Eating Disorder Care Plan
  • March 12, 2024

Eating Disorder Plan Medicare: A Comprehensive Guide

Accessing an Eating Disorder Care Plan can be an invaluable step in receiving support and comprehensive care in your recovery […]

Accessing an Eating Disorder Care Plan can be an invaluable step in receiving support and comprehensive care in your recovery journey.

Eating disorders are inherently complex, and accessing treatment is often difficult, isolating and confusing. 

Living with any form of an eating disorder creates an immense disconnection between self and true living. 

Despite this, treatment is possible. No matter how complex each individual may be, full, complete and authentic recovery is achievable for everyone. 

What Is The Australian Government’s Eating Disorder Plan?
Am I Eligible For An Eating Disorder Care Plan?
What Is Included In An Eating Disorder Care Plan?
How Do I Get Started Once I Have An Eating Disorder Care Plan?
How Can A Dietitian Help With Eating Disorder Recovery?
What Is Collaborative Care In Eating Disorder Treatment?
Why Am I Not Eligible For An Eating Disorder Care Plan?
What Is The Eating Disorder Examination Questionnaire (EDEQ)?
Summary

 

What Is The Australian Government’s Eating Disorder Plan?

The Australian Government introduced the Eating Disorders Plan (EDP) through Medicare, on November 1st 2019. 

This came in response to the growing prevalence of eating disorders within the Australian population – in 2019, the year of the EDP implementation, there were an estimated 1 million people living with an eating disorder nationally (1)

This is 4% of our population, and that number is steadily increasing over time (2)

The implementation of the EDP has provided these individuals with the capacity to access multidisciplinary treatment. 

Navigating this process is often confusing and complicated…and it doesn’t have to be!

It is so important to understand how the benefits work, to provide sufferers and carers with the best possible outcome for combatting these illnesses. 

 

Am I Eligible For An Eating Disorder Care Plan?

You can access the EDP by visiting your General Practitioner (GP) to assess and understand the necessary pathways to treatment. 

Under the EDP, there are two alternative pathways to determine eligibility. 

The patient is eligible if they are enrolled with medicare and have a clinical diagnosis of anorexia nervosa (3), and there is alternative criteria to be met alongside a diagnosis of any of the following; 

  • Bulimia nervosa (BN)
  • Binge eating disorder (BED)
  • Other specified eating or feeding disorder (OSFED)

 

The criteria for those diagnosed with BN, BED or OSFED is:

  • Patient is assessed as having an Eating Disorder Examination Questionnaire (EDEQ) score of 3 or greater, and;
  • Patients condition is characterised by rapid weight loss, or frequent binge eating/compensatory behaviours, 3+ occurrences per week

 

The patient must meet two of the following indicators: 

  • Underweight, with a body weight less than 85% of the individual’s expected weight – where weight loss is directly attributable to the eating disorder;
  • Current or high risk of medical complications due to eating disorder behaviours and symptoms; 
  • Functional impairment, due to serious comorbid medical or psychological conditions significantly impacting medical or psychological health;
  • An eating disorder-related hospitalisation in the past 12 months 
  • An experience of inadequate treatment response to evidence-based eating disorder treatment over the past 6 months despite active and consistent treatment and participation. (4)

 

Guide For Accessing Eating Disorder Care Plan

 

What Is Included In An Eating Disorder Care Plan?

The EDCP is created by either your GP, paediatrician, or consultant psychiatrist if you are deemed eligible. 

This medical professional acts as the leading practitioner in the management of treatment. 

 

The management plan should include:

  • Evidence of diagnosis
  • Goals, treatment plans and recommendations
  • Referrals to specialised health practitioners – such as a psychologist and a dietitian (5)

 

You will work collaboratively with the leading practitioner to create the goals and plans for your unique and individual needs. 

No two people with an eating disorder are the same – there are innate complexities and variances within each illness, even between those with the same diagnosis. 

This plan lasts for 12 months, and the referring doctor will provide a copy of the plan to all allied health professionals involved in your care. You will also receive a copy of the plan yourself. 

 

Over the 12 month duration of the plan, the practitioner can refer you for up to;

  • 40 psychological treatment sessions 
  • 20 dietetic consultations (6)

 

You will be reviewed after every 10 appointments with a psychologist by the managing practitioner.

This will be to assess progress made, and how the goals and recommendations on the plan are being actioned. 

The plan can be reviewed up to 4 times during the year if all 40 psychological sessions are required. 

 

 

How Do I Get Started Once I Have An Eating Disorder Care Plan?

The managing practitioner will make appropriate referrals to a psychologist and a dietitian once the plan is created. 

It is important to find someone who has treated eating disorders, and who specialises in management and recovery. 

Both a psychologist and dietitian are crucial in the recovery process – and it is important that they work together, in tandem with the managing doctor. 

 

Psychological treatments approved for use within the plan are often specific to the diagnosis (7). They include the following: 

  • Cognitive Behavioural Therapy (CBT) 
  • Family Based Treatment (FBT)
  • CBT-Anorexia Nervosa (CBT-AN)
  • CBT for Bulimia Nervosa and Binge Eating Disorder (CBT-BN and CBT-BED)
  • Interpersonal Therapy (IPT) for Bulimia Nervosa and Binge Eating Disorder
  • Dialectical Behavioural Therapy (DBT) for Bulimia Nervosa and Binge Eating Disorder

 

Under the managing practitioner’s recommendations, a referral is made to a psychologist and dietitian. 

This is where recovery begins and with adequate support and care, change and progress can be made.

 

How Can A Dietitian Help With Eating Disorder Recovery?

Dietitians play a crucial role in helping you take action and sustain change. 

Through creating a unique dietary plan, specific to your nutritional needs and physical requirements, the path to healing can truly begin. 

Eating disorders create a distorted perception surrounding adequacy and regularity of meals. 

It is easy to get stuck in a position where you are eating more than you did when you were actively engaging in behaviours.

However, this still is not enough to achieve mental and physical improvements and make true progress. 

Accredited Practising Dietitians such as those at Imbodi Health (8) work with these thoughts, and help you rediscover your relationship with food. 

This can be done through providing meal and snack recommendations that are balanced, adequate and nourishing.

There are various qualifications for dietitians that enhance their knowledge and training surrounding eating disorder management. 

Dietitians at Imbodi have completed specific training in these areas,  such as – Inside Out Completed Dietitian Essentials: The Treatment of Eating Disorders (9)

All of the Imbodi dietitians are also Credentialled Eating Disorder Clinicians with the Australian and New Zealand Academy of Eating Disorders.

This qualification is comprehensive, and designed to meet the requirements of the NEDC competency framework for clinicians training in eating disorders (10)

This equips the team at Imbodi with further guidance for treatment, and strengthening the tools they have to aid and sustain full recovery.

 

What working with a dietitian during eating disorder recovery looks like

 

What Is Collaborative Care In Eating Disorder Treatment? 

It is particularly important that the management of all eating disorders is facilitated through a multi-disciplinary team. 

This is to provide benefit to the patient through many approaches, and ensures all aspects of care are working towards the same goal – recovery. 

This requires consistent communication between your treatment team to create a collaborative approach. 

Having a psychologist, dietitian, psychiatrist and GP is highly effective in providing support and accountability. 

However, in order to have the most sustainable and effective recovery, there is a need for communication between all active providers.

As a clinic specialising in eating disorders, the team at Imbodi (11) understands and emphasises the need for collaboration. 

While working with a dietitian alone is effective, it is strengthened by working and communicating with a psychologist. 

This psychologist can help you manage any difficulties you may be facing with the meal plans/advice indicated by your dietitian. 

The EDP supports the MDT approach, especially through the requirement to review the plan and progress after every 10 sessions. 

All members of your team will be able to communicate and work together to help assess how your goals are progressing, and discuss if any changes need to be made. 

The psychologist must write a letter at every review and at the completion of treatment (13).  

The dietitian involved in your care will work with the team, to tailor your nutrition plan to what your body requires at each step – whether this be challenging and reincorporating fear foods, strategies to avoid bingeing and management of weight restoration. 

 

Why Am I Not Eligible For An Eating Disorder Care Plan?

There are various reasons you may not meet the criteria for the EDP – this does not invalidate your suffering, or deem you as ‘well’. 

The criteria is complex and eating disorders come in many varieties and characteristics – you are no less worthy of adequate treatment and support if you are not eligible for an EDP.

Avoidant restrictive food intake disorder (ARFID) is an eating disorder that does not qualify for the EDP, despite occurring in 1/300 Australians (14)

Alternative pathways to treatment are available, and accessing services through a GP Mental Health Care Plan (15) may be an option. 

 

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What Is The Eating Disorder Examination Questionnaire (EDEQ)? 

To qualify for the EDP, you need to have an EDQ score greater than 3.

The EDEQ  associates behaviours and cognitions with different questions. You can expect to rate the frequency of these behaviours, ranging from 0 days – everyday.

Examples of questions include:

  • Have you been deliberately trying to limit the amount of food you eat to influence your shape or weight (whether or not you have succeeded)?
  • Have you had a definite fear that you might gain weight?
  • Over the past 28 days, how many times have you eaten what other people would regard as an unusually large amount of food (given the circumstances)?

 

These questions may be difficult to answer, and it may be a confronting experience. 

Remember that the answers are confidential, only shared to your treatment team with your consent. 

This is important strengthen your team’s understanding of what you are struggling with, so they can best help you. 

You can also access the EDQ through this link, so you know exactly what to expect heading into your appointment. 

 

 

Summary

The EDP is a big step forward for Australians battling eating disorders. It opens up a real chance for recovery. 

But it’s important to keep in mind that recovery isn’t linear.

The plan won’t make everything better –  it’s tough, really tough. It requires a lot of effort, constant self-encouragement, and minute-by-minute determination.

But remember, recovery is possible. The EDP is here to help guide you along the way. 

With specialised treatment and experts who really get what eating disorders are about, you’re not alone in this. 

The dietitians at Imbodi are experts in this field and work collaboratively to provide you with care, guidance and support.

 

BOOK IN A FREE DISCOVERY CALL WITH OUR DIETITIANS
 

Article written by: Student Dietitian Tara Finn

Article Reviewed by: Dietitian’s Kiah Paetz and Jade Wrigley

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