Let's Talk About Eating Disorders and Virtual Care
Show Notes What is virtual care and how can it be used in treating patients with eating disorders? What are the limitations or advantages of using virtual care in treating eating disorder patients? In this podcast episode, Kate Fisch speaks with Dr. Erin Knopf about virtual care for Eating Disorders. She discusses the benefits and challenges around virtual care and the role it plays in assisting our clients and developing more effective treatments. MEET DR. ERIN KNOPF Dr. Knopf is dedicated to treating patients with eating disorders holistically. As a triple-boarded physician (pediatrician, adult psychiatrist, child/adolescent psychiatrist) and Certified Eating Disorder Specialist, she uses her combined training with intentionality to assess disease severity and devise comprehensive plans to address the eating disorder behaviors as well as comorbid symptoms of anxiety, depression, OCD, trauma and more. She describes herself as the “mechanic of the body” and prioritizes psychoeducation and biological education for patients and families to foster insight and achieve treatment alignment. Dr. Knopf previously worked in an IP/RES/PHP program for almost 5 years and at the onset of the COVID-19 Pandemic, she served as unit psychiatrist for ten months at the ACUTE Center for Eating Disorders. She is a member of IAEDP, AED, AACAP, APA and AAP. Visit Virtual Eating Recovery For You to find out more. IN THIS PODCAST Will virtual care replace physical consultations? The challenges faced with treating eating disorders. Childhood obesity, diets and restrictive eating. Lab results and eating disorders. Do you feel like delivering care virtually gets in the way of connecting with patients? “I will admit, as an extrovert, I don't think there will ever be a way to replace the beauty of in person connection. There are nuances that are missed. But ultimately, would I turn away from virtual care? Absolutely not!” Dr. Erin Knopf When we think about virtual care, the cons might be pretty clear, but the pros just far outweigh, especially when we're talking about someone getting care versus not. . . “It’s an opportunity to bring care to people who would never have it, it's flexible, convenient. So I think overall, the virtual care frontier is really exciting and we can only do it better with our technological advances.” Dr. Erin Knopf What is a big challenge you are currently faced with? “Right now we are, unfortunately, private pay, which I know limits access, but that is not our end game. We are currently working on credentialing with three insurance companies.We offer discounted bundles for services. We do super bills, and we even have a single case agreement.” Dr. Erin Knopf Eating disorders don't discriminate based on socioeconomic status. They also don't discriminate based on geographic location. It is important for all patients to have access to some level of professional care and help. What are your thoughts on the American Academy of Pediatrics’recently issued a statement on childhood obesity? “The first part is it's still relying on BMI as the measure of obesity. It actually doesn't include in the definition any other medical considerations that people get worried about - type two diabetes, hypertension, hyperlipidemia, things like that.” Dr. Erin Knopf The steps that follow such a statement are extremely drastic, especially when we consider its referral to children. . . “ It just says if a child's body is 90th percentile for age match, BMI percentage, then they meet criteria for obesity and therefore should be considered for, drum roll, either weight loss surgery, like bariatric surgery, or weight loss medications.” Dr. Erin Knopf What are your thoughts on why diets and restrictive eating are so common? “Human beings like diet culture because it helps them feel in control and powerful and capable of incredible discipline. Think of how often that's overly valued and praised.” Dr Erin Knopf When treating somebody. What is your number one concern, medically? “Medical stability and medical fragility are the terms that I consider the most. Everyone is pretty accustomed to picturing an emaciated person who meets criteria for eating disorders and has low heart rate, low blood sugar, low body temperature. But really, only 6% of patients with eating disorders are actually underweight. All it takes is 15 pounds of weight loss in three months and your body is malnourished to some degree..” Dr Erin Knopf How do we handle clients who have good lab results but may still have an underlying issue? “Your body is miraculous, that it is going to work for you and protect you as best it can by improving the movement of electrolytes, of improving the mobilization of energy molecules from stored tissue in order to meet your metabolic need. But eventually that will give out. And treatment should not occur when you are in the middle of crisis and your body is comping out. It needs to happen sooner than that. So if the behaviors are there and the weight loss is there or the weight interruption for whatever way it looks is there, yeah. you meet criteria in my book, and I think it is important that we have more early recognition and prevention.” Dr Erin Knopf The one thing that virtual care provides is access to those patients who may not have thought they were able to get treatment and thus there's motivation to get better. Especially now that virtual care has been supported nationally. Hopefully it continues to get the same support even with laws changing. Now that the Pandemic emergency actions are expiring, this does give us an opportunity to bring that expert care to corners that would never have known expert care mattered, would never have known that they actually do meet criteria for an eating disorder and deserve that expert care. So it's just such a wonderful opportunity to improve health outcomes for so many more This is a fascinating topic and Dr. Erin Knopf and is filled with valuable insights, information and examples throughout the podcast. To read the articles or find the book mentioned in the podcast, follow the links below. RESOURCES MENTIONED AND USEFUL LINKS Visit Virtual Eating Recovery For You for more on the fantastic work that Dr. Erin Knopf is involved in. Rate, review, and subscribe to this podcast on Apple Podcasts, Stitcher, Google Podcasts, TuneIn, and Spotify.