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Eating Disorders and Age
Dr. Kimberli McCallum, Director and Founder of McCallum Place
Hosted by Kimberli McCallum, M.D., of McCallum Place
January 28, 2016
EDH: Welcome to today’s #EDHchat! We are excited to have you all with us! We would like to start by welcoming our special guest, Dr. Kimberli McCallum, who will be tweeting as @McCallumPlace. Special thanks to @McCallumPlace for helping us make this twitter chat possible! Dr. McCallum is the Medical Director and Founder of McCallum Place.
Dr. McCallum, please tell us a little about yourself and your current role.
Dr. McCallum: I am the Chief Medical Officer and Founder of McCallum Place Treatment Center. I am a psychiatrist and a psychotherapist with additional training in child and adolescent psychiatry. I have worked with families and sufferers for 25 years. I had several female family members with mixed type AN and BN and several males in my family struggle with BED.
EDH: What impact does age have on eating disorders?
Dr. McCallum: A person can develop an eating disorder at any age but the average age of onset is early adolescence.
Adolescents are starting to form their identity and may not have fully developed skills to cope with stress and change. Sleep is typically disrupted which is already a concern in teens. The brain is still developing and may be particularly vulnerable to low blood glucose and electrolyte abnormalities.
Young adults may be pursuing college or graduate school or may be living alone. Social isolation can lead to rapid deterioration if impulses are frequent and mindset is poor. Life transitions may make this period particularly difficult.
Unaddressed earlier sexual trauma may precipitate symptoms in some patients.
Pregnancy can sometimes support more wholesome behavior but many are at increased risk postpartum due to changes in hormones, in addition to body size, and shape, and significant adjustments to new life responsibilities.
Mid-life adults may first develop symptoms or relapse if vulnerable during major life transitions such as divorce, change in jobs, children leaving school. Struggles with very rigid thinking and inflexibility may lead to significant decline in physical health.
EDH: What are some age related medical complications of eating disorders?
Dr. McCallum: Young adult patients will often struggle with fainting or medical complications related to frequent purging or low available energy. When a young adolescent develops an eating disorder, they are very vulnerable to endocrine suppression. Growth may stop and bone mineral density may not increase as expected. Low available energy can effect heart rate and blood pressure. Girls may lose their menses. Laxative and vomiting can lead to dehydration and fainting or serious problems with reflux or constipation. Excessive exercise can worsen the risk.
In young adulthood osteopenia and osteoporosis may first be detected as the effects of years of struggle may start to accumulate. Fertility can be affected. Medical complications such as hypotension, autonomic instability, chronic dysmotility and poor bone health will begin to contribute to increasing health problems
EDH: Are some age groups easier to diagnose?
Dr. McCallum: Young children and older adults, eating disorders may be misdiagnosed as other medical conditions. Eating disorders are often missed in males, in athletes and in those presenting later in life. Young adults and teenagers with new onset illness are more easily recognized by families.
EDH: How does age impact treatment for eating disorders?
Dr. McCallum: Early aggressive intervention in adolescence is associated with a good outcome for many. The good news is that many with minimal recovery in adolescence go on to fully recover. Maturity helps young adults develop the courage and skills to recover.
Older patients may benefit from groups that address other aspects of wholesome adult identity.
Younger patients benefit from parent training and often family based treatment with parents providing meal support.
Child and adolescent trained specialists can best help clarify the best plan for school, can address common issues related to adolescent brain development. For teens, modify technique by addressing topics such as cyberbullying and emerging sexuality.
Effective Interpersonal skills support recovery and expectations are different during different life phases. Therapy is well served when the developmental aspects of an emerging healthy identity are supported. Partial hospital and residential care is a good option for most patients with serious symptoms not responding to outpatient care. Best delivered by professionals with expertise in the special psychological and medical needs of their life phase.
EDH: Thank you Dr. McCallum for sharing this great insight about eating disorders and age. If you or a loved one has been suffering, we hope this information brings you hope. For more information about Dr. McCallum and The McCallum Place, visit The McCallum Place. Thank you to everyone who participated in our Twitter Chat today! And thank you for the great insight @McCallumPlace.
Please stay tuned for future Twitter Chats from EDH! If you are in need of resources for an eating disorder, visit our website at Eating Disorder Hope.
