BMI, Bariatric Surgery, and Best Practices for Disordered Eating

By: Tyler Boatright


What can we do for patients suffering from eating disorders? How can we help obese patients lose weight without bariatric surgery? Who is a good candidate for bariatric surgery?

Every morning since my clinical rotation started, I’ve been secretly crossing my fingers and hoping I didn’t get assigned any of those patients. It’s not that I don’t want to help them, it’s that I wasn’t sure I knew how to help them.  Lucky for me, our most recent Joint Class Day, hosted by the Johns Hopkins Bayview Dietetic Internship on December 3rd, focused on Obesity and Disordered Eating.

This education-packed day included several valuable lectures from experts, collaborative case studies with interns from other dietetic internships, and inspiring personal stories about bariatric surgery.  In attendance were dietetic interns from the host site, Johns Hopkins Bayview, as well as University of Maryland Eastern Shore, University of Maryland Medical Branch, the National Institute of Health, the US Army, and the University of Maryland College Park.

The morning began with a presentation by Maureen Gately, RD, LDN, a dietitian at the Center for Discovery in Alexandria, VA. She provided us with a brief background about the different types of eating/feeding disorders, behaviors, and diagnostic criteria. Then she spoke about her experience working as a dietitian in an inpatient mental health facility specifically geared towards helping teens experiencing disordered eating. After that, we split into groups to work with interns from other programs on a few case studies. I noticed that we all had the same base of knowledge, but began approaching the problem from different places based on our exposure to over the last few months. After we’d solved our case study we came back together as a group and discussed our conclusions. This presentation helped set me up with background information on eating disorders that served as a solid foundation for the rest of the day.


Our next speaker was Christie Williams, MS, RD, LDN, CDE, an advanced clinical dietitian who led our second session, providing us with evidenced-based strategies, techniques, and methods for dietitians to help obese patients lose weight without surgery. Motivational interviewing, physical activity, food diaries, and rebuilding a healthy relationship with food are just some of the strategies we learned about to help counsel and guide patients towards weight loss. This presentation was incredibly valuable for me, especially as an intern within the first few weeks of my clinical rotation. I know that I will be able to show patients the value of weight loss and provide education about how to lose weight without sacrificing health.

After a brief break for lunch, Suzy Carobrese, MS, RD, LDN, CDE, outpatient dietitian at Johns Hopkins, Bayview, presented on the efficacy, benefits, risks, and complications of using bariatric surgery on the overweight and obese population. We were also able to see up-to-date statistics on how common each type of surgery is, criteria for patients to be eligible for these procedures, and expected patient outcomes. This lecture helped me understand how the bariatric surgery puzzle piece fits into the overall puzzle of healthcare, and how we as dietitians are an important part of helping put together that puzzle.


Our last lecture was given by Julie Hagan, MS, who had a bariatric surgery in 2011. She shared her touching personal story about how bariatric surgery helped her overcome numerous disease states and polypharmacy; she now lives a healthy, happy life. It was really valuable to be able to hear this patient’s first-hand account of how she got ready for the procedure, how she recovered after the procedure, and what her typical day-to-day looks like now. It was fantastic to have her share her personal anecdote as the grand finale for our day of learning about interventions and treatments for obesity.

I truly appreciate the opportunity to learn from lectures given by professional experts, while collaborating and networking with my peers. The things I learned today will not only benefit me for the rest of my internship, but will help me make informed, educated decisions throughout my professional career. I’m so glad I was able to attend this Joint Class Day and I cannot wait until I’m able to put this new knowledge into practice!

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