David- Tell us more about your background and private practice. Tell us about your current vision, and your decision to get your doctorate.
Five years ago, after completion of my master’s degree in Family and Consumer Sciences and becoming a Registered Dietitian Nutritionist (RDN) I founded a company called Nutrition in Recovery which specializes in treating patients with challenging eating and substance use disorders (SUDs). The group now comprises six RDNs who supervise educational groups at SUD treatment centers throughout Los Angeles. My continuing interest in this patient population led me to develop specialized dietary and educational curriculum for people in early recovery. When possible, I have used evidence-based principles to better manage patients with nutrition-related abnormalities. This has led to three journal publications, two book chapters, two poster exhibits, seven webinars, and over 20 podium presentations. I have also written six articles for the Behavioral Health Nutrition Dietetic Practice Group who recognized my work with the “Excellence in Practice” award presented at the national Food and Nutrition Conference and Expo (FNCE) in October 2017. I have also been a master’s thesis committee member for students enrolled at California State University, Long Beach. What I am particularly proud of is my commitment to research and academics from my private practice setting.
I am finishing my first year as a Ph.D. student in Community Health Sciences at UCLA, hoping to improve the role of nutrition interventions in patients with various SUDs. My overall goal is to reduce the incidence of disordered eating in early recovery and to improve the quality of life for patients with disabling addictive disorders. SUDs are associated with malnutrition, preference for nutrient-poor food, compromised gastrointestinal health, and disordered eating. Given the current addiction epidemic, consideration should be given to prioritizing efforts to improve eating habits and overall health in recovery programs. Nutrition interventions during recovery may promote abstinence and prevent or minimize the onset of chronic illness including eating disorders (EDs). Currently there is an urgent need for improved treatment modalities for SUDs to prevent overdose and death, reduce healthcare burden, and to improve quality of life. Nutrition protocols in SUD treatment are not widely utilized. My goal is to develop evidence-based guidelines for nutrition interventions for various addictive disorders, which will hopefully lead to better policies and procedures.
Introducing the concept of food and nutrition into an SUD treatment program faces many obstacles. Many patients in early recovery are not ready for multiple health behavior changes, since most are simply trying to get past the immediate crisis of addiction and the associated life adjustments of abstinence. In several of the treatment centers where I work, patients are surprised when they discover that making small nutritional changes (such as drinking water or eating breakfast) can impact energy levels, overall sense of wellness, and optimism about being sober. There are numerous questions that relate to food, SUDs, disordered eating, and recovery that remain unanswered. Can nutrition be used to improve SUD outcomes? What is the best practice for treating co-occurring eating and substance use disorders? How can RDNs help with recovery from mental health disorders? What policy implications can address food addiction on a societal level? What new programs can be developed for underserved populations that struggle with SUD and nutrition-related challenges?
My goal in pursuing a doctorate in public health is to produce data that guides treatment. I am confident that my work in this area will create better evidence to improve funding for nutrition services, creating opportunities for dietitians to work in publicly-funded as well as underserved SUD treatment centers. RDNs desperately need more evidence of effectiveness in order to advance our profession. With new information, it may be possible to change the way we approach SUD treatment, but more importantly to improve the recovery process amidst the current opioid crisis.