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Sick Enough: A Guide to the Medical Complications of Eating Disorders
Book by Jennifer L. Gaudiani, MD, CEDS, FAED
Study Guide by Alison Barkman, MS, RD, CDN
Edited by Wolf J. Rinke, PhD, RDN

20 CPEUs


Book (258 pgs) and Study Guide with 1 Reporting Form (27 pgs).

This CPE program provides a comprehensive, accessible review of the medical issues that arise from eating disorders by bringing relatable case presentations and a scientifically sound, engaging style to the topic. It will enable you to improve medical diagnosis and treatment, motivate recovery, and validate the lived experiences of individuals of all body shapes and sizes, while firmly rejecting a dieting culture. More specifically you will discover how to:

  • Care for patients who do or do not meet DSM-V criteria for eating disorders.
  • Identify the side effects associated with various eating disorders.
  • Evaluate lab values that may be affected by eating disorders.
  • Implement intuitive eating and health strategies for different populations.

For more information and customer comments, click here.
Approved by CDR

For RDs/RDNs & DTRs/NDTRs for the Professional Development Portfolio:


SUGGESTED Performance Indicators (PIs):
2.2.1, 2.2.4, 3.3, 3.3.1, 3.3.3, 4.1.1, 4.1.2, 4.1.5, 4.2.1, 4.2.2, 4.2.8, 8.1.1, 9.1.3, 9.6.1, 10.1.2, 10.1.3, 10.2.1, 10.2.2

DON'T SEE your Performance Indicators Listed here?
There are many Performance Indicators (PIs) that are applicable we can't list them all &
Per CDR you may use ANY PI as long as it relates to your Learning Plan.
For details
click here.

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To order an ADDITIONAL Reporting Form click below:


20 CPEUs



Sick Enough: A Guide to the Medical Complications of Eating Disorders
Book by Jennifer L. Gaudiani, MD, CEDS, FAED
Study Guide by Alison Barkman, MS, RD, CDN
Edited by Wolf J. Rinke, PhD, RDN

A self-directed accredited learning program approved for 20 continuing professional education units

©2020 Wolf Rinke Associates. All rights reserved for the book and ALL portions of this self-directed accredited learning program. Reproduction in whole or part without written permission from the author, except for brief excerpts, is prohibited.



Welcome to the pre-approved, accredited CPE program for Sick Enough: A Guide to the Medical Complications of Eating Disorders. The program consists of a book of the same title by Jennifer L. Gaudiani, MD, CEDS, FAED and this study guide. This CPE program is designed to help you gain a better understanding of the medical complications of eating disorders and help practitioners recognize how eating disorders and disordered eating impact people of all shapes and sizes even when they do not seem “sick enough” by medical definition. It is also designed to help you earn 20 Level 2, Continuing Professional Education Units (CPEUs).
To get the most out of this CPE program, it is suggested that you adhere to the following four steps:

  • Review the objectives of this study guide.
  • Read and study the book.
  • Assess what you have learned by answering the self-assessment questions in this study guide.
  • Compare your answers to the answer key, which you will find at the end of the study guide. If you scored at least 80% (40 questions) correct, you have completed the program and are ready to transfer your answers to the CONTINUING PROFESSIONAL EDUCATION REPORTING FORM in front of this study guide. If you scored less than 80% correct, re-read the appropriate sections of the book and re-test yourself until you score at least 80% (40 questions) correct.

After you have successfully completed the program, complete the CPE REPORTING FORM and the MANDATORY Critical Thinking Evaluation Tool (CTT) which per CDR must be completed by all credentialed practitioners and:
Submit them online at www.easyCPEcredits.com,
Or fax them to (410) 531-9282,
Or mail them to Wolf Rinke Associates, 721 Valley Forge Road #486, Valley Forge, PA 19481

Upon receipt of your CPE Reporting Form and the CTT, we will email you a Certificate of Completion within 3-5 business days.

NOTE: Per CDR we are NOT able to send you a Certificate of Completion unless we receive your completed CTT.

When you submit your CPE Reporting Form and the CTT to us via www.easyCPEcredits.com, fax or mail, be sure to write your correct email address in the space provided on the CPE Reporting Form. If writing by hand, be sure to print your email address clearly.

To ensure that our emails are delivered to your inbox (instead of your junk/spam folders), please add cpesupport@wolfrinke.com to your Address Book or Safe List of allowed email senders. Also, be sure to allow attachments from this email address.


As a result of studying and applying the concepts presented in this book, you will be better able to:

  • Recognize clients/patients can have significant eating disorder behaviors who may not meet DSM-V criteria for an official diagnosis of an eating disorder.
  • Propose how to care for such patients who do or do not meet DSM-V criteria for eating disorders.
  • Discuss and identify anorexia nervosa, bulimia nervosa, and binge eating disorder.
  • Differentiate between anorexia nervosa and atypical anorexia nervosa.
  • Identify the different purging methods used by those with bulimia nervosa.
  • Educate clients on how the body goes into hibernation from excessive restriction.
  • Evaluate eating disorders in different populations including all ages and genders, as well as special patient populations.
  • Discuss the connection between an eating disorder and a patient’s menstruation.
  • Recommend other healthcare practitioners who play a vital role in the care of eating disorders including a speech-language pathologist and therapist.
  • Identify the medical complications that occur with an active eating disorder.
  • Discuss the side effects of bulimia nervosa including acid reflux, damaged lower esophageal sphincter, and edema.
  • Assess the difference in personality traits typical of various eating disorder types.
  • Evaluate lab values that may be affected by eating disorders.
  • Recognize refeeding syndrome.
  • Define intuitive eating and health at every size.
  • Differentiate between typical picky eating in kids and avoidant restrictive food intake (ARFID).
  • Recommend a plan of action for a client suffering from orthorexia.
  • Identify the ways a person may have orthorexic tendencies.
  • Assess how eating disorders may interfere with fertility.
  • Apply knowledge in counseling a pregnant woman with a history of an eating disorder.
  • Assist a diabetic patient with an eating disorder.
  • Differentiate between an athlete with an eating disorder vs. an athlete who needs proper education in sports nutrition.


PART I: Not Enough Calories
1. 30,000-Foot View: What Happens When You Starve
2. Going into Hibernation
3. Hormones and Bones
4. The Empty Tank
5. Extreme Presentations
6. Starting to Eat Again

PART II: Purging
7. 30,000-Foot View: What is Purging? Why Does it Cause Medical Issues?
8. How Does Purging Physically Affect the Body?
9. Electrolytes and Stopping Purging

PART Ill Patients in Larger Bodies
10. Binge Eating Disorder (BED) and Weight Stigma

PART IV: The Unmeasurables (a.k.a, The Very Real Medical Problems that Modern Medicine Can't Measure)
11. Irritable Bowel Syndrome (IBS) and Associated Conditions
12. Postural Orthostatic Tachycardia Syndrome (POTS) and Associated Conditions

PART V: Specific Populations
13. Type 1 Diabetes Mellitus and Concurrent Eating Disorders (ED-DMTl)
14. Avoidant Restrictive Food Intake Disorder (ARFID)
15. Orthorexia and Food Intolerances
l6. Elite Athletes
I 7. Male Patients
18. Gender and Sexual Minorities
19. Women's Sexual and Reproductive Health
20. Older Patients
21. Substance Use Disorder
22. Caring for the patient Who Declines Treatment: The Spectrum from Mandated Treatment to Hospice Car

Conclusion: How We Can Each Make a Positive Contribution


Jennifer L. Gaudiani, MD, CEDS, FAED is a Board-Certified internal medicine physician, known nationally and internationally for her work on the medical complications of eating disorders. Her outpatient medical practice, the Gaudiani Clinic, cares for individuals of all genders, shapes, and sizes, from around the United States.


Alison Barkman, MS, RD, CDN is a registered dietitian and certified intuitive eating counselor with over 10 years of experience in a variety of settings including clinical nutrition, private counseling, and as an adjunct professor of nutrition at Long Island University, Brookville, NY, and Adelphi University, Garden City, NY.
Alison works privately with clients on intuitive eating and non-diet approaches to nutrition. She helps her clients break free from chronic dieting and disordered eating. Alison’s goal is to help children and adults stop following food rules, feel positive about their bodies, and actually enjoy food.
Alison’s podcast, Speaking of Hungry, explores rejecting diets and embracing food freedom. On the podcast, she interviews experts in the field of disordered eating, intuitive eating, and eating disorders. She is an anti-diet social media influencer and presents on intuitive eating to a variety of audiences.
Alison earned a Bachelor of Science in speech communications from the State University of New York at Plattsburgh. She returned to school and earned a Master of Science in nutrition with a concentration in nutrition and exercise science from Long Island University (LIU) in Brookville, NY.
Alison’s website is www.alisonbarkman.com and she can be found on Facebook and Instagram at @AlisonBarkmanRD.


Wolf J. Rinke, PhD, RDN is the president and founder of Wolf Rinke Associates, a company that has provided high-quality CPE programs to nutrition and dietetics practitioners since 1990.
Dr. Rinke earned a BS at Drexel University, an MS at Iowa State University, a PhD in Continuing and Vocational Education (Adult Ed) at the University of Wisconsin and interned at Walter Reed Army Medical Center. He participated in a test item writer workshop sponsored by the Commission on Dietetic Registration (CDR).
Dr. Rinke is a past Adjunct Associate Professor, Graduate School of Management & Technology at the University of Maryland, and a former Adjunct Faculty Member of the School of Continuing Studies at The Johns Hopkins University.
He has served as past president of the District of Columbia (DC) Dietetic Association and has been honored by the Academy of Nutrition and Dietetics with the Award for Excellence in the Practice of Management, the Outstanding Dietitian of the Year Award, and the Outstanding Service Award, in addition to delivering the Lenna Frances Cooper Lecture.
Dr. Rinke has served in numerous leadership roles at the Academy of Nutrition and Dietetics: Chair of the Scholarship Committee for Dietitians in Business and Communications; Chair of the Communication Committee, Honors Committee, and Licensure Panel and Ethical Practices Task Force for the Commission on Dietetic Registration; Chair of the Area Coordinating Committee and Chair for the Code of Ethics; Member of the Resource for Education Programs Committee; Member of the House of Delegates; and Member of the Board of Directors.
Dr. Rinke is the author of more than 500 articles, numerous CPE self-study programs, and several popular books including Make It a Winning Life: Success Strategies for Life, Love and Business; Winning Management: 6 Fail-Safe Strategies for Building High-Performance Organizations; and Don t Oil the Squeaky Wheel and 19 Other Contrarian Ways to Improve Your Leadership Effectiveness.


Special thanks to the following individuals for their careful review of this CPE program.

Lisa Licari, RDN, CDN
Permanent Change Nutrition
Garden City, NY

Marina Park, MS, RDN
Pediatric Dietitian/Nutritionist
Pediatric Gastroenterology Associates
Bon Secours Mercy Health
Richmond, VA

Amber Rosalez, MS, RDN, LDN
Nutrition Manager of Eating Disorder Program
Eating Recovery Center
Chicago, IL


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