Physiological Testing in the Treatment of Eating Disorders

The Walker Wellness Clinic thinks the patient needs to be informed of how female physiology works and this means educating the patient on her precise metabolic rate, the various stages in life that weight changes may occur, and the rationale behind these physiological changes. Many eating disorders begin when the patient has fallen prey to the myths and misunderstandings of how weight management works. None of the compensatory behaviors such as restricting, binging and purging, using laxatives or diuretics, or over-exercising are effective ways to manage a healthy weight range.

We do not randomly assign weight ranges or caloric intake to our patients because we realize that body types are different. Rather, we precisely measure one’s individual metabolic rates and establish a weight range based on medical stability and her unique body type. Patients are informed at all times of their weight and the calories they are consuming. This allows patients to overcome their anxiety about their morbid fear of becoming overweight. We do not force them to eat foods they dislike and we respect and honor their preferences such as being a vegan or vegetarian. However, we encourage them to challenge foods that they may be fearful of consuming. Therefore, we use clinical assessments such as the following to accomplish the aforementioned goals:

Resting Metabolic Rate Test (RMR) and Body Composition Analysis

At the onset of treatment a resting metabolic rate test is administered to measure the metabolism of the patient and this determines the precise number of calories that the patient needs to lose, gain, or maintain a healthy weight range. The resting metabolic rate test (RMR) is used throughout the course of treatment to measure the patient’s metabolism and a body composition analysis is completed to measure the percentage of adipose tissue (fat tissue) and muscle mass tissue. Every patient has a different metabolic rate dependent upon many variables such as genetic predispositions, body type, history of dieting, hormonal imbalances, and stress levels.

Nutrition Analysis and Exercise Prescription

The Walker Wellness Clinic implements this unique approach to treatment because our philosophy is that patients need to be informed of their healthy weight range and the number of calories their body needs to become medically stable. The weight ranges are set by the clinical dietitian and medical team based on the patient’s medical stability (i.e., not having the amenorrhea (loss of their menstrual cycle for at least three consecutive months, cardiac damage, or osteoporosis) and resting metabolic rate test results. Unlike many other treatment programs, patients learn to feel empowered and educated by not having anxiety about their weight range. In fact, patients benefit by understanding why their weight needs to be in a healthy range and the caloric intake that is needed to maintain this range. In other words, patients learn to “face the music” by overcoming fear anxiety about their weight range.

If a patient has been chronically dieting, restricting, over-exercising, or using other compensatory behaviors, it may slow down her metabolism and make her more vulnerable for weight changes. Our clinical objective is educate the patient on establishing a healthy weight range and increase her metabolic rate gradually to avoid making them vulnerable to gain weight easily in the future.
In contrast to other treatment programs, our goal is to avoid setting a random weight range that may be clinically inappropriate for the patient. However, by slowly and systematically increasing their caloric intake and measuring their metabolism, we can avoid having patients become significantly overweight and teach them to manage their weight independently.

Likewise, a nutritional analysis is completed to assess patients’ overall nutritional intake and to determine if their food intake is adequate based on their metabolic rate. An exercise prescription is also designed to help patients increase metabolic rate and maintain a healthy weight range. The exercise physiologists will custom design the exercise prescription by eliciting the input of patients and their favorite activities (i.e., snow skiing, running, rollerblading, swimming, fencing, ballroom dancing, etc.).

In conclusion, the exercise prescription and nutrition analysis are all incorporated into their overall treatment program by using these precise clinical assessments so that patients can actively participate in understanding the balance between their energy input (caloric intake) and energy output (exercise prescription).

Sport and Exercise

Although the appropriate amount of exercise in relation to the specific condition of the patient will be addressed early in the treatment process, exercise will be an integral component of the overall program. An exercise physiologist will provide the patient with an individualized comprehensive exercise prescription and on-going support. In addition, patients will learn the physiological implications of eating disorders, the physiological issues concerning his or her specific circumstances and the physiological process of recovery.