Treating children with eating disorders

Julie Lesser, MD
Eating Disorders Institute

Ah, the middle school years. For most kids, this is a time for hanging out with friends, exploring new boundaries and becoming a full-fledged teen. But what happens when this period of development is hampered by an uncontrollable fear of gaining weight?

“Eating disorders may take a significant toll at any age, but they're especially dangerous for children ages 13 and younger,” says Julie Lesser, MD, Methodist Hospital Eating Disorders Institute. “Changes in diet may impact health more rapidly in children than in adults. Not only are they still growing, but children require adequate fuel to be active, especially if they are participating in organized sports. If they develop an eating disorder, they may become malnourished very quickly.”

Potential red flags

Girls are far more likely to have eating disorders. However, boys are still susceptible. The following signs may help identify a child with an eating disorder:

• eating in secret
• preoccupation with food
• calorie counting
• fear of becoming fat
• binge eating
• purging
• food phobias or avoidance

Understanding food phobias

A fear of certain foods may be a telltale sign of an eating disorder. For example, high-fat foods may increase anxiety levels in some kids with eating disorders. By avoiding these foods, they learn they may temporarily keep the anxiety in check. This is known as “negative reinforcement.”

Eating disorders may deprive brain cells of needed energy and, eventually, change the way people process information. This change in brain chemistry is thought to contribute to food phobias and distorted thinking, especially in regard to one's perceived body image.

Comprehensive treatment a must

Untreated eating disorders may lead to significant medical complications. Therefore, receiving care from a comprehensive treatment program is extremely important. Usually, this includes a medical doctor, a psychologist or therapist, a psychiatrist, a dietitian and a physical therapist. Families play an important role in treatment and recovery.

The first goal is to help children achieve a healthy weight. Often they require medical care to correct changes in metabolism or medical complications.

Eating disorders may damage the brain, heart, bones, kidneys and liver. Consequently, the medical team must regularly monitor children for related complications.

Psychologists or therapists help children with eating disorders cope with negative behaviors, distorted thinking patterns and any underlying issues that may have triggered the condition. For example, with cognitive behavioral therapy, patients learn to recognize situations that trigger eating disorder behaviors and then work to develop positive coping techniques. Dialectical behavior therapy is similar. It focuses on replacing negative coping strategies with more adaptive options.

Family involvement is critical

At Eating Disorders Institute, families are part of the treatment team. “Recovery rates are higher when a patient's family is involved in monitoring meals and building coping strategies,” Dr. Lesser says. “We work very hard to help parents realize that children with eating disorders have an illness — they do not engage in these behaviors intentionally. Children find it affirming when family members recognize their recovery efforts.”

To learn more about childhood eating disorders or to schedule an appointment, call 952-993-6200 or visit Eating Disorders Institute.