Best nutrition counseling practices for the treatment of anorexia nervosa: A Delphi study
Article first published online: 27 JUN 2014
© 2014 Wiley Periodicals, Inc.
International Journal of Eating Disorders
Volume 48, Issue 1, pages 111–122, January 2015
How to Cite
Mittnacht, A. M. and Bulik, C. M. (2015), Best nutrition counseling practices for the treatment of anorexia nervosa: A Delphi study. Int. J. Eat. Disord., 48: 111–122. doi: 10.1002/eat.22319
- Issue published online: 23 DEC 2014
- Article first published online: 27 JUN 2014
- Manuscript Accepted: 30 MAY 2014
- Manuscript Revised: 27 MAY 2014
- registered dietitians who treat eating disorders;
- nutritional counseling;
To use Delphi methodology to evaluate the extent to which a panel of registered dietitians (RDs) who treat anorexia nervosa (AN) concur on parameters related to nutrition counseling for AN.
The twenty-one panelists who participated in this study: (i) were RDs (ii) had specialized in nutritional counseling for eating disorders for 5 years or more, and (iii) had Internet access at home or work. Over a 10-week period (between 8/2013 and 11/2013), panelists completed three iterative questionnaires. Questionnaire 1 included 12 open-ended questions regarding nutrition counseling for patients with AN. Subsequent questionnaires were developed based on a content analysis of responses to the first questionnaire, and panelists were asked to rank their level of agreement with these items.
Consensus was defined as 85% agreement and was achieved for 47 (35.3%) of the 133 items included in the third questionnaire. Items achieving consensus described nutrition counseling approaches that are applicable to all patients with AN, and their wording typically allowed for consideration of individual needs. Some items that did not achieve consensus reflected approaches for which individual tailoring may be necessary depending on age, stage of illness, and other patient factors. Consensus was also not shown for approaches for which there is little evidence.
Nutritional counseling intervention for AN has some consensus features, but the need for individualization was apparent. A stronger evidence-base for nutritional counseling interventions for AN would provide guidance and facilitate greater consistency among RDs regarding how to best care for this patient population. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:111–122)