Eating Concerns Team

Mission

The Eating Concerns Team (ECT) is a multidisciplinary group within Tulane Campus Health that provides consultation, assessment, and treatment recommendations to students who are struggling with eating and body image concerns. The ECT is committed to empowering students to make healthy, long-lasting changes while working towards recovery. We also serve as a collaborative resource to provide campus-wide outreach, education, and advocacy. The ECT is committed to creating an inclusive and affirming environment for all bodies.

Getting Started

Eating disorders are biopsychosocial illnesses that are prevalent in college-aged individuals and impact people at all intersections of identity. Eating disorders can negatively impact an individual’s physical, emotional and nutritional health in ways that make the college experience quite challenging. Incoming or returning students with an active or recent eating disorder or with any body image or eating concerns can find support through the ECT.

Campus Health takes a collaborative, individualized approach to caring for students with eating and body image concerns. We will work with you to determine the best combination of services based on comfort level, preference, symptoms, and severity of the problem.

You can initiate care for a body image or eating concern in several ways. If you would like to start by talking with a registered dietitian or medical provider, you can make an appointment with the Student Health Center. If you would like to start by talking with a licensed therapist, you can make an appointment with the Counseling Center. If you intend to take time off from school for more intensive eating disorder treatment and you have questions about how that may impact your academic standing, financial aid or scholarships, you can consult with a Case Manager.

Reasons to Seek Support

Examples of scenarios that would be appropriate for care with a member of the ECT include, but are not limited to:

• A student is seeking outpatient treatment on-campus after completing a course of treatment at a higher level of care for a diagnosed eating disorder (e.g., a residential treatment or an intensive outpatient program).
• A student went home for winter break, and a friend or family member noticed that they lost a significant amount of weight. The student has been skipping meals to “fight off the ‘freshman 15,’” but has never been in treatment for eating concerns and would like to consult with a professional.
• A student has a history of treatment for bulimia and has been in remission for a few years. They recently moved into an apartment on their own and started purging after eating about twice per week.
• A student feels constant self-consciousness about their body size and shape. They want to learn more about what a healthy weight looks like for them and would like to explore the reasons why they feel disconnected from their body.
• A student has been on a new diet for about two weeks. They have started to feel dizzy and nauseous throughout the day, and on one occasion, they lost consciousness in class.

While the ECT collectively serves as an outpatient resource, some students may require a higher level of care than what can be safely and effectively provided by Tulane Campus Health. Your treatment plan may include referrals to off-campus providers who take your insurance and can best meet your needs.

What to Expect

Nutrition Evaluation

An initial nutrition evaluation is scheduled for one hour and consists of an in-depth interview, assessment, and review of dietary intake. Throughout each follow up session, we will work collaboratively on individualized goal setting as you work towards developing a healthier relationship with food and body. This may include reconnecting to hunger and fullness cues, creating a meal plan to meet your needs, and changing foods in your diet to add variety and flexibility. Our dietitian works from a Health At Every Size (HAES) lens. Therefore, with the exception of individuals requiring medically necessary weight restoration, the dietitian will promote non-weight focused healthy behaviors that respect each individual’s setpoint weight and diverse body type. For continuity of care, the dietitian can work with students who are stepping down from higher levels of care for eating disorder treatment and can also assist with the provider referral process both on-campus and within the New Orleans community.

Therapy Evaluation

If you are interested in seeking mental health support, we are here to help. Not sure where to start? You can meet with the Student Health Center’s Behavioral Health Provider for an initial consultation and for support navigating the mental health resource options both on and off-campus. In addition, the Counseling Center offers short-term individual therapy (12 sessions per academic year) and unlimited access to group therapy and workshops.

If you are interested in finding a long-term therapist in New Orleans who takes your insurance, you can contact the Care Coordinator for referrals and referral support. We recommend seeking a community provider if you were in long-term therapy prior to coming to Tulane, or if you anticipate that you will want to work with the same therapist over multiple academic years or on an open-ended basis.

Medical Evaluation

An initial one-hour medical consultation will include an in-depth evaluation of how your eating habits or disturbance in body image may be negatively impacting your health. It may include:

• Vital signs (i.e., blood pressure, pulse, respiratory rate)
• Weight measurement (Usually this is done “blind”, meaning the patient is not informed of the number. Sometimes we ask that the weight be taken with a patient gown on instead of street clothes.)
• An in-depth history and intake: a medical and psychological history and a history of any eating disorder behaviors, a 24-hour diet history, and a history of any symptoms that may have led the student to seek medical help
• A physical exam
• Additional tests, if indicated, may include an electrocardiogram (EKG), and lab work. You do not need to fast for any blood tests.
• A referral to a specialist off campus for additional evaluation, if indicated

Students will be assessed to determine whether they are able to maintain and/or achieve a healthy weight on an outpatient basis in accordance with the American Psychiatric Association’s most recent practice guidelines and the National Institute for Health and Clinical Excellence (NICE) standards. Your medical provider might refer you to other members of the ECT for additional support and will make a recommendation for frequency of follow-up visits. If you have severe symptoms and need urgent intervention beyond the capacity of Campus Health, your medical provider might recommend an ER visit, usually for IV fluids and electrolytes.

FAQ

I think someone I care about might have an eating disorder. What should I do?

How to Support a Loved One with an Eating Disorder | National Eating Disorders Association

Can I make an appointment for my friend or child?

To access a student’s medical record and make an appointment, we must speak directly to the person who will be seen. If you are concerned about a friend or your child, however, you may seek consultation from a trained professional at the Counseling Center. You may also file an anonymous Concerns Report, which will alert University officials that a student is in need of support.

If I get help from the Eating Concerns Team, will my parents or case manager be notified?

In accordance with healthcare privacy laws, our services are strictly confidential. If you and your clinician decide that communication with a parent or case manager would be beneficial to you, we will first discuss this option with you and ask you to provide written consent. Although rare, exceptions to these privacy laws are made in cases of severely life-threatening emergencies.

How do I know if I have an eating disorder?

The ECT's individualized approach tends to focus on the symptoms causing distress and the meaning of these symptoms in students’ lives. Thus, we take a holistic approach to treating people instead of providing diagnoses. If you are wondering whether to seek treatment, you can start with an online screening tool provided by the National Eating Disorders Association.

Resources

National Eating Disorder Association (NEDA)

Association for Size Diversity and Health (ASDAH)

The Health at Every Size Approach

Health at Every Size Curriculum Videos

National Association of Anorexia Nervosa and Associated Disorders (ANAD)

The Alliance for Eating Disorders Awareness (findedhelp.com)

Support groups for friends and family: Programs & Services - The Alliance for Eating Disorders Awareness

Pro-recovery support group include LGBTQ+: Programs & Services - The Alliance for Eating Disorders Awareness