disorder is double that of the general population (Hart, Twigg, Abraham, & Russell, 2005). 

It is important to note that not all cases meet the full diagnostic criteria for an eating disorder. The most common eating disorders found in individuals with T1DM are bulimia nervosa and Eating Disorders Not Otherwise Specified (EDNOS) (Hart et al., 2005).

The monitoring and management of T1DM requires specific attention to insulin replacement through lifelong insulin injections (up to 6 every day) or the use of an insulin pump; the monitoring of blood glucose levels up to 6 times every day; and adherence to a healthy diet and eating and exercise plan (Diabetes Australia, 2015).

Insulin treatment may be associated with weight gain (Torjesen, 2019). In an attempt to adequately manage the condition, the individual can experience emotional distress with an emphasis on weight, shape and dietary constraint. These concerns typically increase from adolescence to adulthood (Moskovich et al., 2019; Rydall, Rodin, Olmsted, Devenyi, & Daneman, 1997). The additional pressure of diabetes management places the individual at risk of developing disordered eating behaviours such as binge eating, dietary restriction and compensatory behaviours, which include the unique capacity to restrict insulin for weight control. These behaviours are associated with poor metabolic control and serious health complications (Moskovich et al., 2019).

Up to 45–80% of young women with T1DM report binge eating behaviour (Colton, Olmsted, Daneman, Rydall, & Rodin, 2004) (Bryden et al., 1999). Additionally, a longitudinal study assessing women over 11 years, with a diagnosis of T1DM, demonstrated that insulin omission for weight control was a very common problem. This study highlighted a persistence in frequency of insulin omission over the 11 year period, which correlated with higher rates of diabetes-related medical complications and tripled the risk of mortality (Colton et al., 2015). 

The concept of insulin restriction, underdosing or omitting is a unique purging behaviour available to individuals living with T1DM and is referred to as ‘Diabulimia’. The term specifically refers to an eating disorder in a person with diabetes, typically T1DM, where the individual purposefully restricts insulin to lose weight (National Eating Disorders Association, 2018). 

Twenty to forty per cent of young adults with T1DM are estimated to turn to insulin restriction or omission to manipulate their body weight (Reuters Health Information, 2019). The act of deliberately underdosing or omitting insulin induces hyperglycaemia and loss of glucose in the urine; contributes to poorer metabolic control and an increased risk of a range of short term and long term diabetes-related medical complications. These complications include abnormal lipid profiles, diabetic ketoacidosis, retinopathy, neuropathy, nephropathy and a higher than expected mortality rate (Colton et al., 2015). 

Although weight control is cited as one of the main reasons for omitting insulin (Colton, Rodin, Bergenstal, & Parkin, 2009), other motivating factors include fear of hypoglycaemia, denial of having diabetes, embarrassment about blood glucose testing and insulin administration, exhaustion from diabetes management, fear of needles and secondary weight gain. These overwhelming feelings can create depressive symptoms that have been identified as predictive factors for comorbid conditions in individuals with T1DM (Gagnon et al., 2017), with depression and anxiety the most common psychiatric illnesses accompanying an eating disorder (O’Brien & Vincent, 2003).

Type 2 diabetes (T2DM) and eating disorders 

Prevalence of T2DM is increasing worldwide and is linked to high body weight, diet and food consumption. A diagnosis of T2DM does not increase the likelihood of developing an eating disorder, but the relationship between T2DM and high body weight means that eating disorders such as BED are more likely to be found in individuals living with T2DM (Colton et al., 2009). Current research does not demonstrate the exact relationship between T2DM and eating disorders (Colton et al., 2009), however, in most cases of eating disorders comorbid with T2DM the eating disorder appears first (Gagnon et al., 2017).

Night eating syndrome (NES) is characterised by the consumption of >25% of daily caloric intake after the evening meal and waking at night to eat at least three times per week. The association between binge eating disorder (BED), NES, and co-occurring T2DM (Colton et al., 2009) relates to a weight-gain effect, attributable to food-restriction behaviours in people who binge eat. Restrictive eating increases the risk of binge eating, which when combined with a lack of exercise and no other compensatory behaviour, increases BMI and consequently, the onset of T2DM (Davison, 2003).

Research suggests that individuals with BED are at three to six times greater risk of developing obesity (Kessler et al., 2013; Abbott S, Dindol N, 2007). Additionally, NES is seen in individuals with T2DM and depressive symptoms. Health outcomes related to NES include weight gain, poor glycaemic control and an increased number of diabetes complications (Morse, Ciechanowski, Katon, & Hirsch, 2006). Health complications associated with BED and NES in T2DM can be attributed to the large consumption of food/calories consumed over a short time, followed by the prolonged fasting. This behaviour alters the blood glucose levels (glycaemic variability) of individuals living with T2DM, causing increased vascular disease, and short and long term diabetes complications. As the prevention and management of high body weight is thought to reduce the prevalence of T2DM, research suggests that the treatment and management of BED and NES should be considered in the management of T2DM (Abbott S, Dindol N, 2007).

What are the signs that tell us an eating disorder may be present?

It may be difficult to identify an eating disorder in an individual living with diabetes. A patient may show no signs of eating pathology while concealing an entrenched eating disorder (Hart et al., 2005).

It is important that first-line health practitioners are able to recognise the signs and symptoms of comorbid diabetes and eating disorders, which may be marked by overall ill health. These include (National Eating Disorders Association, 2018; Hart et al., 2005):

• Unexplained high HBA1C
• Unexplained blood glucose levels.
• Repeat Diabetic Ketoacidosis admissions
• Menstruation disruption
• Chaotic eating behaviour
• Increased infections
• Hyperglycaemia or Hypoglycaemia
• Proteinuria
• Polyuria
• Electrolyte Disturbances
• Diabetic Ketoacidosis
• Frequent or excessive urination, thirst or hunger
• Muscle Atrophy
• Organ damage 
• Nerve damage
• Retinopathy and Macular Edema

Signs and symptoms may vary with the disordered eating and compensatory behaviours that an individual is experiencing. For example, diabetes complicated by anorexia may be associated with electrolyte imbalances, while individuals experiencing bulimia nervosa or BED may be associated with hypertension.

For an individual that may be in the early stages of an eating disorder, the signs and symptoms associated with diabetes-related health complications may not be present. Therefore, it is important to ask the right questions, using diabetes-specific tools to screen for eating disorders in individuals with diabetes (Markowitz et al., 2010).

Generic eating disorder screening tools may misrepresent the prevalence of eating disorders in individuals with comorbid T1DM as they do not account for the strict dietary monitoring that forms part of an individual’s diabetes management. Similarly, such tools do not address the use or misuse of insulin by individuals living with diabetes (Wisting, Wonderlich, Skrivarhaug, Dahl-Jorgensen, & Ro, 2019).

The Diabetes Eating Problem Survey – Revised (DEPS-R), is the first screening tool for disordered eating that has been specifically designed for diabetes and its psychometric properties (Wisting et al., 2019). It is a short, 16-item, diabetes-specific, self-report measure of disordered eating, which can be completed in less than 10 minutes.

Additional research has suggested the use of the modified SCOFF eating disorder screening questionnaire (mSCOFF) (Zuijdwijk et al., 2014). In this instance, the final question within the SCOFF questionnaire is modified to include a simple question that relates to insulin intake.

What does treatment look like?

The treatment of comorbid diabetes and eating disorders is complex and it can be difficult to engage patients in treatment (Hart et al., 2005).

Standard treatment requires addressing the medical, nutritional and psychological issues through a coordinated, consistent, multi-disciplinary approach. This approach should include a diabetes specialist, physician, diabetes educator, a dietitian with experience in eating disorders and/or diabetes, a mental health professional and psychiatrist (PENN Canada, 2018).

The initial goal of treatment is to establish medical safety for all patients, with a focus on the prevention of diabetic ketoacidosis in individuals experiencing recurrent insulin restriction and hyperglycaemia, (Goebel-Fabbri et al., 2009). Once patients have been medically stabilised, eating disorder symptoms should be addressed before the implementation of optimal diabetes management (Goebel-Fabbri et al., 2009). Customising treatment goals based on eating disorder diagnosis and symptom severity and presentation is essential in achieving optimal health outcomes for the individual living with diabetes (Goebel-Fabbri et al., 2009).

The National Institute for Health and Care Excellence UK (NICE) Guidelines reiterate the importance of a multi-disciplinary, shared-care approach to the treatment and management of an eating disorder comorbid with diabetes. The guidelines provide recommendations for the management and treatment of eating disorders in individuals living with comorbid diabetes and may be accessed online (National Institute for Health and Care Excellence, 2017). NICE also provide the NICE Pathways interactive tool titled "Managing comorbid health problems in people with eating disorders".

Resources for health professionals

Due to the complexity of diabetes management, the signs and symptoms of an eating disorder complicated by diabetes may go undetected and in turn, untreated. As a health professional, it is important to be aware of these signs and symptoms and to confidently screen and assess individuals living with diabetes. At this point in time there is not one specific resource dedicated to the treatment and management of eating disorders complicated by diabetes within Australia. However, the following resources provide support for health professionals working with individuals experiencing disordered eating and living with diabetes, individuals caring for someone with diabetes or for persons living with diabetes.

Read

• The Australia Government’s National Diabetes Service Scheme (NDSS) provides the Diabetes and Eating Disorders Fact Sheet that is available online to download and print.
• The Australian Diabetes Society provides the National Evidence-Based Clinical Care Guidelines for Type 1 Diabetes in Children, Adolescents and Adults. These guidelines address psychological health in type 1 diabetes, including eating disorders and can be accessed online.
• Eating Disorders Victoria Eating Disorders and Diabetes Fact Sheet
• Diabetes UK provides the Diabetes UK: Diabetes and emotional health - a practical guide for healthcare professionals supporting adults with Type 1 and Type 2 diabetes Chapter 8 – Eating Problems resource. This resource provides an informative overview of diabetes comorbid with an eating disorder or disturbed eating behaviours.
• Doctor Ann Goebel-Fabbri, PhD, has written and published the book “Prevention and Recovery from Eating Disorders in Type 1 Diabetes: Injecting Hope”. Reviewed by NEDC Chair, Phillipa Hay in the Journal of Eating Disorders, each chapter of the book takes a phase of people’s journeys from prevention, through seeking treatment and barriers, treatment experience, and life after treatment, including a chapter for people who continue to have eating disorder symptoms (Hay, 2019). Professor Phillipa Hay suggests the book is relevant for all clinicians working in either area, eating disorders or T1DM (Hay, 2019).
• The Journal of Eating Disorders Thematic Series on Diabetes and Eating Disorders contains research articles exploring T1DM and T2DM and eating disorders.
• The Journal of Practical Diabetes (2005) published a paper titled ‘The practical management of patients with type 1 diabetes requiring in-patient care due to an eating disorder.’  This Practice Point provides an informative discussion about the clinical experiences of managing T1DM patients at an in-patient level.
• The Diabetes Canada Clinical Practice Guidelines provides information related to the management of diabetes comorbid with mental health conditions including eating disorders.
• PEN: Practice-Based Evidence in Nutrition - The Global Resource for Nutrition Practice provides the Diabetes – Eating Disorders resource. This resource provides a background summary of recommendations and evidence about eating disorders comorbid with diabetes. This resource is accessible via limited free access or through a paid subscription. You must sign up to access this resource.
• Diabetes and Eating Disorder Awareness New Zealand provide information and links to external resources that are of benefit to health professionals practising in both Australia and New Zealand.
• American National Eating Disorders Association has produced the following information about “Diabulimia”. This page offers general information about the signs, symptoms and health consequences of diabulimia. The page also outlines suggested options for treatment.

Watch

Diabetes UK online provides information about ‘Diabulimia’, including an informative video interview with Specialist in Diabetes and Mental Health, Professor Khalida Ismail, Professor of Psychiatry and Medicine and Honorary Consultant Psychiatrist in Diabetes at King's College London.

Listen

Diabetes NSW and ACT provide education in the form of programs, information and support to people living with or at risk of diabetes, their families, friend and carers. An informative podcast is available online that discusses diabetes and eating disorders, ‘Diabulimia’ and the intentional misuse of insulin for weight control. The podcast was produced with Doctor Lisa Robins, a clinical physiologist and Kate Alison, accredited practising dietitian at Diabetes NSW and ACT.

For additional information or to find professional support in your state please visit the Supports and Services section of the NEDC website.

For immediate support or advice about referral pathways please contact the Butterfly National Helpline on 1800 33 4673.

References

Abbott S, Dindol N, T. A. and P. M. (2007). Binge eating disorder and night eating syndrome in adults with type 2 diabetes. Obesity, 15(5), 1287–1293. Retrieved from http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed8&NEWS=N&AN=17495205

Australian Government Institute of Health and Welfare. (2018). Diabetes Snapshot. Retrieved August 2, 2019, from https://www.aihw.gov.au/reports/diabetes/diabetes-snapshot/contents/how-many-australians-have-diabetes

Bryden, K. S., Neil, A., Mayou, R. A., Peveler, R. C., Fairburn, C. G., & Dunger, D. B. (1999). Eating habits, body weight, and insulin misuse. A longitudinal study of teenagers and young adults with type 1 diabetes. Diabetes Care, 22(12), 1956–1960. https://doi.org/10.2337/diacare.22.12.1956

Colton, P., Olmsted, M., Daneman, D., Rydall, A., & Rodin, G. (2004). Disturbed eating behaviour and eating disorders in preteen and early teenage girls with type 1 diabetes: a case-controlled study. Diabetes Care, 27(7), 1654–1659. https://doi.org/10.2337/diacare.27.7.1654

Colton, P., Rodin, G., Bergenstal, R., & Parkin, C. (2009). Eating disorders and diabetes: Introduction and overview. Diabetes Spectrum, 22(3), 138–142. https://doi.org/10.2337/diaspect.22.3.138

Davison, K. (2003). Eating Disorders and Diabetes: Current Perspectives. Canadian Journal of Diabetes.

Diabetes Australia. (2015). Type 1 diabetes. Retrieved August 28, 2019, from https://www.diabetesaustralia.com.au/type-1-diabetes

Diabulimia | National Eating Disorders Association. (2018). Retrieved September 17, 2019, from https://www.nationaleatingdisorders.org/diabulimia-5

Gagnon, C., Aimé, A., & Bélanger, C. (2017). Predictors of Comorbid Eating Disorders and Diabetes in People with Type 1 and Type 2 Diabetes. Canadian Journal of Diabetes, 41(1), 52–57. https://doi.org/10.1016/j.jcjd.2016.06.005

Goebel-fabbri, A., Copeland, P., Touyz, S., & Hay, P. (2019). EDITORIAL : Eating disorders in diabetes : Discussion on issues relevant to type 1 diabetes and an overview of the Journal ’ s special issue, 0, 7–9.

Goebel-Fabbri, A. E., Uplinger, N., Gerken, S., Mangham, D., Criego, A., & Parkin, C. (2009). Outpatient management of eating disorders in type 1 diabetes. Diabetes Spectrum, 22(3), 147–152. https://doi.org/10.2337/diaspect.22.3.147

Hart, S., Twigg, S., Abraham, S., & Russell, J. (2005). The practical management of patients with type 1 diabetes requiring in-patient care due to an eating disorder. Practical Diabetes International, 22(5), 165–170. https://doi.org/10.1002/pdi.799

Hay, P. (2019). Book Review: Prevention and Recovery from Eating Disorders in Type 1Diabetes: Injecting Hope. Journal of Eating Disorders, 7(1), 1–2. https://doi.org/10.1186/s40337-019-0233-7

Kessler, R. C., Berglund, P. A., Chiu, W. T., Deitz, A. C., Hudson, J. I., Shahly, V., … Xavier, M. (2013). The Prevalence and Correlates of Binge Eating Disorder in the World Health Organization World Mental Health Surveys. Biological Psychiatry, 73(9), 904–914. https://doi.org/10.1016/j.biopsych.2012.11.020

Moskovich, A. A., Dmitrieva, N. O., Babyak, M. A., Smith, P. J., Honeycutt, L. K., Mooney, J., & Merwin, R. M. (2019). Real-time predictors and consequences of binge eating among adults with type 1 diabetes. Journal of Eating Disorders, 7(1), 1–9. https://doi.org/10.1186/s40337-019-0237-3

National Eating Disorders Association. (2018). Diabulimia | National Eating Disorders Association. Retrieved from https://www.nationaleatingdisorders.org/diabulimia-5

National Institute for Health and Care Excellence. (2017). Recommendations | Eating disorders: recognition and treatment | Guidance | NICE. United Kingdom: National Institute for Health and Care excellence. Retrieved from https://www.nice.org.uk/guidance/ng69/chapter/Recommendations#physical-and-mental-health-comorbidities

O’Brien, K. M., & Vincent, N. K. (2003). Psychiatric comorbidity in anorexia and bulimia nervosa: nature, prevalence, and causal relationships. Clinical Psychology Review, 23(1), 57–74. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12559994

PEN: Practice-based Evidence in Nutrition. (2018). Diabetes - Eating Disorders. Retrieved from https://www.pennutrition.com/KnowledgePathway.aspx?kpid=4247&trcatid=38&trid=4235

Torjesen, I. (2019). Diabulimia: the world’s most dangerous eating disorder. BMJ (Clinical Research Ed.), 364(March), l982. https://doi.org/10.1136/bmj.l982

Wisting, L., Wonderlich, J., Skrivarhaug, T., Dahl-Jørgensen, K., & Rø, Ø. (2019). Psychometric properties and factor structure of the diabetes eating problem survey - revised (DEPS-R) among adult males and females with type 1 diabetes. Journal of Eating Disorders, 7(1), 1–7. https://doi.org/10.1186/s40337-018-0232-0

Zuijdwijk, C. S., Pardy, S. A., Dowden, J. J., Dominic, A. M., Bridger, T., & Newhook, A. (2014). The mscoff for screening disordered eating in pediatric type 1 diabetes. Diabetes Care, 37(2), 26–27. https://doi.org/10.2337/dc13-1637

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Discussing comorbid diabetes and eating disorders in practice

Putting research into practice. The NEDC discusses comorbid diabetes and eating disorders with The Queensland Diabetes and Endocrine Centre at Mater Health Services. Read the Q and A online.

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Looking back and moving forward: Achievements of the NEDC in 2018 - 2019

As we commence a new funding period for the NEDC, 2019-2022 we look back on the activities and achievements from the past year and activity period.

Tasked with actively engaging with Primary Health Networks to build an integrated approach to eating disorder care and management across Australia, the NEDC delivered forty education events attended by 1,492 health professionals in 22 PHNs.

Significantly, NEDC produced and delivered five Introductory Training videos with content mapped to the NEDC core competencies. With a goal to develop a nationally consistent approach to the prevention, treatment and management of eating disorders in Australia, these training videos provide online access to professional learning for all.

Additional activities during this period included a coordinated review of the eating disorders training and education available to professionals in Australia, and mapping these training offerings to the NEDC core competencies. This review presents a gap analysis of training content as well as geographic and disciplinary coverage of training within Australia.

Strong NEDC relationships with our key stakeholders continue to provide the foundations required to extend our reach and partnership across new areas of primary and secondary care and amongst diverse sports and education sectors.

In 2018 the NEDC partnered with the Australian Institute of Sport (AIS) in the development of a joint position statement on the management of eating disorder risk and occurrence in high-performance athletes. Moving forward, we will work together to deliver this position statement across the 102 National Sporting Organisations associated with the AIS.

Other partnerships have included working on eating disorder initiatives with the Australian Association for Social Workers, Occupational Therapy Australia, Dietitians Association of Australia, and the Australian Dental Association (ADA).

With your support, the strength of the NEDC continues to grow. We move into our new funding period with a strong membership base that is increasing every day. We thank our members, collaborators and contributors for their ongoing involvement and support.

We look forward to the period ahead as we continue to drive the evolution of a framework that will support and educate our workforce, with a nationally consistent approach to the prevention, treatment, and management of eating disorders.

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ANZAED Conference 2019

The Australia and New Zealand Academy for Eating Disorder (ANZAED) Conference was held in Adelaide on 23 and 24 August 2019, bringing together over 350 clinicians, researchers and people with lived experience from across Australia and New Zealand. The NEDC was in attendance and presented or co-delivered several sessions. Here are some of our highlights:

• NEDC National Director Dr Beth Shelton joined several sector leaders in delivering the Saturday morning breakfast session to a packed room, presenting and discussing the draft Medicare guidelines for eating disorders, including patient and professional inclusion criteria, referral and review processes as well as future planning. In particular, Dr Shelton spoke about the work that the NEDC will be undertaking to explore options for a credentialing system for eating disorder clinicians.
• The NEDC also presented a session on the Workforce Core Competencies for eating disorders, where we explored the various roles that workers across healthcare and related systems have in identifying and responding to eating disorders. We examined the areas of competency that each of those groups needs to meet under the National Practice Standards for Eating Disorders. We then encouraged attendees to identify their place on the continuum of care, have a look to see what competencies people in their group should have, and do their own self-assessment to see if there are any areas of practice that they need to develop. The NEDC website is a great starting point for any other clinicians or health and helping professionals wishing to do the same.
• Former NEDC National Director, Christine Morgan, was presented with a Lifetime Achievement Award for her exceptional contribution to the field of eating disorders, including the establishment and leadership of the NEDC for almost ten years, among many other significant achievements. Congratulations Christine on this well-deserved award!

It was wonderful to see so many NEDC members, including several members of our Steering Committee, represented in the program, presenting on topics ranging from advanced clinical skills to new research findings to the role of lived experience mentoring in recovery support. In particular, the NEDC congratulates our Steering Committee member Professor Tracey Wade and her conference co-chair Dr Randall Long on bringing together such a full and exciting program and delivering such a successful professional event.

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Save the Date: NEDC Members’ Meeting – February 2020

The NEDC is pleased to announce the next NEDC Members’ Meeting!

Themed “Building the System of Care for Eating Disorders” the NEDC Members’ Meeting provides a professional learning experience that brings valuable workshops, seminars and networking opportunities to you, our members.

The Member’s Meeting is a platform that offers NEDC members the opportunity to come together, share knowledge and engage with Primary Health Network affiliates and key eating disorder experts as we work together to build an integrated approach to eating disorder care across Australia.

• Engage with sector leaders about building the system of care
• Learn about evidence-based initiatives in primary care
• Access training and professional development opportunities
• Network with local and national professionals
• Gather evidence-based tools and resources from the NEDC and our sector partners
• Engage with NEDC plans and projects - share your suggestions, requests and recommendations

The Members Meeting will be held on the 27th – 28th of February 2020 at Rydges Melbourne, 186 Exhibition Street, Melbourne CBD.

Members will receive additional information and invitation via email in the coming months.

The NEDC members meeting is exclusively for our NEDC members. If you are not already an NEDC Member – Sign up today! Membership is FREE.

Stay posted for further information and full meeting details!

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Eating Disorders Queensland: Training Opportunities 

Eating Disorders Queensland is a specialist, community-based service. It is our mission to facilitate hope and recovery for all people affected by eating disorders. We are passionate about sharing our values with professionals and provide training in identifying, understanding, and working with individuals affected by eating disorders.

Our training explores the following themes:

• Identifying eating disorders and early warning signs
• Understanding eating disorders and prevalence
• Eating disorders across a continuum
• The power of language
• Feminist practice framework
• Exploring intervention modalities
• Lived experience perspectives
• Challenges faced in treatment including ambivalence

Contact admin@edq.org.au to express your interest in the available training opportunities below.

Peer Mentor /Lived experience speaker program

Eating Disorders Queensland is recruiting mentors to join our Peer Mentor Program for 2020. A mentor is someone who has a lived experience of an eating or body relationship issue. Mentors are provided with training by EDQ to mentor an individual in their recovery journey. Mentors are required to have been in stable recovery for 2 years.

Once the mentor training has been completed, individuals can attend speaker training, to go on our roster for speaking engagements.

Carer Peer Mentor Program

A carer/family mentor is someone who has supported a loved one through their eating disorder recovery journey and would like to provide peer support to other carers. A mentee is someone who is currently supporting a loved one and would like to connect with a carer for peer support.

Please enquire admin@edq.org.au to express your interest in becoming or referring a mentor/mentee and upcoming training dates. 

Eating Disorders Victoria - Training Opportunities 

Eating Disorders Victoria currently have the following training opportunities available.

Eating Disorders Explained - Pregnancy and Early Parenthood

A three-hour workshop to educate maternal and allied health professionals on eating disorders during pregnancy and early parenthood.

• Wednesday 9 October 9:30am – 12:30am
• $55/head
• Level 2, Collingwood Football Club Community Centre Corner Lulie and Abbot Streets, Abbotsford, VIC 3067

For more information please contact Eating Disorders Victoria

PHONE: 1300 550 236

EMAIL: oliviadonati.beech@eatingdisorders.org.au 

https://www.eventbrite.com.au/e/eating-disorders-explained-pregnancy-and-early-parenthood-tickets-72653240799

Eating Disorders: Early Intervention and Community Treatment Bairnsdale

This activity-based training has been designed specifically for GPs and will include a panel of experts and people with a lived experience of an eating disorder.

• DATE: Saturday, October 26th
• TIME: Registration from 8.45 am
• Training from 9 am – 4 pm
• Morning tea and lunch will be provided
• LOCATION: The Riversleigh
• 1 Nicholson St
• Bairnsdale, VIC 3875

COST: No cost thanks to Gippsland PHN
AUDIENCE: GPs only

For enquiries contact Rebecca Lister by email on rebecca.lister@eatingdisorders.org.au

https://www.eventbrite.com.au/e/eating-disorders-early-intervention-and-community-treatment-bairnsdale-tickets-70103789321

Eating Disorders: Early Intervention and Community Treatment Traralgon

This activity-based training has been designed specifically for GPs and will include a panel of experts and people with a lived experience of an eating disorder.

• DATE: Wednesday, Nov 13th
• TIME: Registration from 8.45 am
• Training from 9 am – 4 pm
• Morning tea and lunch will be provided
• LOCATION: Gippsland PHN, 11 Seymour St Traralgon 3844
• COST: No cost thanks to Gippsland PHN
• AUDIENCE: GPs only

Enquiries: Rebecca Lister rebecca.lister@eatingdisorders.org.au

https://www.eventbrite.com.au/e/eating-disorders-early-intervention-and-community-treatment-traralgon-tickets-70103803363

For further information about Eating Disorder Victoria (EDV) training opportunities please contact EDV by phone on 1300 550 236.

WA Eating Disorders Outreach & Consultation Service (WAEDOCS) - Training Opportunities

In response to the coming introduction of the new Medicare Benefits Scheme (MBS) Item Numbers for eating disorders WAEDOCS has scheduled the below training opportunities:

Enhanced Cognitive Behaviour Therapy for Eating Disorders (CBT-E) – Workshop for psychologists and other mental health practitioners

• Date: Friday 29^th November and Saturday 30^th November 2019
• Time: 9:00 am – 4:30 pm
• Venue: Trinity on Hampden, 230 Hampden Road, Crawley, WA, 6009
• Cost: $200 + GST (free for NMHS staff)
• Presenter: Dr Anthea Frusland

Family-Based Treatment for Eating Disorders (FBT) – Workshop for psychologists and other mental health practitioners

• Date: Friday 1st  November and Saturday 2nd  November 2019
• Time: 9:00 am – 4: 30 pm
• Venue: Trinity on Hampden, 230 Hampden Road, Crawley, WA, 6009
• Cost: $200 + GST (free for NMHS staff)
• Presenter: Andrew Wallis and Bronwyn Raykos

Eating Disorders Essentials – Workshop for private practising dietitians

• Date: Thursday 26th November and Tuesday 3rd  December 2019
• Time: 8:00 am – 5:00 pm
• Venue: Trinity on Hampden, 230 Hampden Road, Crawley, WA, 6009
• Cost: $200 + GST (free for NMHS staff)
• Presenter: Melissa Edwin, Sonya Douglas, Kate Fleming, Nikki Cummings 

Please contact WAEDOCS by email at WAEDOCS@health.wa.gov.au for further information about the opportunities listed above. Ongoing training opportunities will be available in the coming year. 

Hobart: Butterfly MHPN Hobart Eating Disorders Network

The Butterfly Foundation, in partnership with MHPN, have successfully established an Eating Disorders Network in Hobart, the Butterfly MHPN Hobart Eating Disorders Network.

The first meeting was held on Tuesday 24th September with 44 registered attendees. 

Presentations at the event included the showcasing of the Eating Disorders National Helpline by the Butterfly Foundation's National Helpline Manager, Juliette Thomson,  along with a presentation from Meg Boman, Dietician at the Royal Hobart Hospital, on observations of eating disorders in Diabetes populations.

The network meetings will be held quarterly, with the next meeting set to occur in March 2020. 

Key objectives of the Eating Disorder Network will be to provide services and practitioners working in this area with an opportunity to:

• be informed about the activities within the sector
• share knowledge
• establish networking opportunities that will support collaboration between sector providers
• receive psychoeducation about eating disorder-related issues
• showcase related mental health services 
• participate in Q & A panel-style sessions

The Butterfly MHPN Hobart Eating Disorder Network looks forward to the success of this initiative in aid of improving outcomes for the people of Tasmania living with an eating disorder. For more information, please visit the Mental Health Professionals Network online. 

Additional events in Hobart include a Collaborative Care Skills Workshop, which is being held on Saturday 19th October and Saturday 2nd November 2019.  This will be a two-day workshop where people caring for someone with an eating disorder can learn skills to support their loved one. Full details are available in the flyer below. 

Expressions of Interest Invited ~ Registered or Clinical Psychologist at the Myrtle Oak - Clinic Tuggerah - 2/3 days/wk (flexible)

The Myrtle Oak Clinic based in Tuggerah is seeking a psychologist with experience in conducting psychological assessments and delivering evidence-based treatment, preferably in a multidisciplinary team approach. We provide a range of psychological and dietetic services for people of all ages, with a special interest in the treatment of eating disorder presentations and child/adolescent psychology.
We are a small multi-disciplinary team who enjoy working in a supportive environment.

Myrtle Oak Clinic is the first multidisciplinary private practice on the Central Coast and Newcastle to specialise in the treatment of eating disorders. Treatment is offered to all ages and genders, across the continuum, from those at risk of developing an eating disorder through those living with a chronic eating disorder.
Opportunities to conduct groups, information sessions and workshops are also available. Assessment and treatment are also offered for general mental health concerns such as anxiety disorders, mood disorders, stress management, poor body image and self-esteem, and adjustment to chronic health conditions.

The Opportunity:

We are currently expanding and have a need for a Registered or Clinical Psychologist who is interested in working with a mix of clients from adolescents/general mental health and Eating Disorder clients to join our supportive and friendly professional team who values a multidisciplinary treatment approach.
The candidate must have the ability to engage and maintain effective therapeutic relationships with a diverse range of people and their families/carers.
Hours are flexible and family-friendly and also provide administrative support.

Selection Criteria

• Full Registration as a Psychologist (or Clinical Psychologist) with AHPRA;
• Registration as a provider for Medicare and health funds (or eligibility for such);
• A professional and highly ethical approach;
• Commitment to evidence-based practice including:
  • Clinical experience with CBT and/or CBT-E;
  • Clinical experience or good knowledge of Acceptance and Commitment Therapy (ACT) and/or mindfulness;
  • Experience in the assessment and treatment of mental illness such as depression, anxiety, body image, self-esteem, and other mental health conditions;
  • Experience working with families, children, adolescents and adults;
  • Excellent rapport building and client engagement skills;
  • Ability to work independently and as part of a multi-disciplinary team;
  • NSW Working with Children Check;
  • Professional Indemnity Insurance.

If you are interested in this position, please forward your resume with a covering letter via email to jodie@myrtleoakclinic.com.au For all enquiries please contact 02 4362 3443.

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