Patient
KB

Height: 5 ft 5 in

Weight: 108 lbs

BMI: 18

Registered Dietitian

Phoebe Waller, RD

Insurances: Aetna,United Healthcare

Diagnosis and Treatment Plan

Nutrition Diagnosis

disordered eating pattern related to restriction for 15+ years as evidenced by diagnosis of anorexia nervosa

Patient familiar to clinician. Treated patient previously in RTC Spring 2023.

Pt left IOP in Monterey California in June-July 2023. By September 2023, pt was recommended to attend a HLOC. Began at Healthy Futures IOP and has been there ever since, originally 3d/week, then 4days, then 2 days/week - current treatment team has decided it is “time to sink or swim” with recovery. Reports anxiety was out of control and the worst its ever been throughout IOP. Anxiety has improved with Prozac. Pt works with a therapist 1x/week and an IOP RD every other week. Reports feeling like needs her clinicians to tell her what to do, but she needs to work on being more honest with her treatment teams. Reports struggling with continued fluid restriction and food restriction (food restriction has improved since RTC in 2023).

Nutrition Intervention

Education materials provided:

Intervention

1. Meals and Snacks (ND -1) and Nutrition Education (E -)

Patient will follow the following recommendations:

MEAL PLAN:

  • increase hydration via Liquid IV 1x/day, goal of 3 water bottles daily
  • breakfast: solid meal of 2 hard boiled eggs, 2 pieces of toast with butter/avo/peanut butter, liquid breakfast of Boost Plus on more challenging mornings
  • 2 complete snacks per day consisting of a carbohydrate and fat/protein source (goldfish and cashews, cheese and crackers, mango and cottage cheese)
  • take iron/vitamin C in mornings and multivitamin in evenings, can switch order if iron pill starts making you feel nauseous

2. Nutrition Counseling (C-1): Goal Setting For Physical Activity

B. Planned Exercise:

walk 10 minutes with dogs on off days from work only

3. Nutrition Counseling (C-1): Goal Setting For Nutrition

  • Honesty with treatment team
  • eating complete snacks consisting of a carbohydrate and fat/protein source
  • eating a complete breakfast consisting of 3-4 components.

4. Nutrition Counseling (C-1): Self-Monitoring

  • utilizing recovery record to keep track of meals and snacks

B. Weight Checks: Weekly via IOP, sign ROI for IOP

Monitoring and Evaluation

Follow up

6/11/24 @ 1PM

Topics Discussed

Eating Disorders & Disordered Eating

Appointment History

Number of Sessions: 20

Last Updated: May 31, 2024