Thyroid Health and Eating Disorders: A Critical Connection for Dietitians
August 20 @ 10:00 am - 11:00 am PDT

Eating disorders (EDs) are complex psychiatric conditions with profound physiological consequences, notably impacting thyroid function. This presentation will delve into the intricate relationship between malnutrition, adaptive metabolic changes, and thyroid health in ED patients, with a particular focus on Euthyroid Sick Syndrome (ESS).
We will explore the mechanisms underlying ESS, its characteristic laboratory findings, and its clinical presentation, emphasizing how it mimics primary hypothyroidism. During nutritional rehabilitation, the body transitions into a hypermetabolic state, where the normalization and potential ‘overshoot’ of thyroid hormone levels, particularly T3, significantly contribute to increased energy expenditure, posing substantial challenges for weight restoration. A critical discussion will highlight the significant risks associated with inappropriate thyroid hormone replacement in this population, including the exacerbation of cardiac complications and the reinforcement of disordered eating behaviors. Furthermore, we will briefly address the symptomatic overlap between EDs and conditions like POTS, EDS, and MCAS, underscoring the importance of vigilant eating disorder screening. The presentation will empower eating disorder specialized dietitians with essential knowledge for comprehensive patient assessment, prioritizing nutritional rehabilitation as the cornerstone of ESS and hypermetabolism management, and fostering interdisciplinary collaboration to optimize patient outcomes. |
Learning Objectives:
Following this presentation, participants will be able to:
- Differentiate Euthyroid Sick Syndrome (ESS) from Primary Hypothyroidism: Participants will be able to distinguish between Euthyroid Sick Syndrome (ESS) and primary hypothyroidism in eating disorder patients based on key laboratory findings and clinical context, recognizing ESS as an adaptive metabolic response to malnutrition.
- Identify Risks of Inappropriate Thyroid Hormone Replacement: Participants will be able to articulate the significant medical and behavioral risks associated with the inappropriate use of exogenous thyroid hormones in eating disorder patients, particularly those with ESS.
- Prioritize Nutritional Rehabilitation for ESS and Hypermetabolism Management: Participants will be able to explain why nutritional rehabilitation is the cornerstone of ESS and hypermetabolism management in eating disorders and describe its role in normalizing metabolic and thyroid function.