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Eating Disorders in Pre-Adolescents
Kim McCallum, M.D.
Kim McCallum, M.D. – Medical Director & Founder of McCallum Place
December 15, 2016
EDH: Dr. McCallum is the Founder of The McCallum Place and here to share her expertise. Welcome, Dr. McCallum!
EDH: Please tell us a little bit about yourself and your current involvement in the eating disorder community.
Dr. McCallum: I am the founder of McCallum Place, a child and adolescent psychiatrist, and a patient and family advocate
Dr. McCallum: I also train psychiatrists and other ED professionals on how to evaluate and treat eating disorders
Dr. McCallum: We use Family Based Therapy, team-based interventions, partial hospitalization and medication strategies to help patients with eating disorders
EDH: What are some of the issues that adolescents face when dealing with eating disorders?
Dr. McCallum: Adolescent Brains are still rapidly developing, emotion regulation is emerging, more impulsive in action, and mindsight is not fully developed
Dr. McCallum: Restrictive eating may disrupt this process
Dr. McCallum: Adolescent bodies are changing rapidly. They are gaining weight, and their height and shape are changing.
Dr. McCallum: Out-of-balance eating may change the natural trajectory of growth and development
Dr. McCallum: Hormones are surging, there is an increased interest in peers, sexuality, and restrictive eating will blunt that surge and potentially suppress sexual interest
Dr. McCallum: Most teens are becoming more independent and find themselves with less parental and teacher supervision
Dr. McCallum: This may increase anxiety, especially if you are prone to social anxiety
Dr. McCallum: A loss of family meals or sensitivity to parents’ dieting, concerns about weight gain or health can trigger unbalanced, overly restrictive eating, precipitating anorexia or binge eating
Dr. McCallum: Schoolwork is more complicated; they are learning to balance activities and social life.
Dr. McCallum: Teens with eating disorders often miss some school due to the need for monitored meal support and intensive treatment.
Dr. McCallum: School routines and coordinating efforts with the school staff are important for a successful transition back into the classroom
Dr. McCallum: Some teens adopt unwholesome eating strategies in a misinformed attempt to gain control
Dr. McCallum: These days, many teens are involved in elite sport, and coaches and parents may not understand the significant caloric needs required for intensive training.
Dr. McCallum: Kids are at risk of weight loss and injuries. Injuries can increase stress and lead to anxiety associated with prescribed rest.
Dr. McCallum: Teenagers may be adapting to a loss of a pet/friend or family member, divorce, bullying, or changes in school that are unsettling and create more anxiety.
Dr. McCallum: Advertising focuses a lot on presenting the body ideal. Eating disorders complicate all of these changes
EDH: What are the early signs/symptoms that may indicate an adolescent is struggling with an eating disorder?
Dr. McCallum: Emotional symptoms of an ED might include numbness, irritability
Dr. McCallum: Mindset changes to increased preoccupation with body size, shape and weight, they may voice critical judgment or need to be reassured about appearance
Dr. McCallum: Family and friends may notice rigid eating, avoidance of certain foods, loss of flexibility around eating, preoccupation with calories or ingredients
Dr. McCallum: To hide behaviors, teens may avoid eating around others and lie about eating meals away from family
Dr. McCallum: Some teens will begin purging, parents may notice that they run to the bathroom after eating, or find evidence of vomiting stored in bags or trash cans, vomiting can affect plumbing
Dr. McCallum: Binge eating can become a habit. Typically teens are ashamed and will hide the behavior, families may find hidden food wrappers, and food may disappear
EDH: What are early interventions for an adolescent developing an eating disorder?
Dr. McCallum: A Comprehensive psychiatric and medical evaluation is key to clarify medical risk, the possibility of malnutrition and to screen for anxiety and depression is important.
Dr. McCallum: Restoring appropriate nutrition is very important.
Dr. McCallum: If weight is suppressed, parents should monitor meals with a focus on full weight restoration, addressing unwholesome behaviors, reintroducing foods that have been omitted.
Dr. McCallum: Some find that advice from a dietitian is helpful
Dr. McCallum: Family-based treatment is typically a good first step.
Dr. McCallum: Once the eating is more stable, therapy typically focuses on adolescent development, identity, interpersonal and family concerns
Dr. McCallum: If symptoms are severe or there are medical complications, depression, or PTSD, partial hospital care with more intensive therapy, skills, family support, meal exposures and medical monitoring may be indicated
EDH: What encouragement might you offer parents/caregivers who have an adolescent with an eating disorder?
Dr. McCallum: With early specialized intervention, full recovery rates for teenagers are high
Dr. McCallum: Be prepared that treatment may take a while, typically over a year, requiring lots of support, but efforts and attention will pay off. Think marathon, not sprint.
Dr. McCallum: Parents are not to blame for EDs, but they can evaluate and challenge their own beliefs about body size, shape and weight, exercise and eating behavior to create a wholesome environment for recovery
EDH: What services are offered at McCallum Place for adolescents?
Dr. McCallum: We offer comprehensive evaluation, IOP, partial hospital services and residential level of care.
Dr. McCallum: Our programs integrate medical, psychological and nutritional therapies
Dr. McCallum: We design meal exposures to help introduce foods that have been omitted
Dr. McCallum: Interfere with unwholesome food rituals and support restoration to a safe, natural weight
Dr. McCallum: We provide family therapy and support, coaching skills to support full recovery.
Dr. McCallum: We offer once a week individual family therapy, parent skills group, parent support groups and a monthly full-day interactive family curriculum
EDH: If you are struggling with an eating disorder, we hope this might be a helpful resource for you.
EDH: Please stay tuned for future Twitter Chats from EDH, and visit us at www.eatingdisorderhope.com
EDH: If you are interested in learning more about McCallum Place, please visit their website at www.mccallumplace.com
The EatingDisorderHope.com editorial team comprises experienced writers, editors, and medical reviewers specializing in eating disorders, treatment, and mental and behavioral health.
