Course Description:

When it comes to eating disorders, there is an ever-widening gap between research and practice. Despite a fast-growing body of scientific evidence implicating specific biologic abnormalities as etiologic factors, mainstream treatments prioritize the treatment of psychologic issues and rely heavily on pharmaceutical interventions.

Over the course of four modules, this course offers clinicians an immersive education in a functional medicine model for the treatment of anorexia nervosa, binge-eating disorder, and food addiction. Following a review of the standard treatment methods for these disorders, we explore the neural, genetic, metabolic, and biological factors that precipitate appetite dysregulation disorders. Research and experience-informed treatment recommendations will be presented, with an emphasis on objective testing and biochemical individuality.

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1. A Biologic Model of Eating Disorder Pathogenesis

Hope on the Horizon: A Biologic Model of Eating Disorder Pathogenesis
In the first Module, we provide an overview of current treatment models for eating disorders and their inadequacy in addressing the sharp rise epidemiologists have observed on a global scale for these disorders. We then examine some of the root causes for appetite dysregulation, including genetic factors, celiac disease, and, in particular, the critical role played by lipid deficiencies in these disorders.

2. Targeting Micronutrient Deficiencies in Treatment

Module 2 plumbs the relationship between dietary habits and the biologic pathways through which nutritional imbalances impact neurologic and behavioral dysfunction. We will explore the effects of vegetarianism and veganism on anorexia for zinc deficiencies, and how metabolic factors from particular diets can produce appetite dysregulation. Next, we demonstrate the importance of addressing B vitamin deficiencies—B12, folate, B3, and thiamine (with particular attention paid to the latter)—in treating those with eating disorders. Lastly, we will focus on the physiologic and neurologic ramifications of vitamin B3 deficiency (pellagra) and thiamine deficiency (beriberi), along with a discussion on Postural Orthostatic Tachycardia Syndrome (POTS, a form of dysautonomia associated with thiamine deficiency).

3. Amino Acids and Probiotics for Eating Disorders

Healing the Gut, Helping the Mind: Amino Acids and Probiotics for Eating Disorders
In Module 3, we begin with a look at protein, and the physical, neurologic, and behavioral consequences of dietary  patterns that minimize or exclude protein consumption. Diet, age, the essential mineral zinc, and digestive enzymes will be discussed in regard to their influences on amino acid absorption and bioavailability. We then examine the co-occurrence of amino acid precursors for eating disorders, and provide free-form amino acid supplementation recommendations for your patients. From there, we turn to developments in modern psychiatry: the gut-brain connection, and the therapeutic applications of probiotics. In particular, we demonstrate how gut dysbiosis and Clostridia overgrowth are underlying factors for those with eating disorders.

4. Integrative Solutions for Binge-Eating

In the final module, we take a comprehensive look at binge-eating disorders (BED) as arising from biochemical pathways regulating satiety and hunger. Current options for the pharmacologic management of BED will be objectively reviewed, along with orthomolecular interventions and micronutrients to counteract BED, which has both genetic and nutritional components. Dietary factors capable of influencing feeding behavior, such as MSG, sugar, and opioid peptides derived from dairy and wheat, will be examined. Lastly, guidelines for applying a functional medicine protocol for the treatment of BED will be reexamined, and clinical recommendations for nutritional supplementation to optimize neurotransmitter synthesis and address micronutrient imbalances presented.

Learning Objectives:

Upon completion of this course, registrants will be able to:

  • Explain why many young people diet, but relatively few develop eating disorders
  • Elucidate the biologic pathways and mechanisms underlying associations between celiac disease and anorexia nervosa
  • Describe the essential biologic functions of lipids, elucidate the neurologic consequences of essential fatty acid and cholesterol deficiencies, and relate lipid deficiencies to eating disorder presentations in terms of a functional medicine model
  • Elucidate an evidence-based rationale for prioritizing micronutrient repletion over psychotherapeutic interventions in the treatment of eating disorders
  • Identify dietary and environmental factors capable of inhibiting zinc absorption, and describe how zinc deficiency can contribute to anorexia-type symptomatic presentations
  • Describe genetic and dietary factors that can contribute to low folate levels
  • Explain how poor diet and/or disordered eating behaviors can precipitate paresthesia and neurologic decline associated with POTS
  • Identify and elucidate the neural correlates of food addiction
  • Safely and effectively implement functional medicine protocols for micronutrient repletion, neurotransmitter optimization, and digestive optimization in eating disorder presentations
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