Dr. Sara Forman, director of Boston Children’s Hospital’s Outpatient Eating Disorders Program and Dr. Tracy Richmond, director of the PREP weight management program in Adolescent Medicine, share five things parents should know about eating disorders.
Kids don’t have to be really thin to have an eating disorder.
Not everyone with an eating disorder looks like he or she has an eating disorder. The condition is often hidden in secret habits or obsessions. For example, binge eating and bulimia — or binging and purging — are common eating disorders not necessarily associated with thinness.
Eating disorders can affect anyone.
Boys and girls of all races/ethnicities and socioeconomic groups develop eating disorders. “We are seeing younger and younger kids. We see patients as young as nine, ten years old,” says Forman. “There is a lot of focus in schools today on performance: academic performance, athletic achievement … there’s a lot of ‘body talk.’”
Eating disorders, particularly anorexia nervosa, are the most deadly mental health condition.
Anorexia nervosa has an estimated mortality rate of 10 percent over a lifetime. While some patients die of metabolic complications of the disease, many commit suicide. The risk of suicide is much higher in females with eating disorders than in females who don’t have an eating disorder.
The majority of children and teens with an eating disorder recover in a timely manner provided they get professional help.
The good news is — there is help available. The first health care professional to talk to is your child’s pediatrician. Your child’s care team should ultimately include specialists trained in medicine (such as a pediatrician or physician in an eating disorder clinic), mental health and nutrition.
Evidence-based treatment options such as family-based therapy and cognitive behavioral therapy have proven very effective.
Family-based therapy is a way of re-empowering the family to feed the child at home. All meals are supervised and prepared by the adult, and everything is done under the care of a therapist. Gradually, the child takes back the responsibility of feeding himself or herself.
Cognitive behavioral therapy is a type of psychotherapy that is goal-oriented and focuses on changing the patterns of thinking and behaviors in patients.
Parents can often feel isolated and unsupported when trying to help their child overcome an eating disorder. “It’s important to get the help and support you need,” says Forman. This might mean seeing a therapist to work through your own feelings and struggles in relation to your child’s eating disorder.
A critical component of recovery from an eating disorder is an environment free of blame for everyone involved. Parents shouldn’t feel guilty or shameful for not noticing the problem earlier or preventing it. “Eating disorders are often illnesses of denial and secrecy, and it is not uncommon for parents to have no knowledge of a problem,” says Richmond. “It can be hard to differentiate between rebellious or avoidance-based adolescent behavior and eating disorder behavior.”
“Remember, it’s a psychological illness as well as a physical illness,” Forman adds. “You can’t just tell someone to stop doing it; it’s irrational.” Patience and understanding are very important.
“It’s not just: ‘Eat more.’ It’s about more than just food,” says Forman.
Another thing Forman and Richmond repeat to parents is: the recovery period is not short. It frequently takes months to years. (Again: patience.) Richmond stresses the focus should never be about appearance and numbers. “It should be about maintaining a healthy lifestyle and eating all foods in moderation,” she says.
For certain eating disorders, medications can be helpful. “SSRIs (selective serotonin re-uptake inhibitors, commonly used as anti-depressants) like Fluoxetine have been proven helpful for some cases of bulimia,” says Forman, adding, “There’s still so much we’re learning.”
Helpful resources for parents, children/ teens, and families struggling with eating disorders:
- Division of Adolescent Medicine
- PREP, Boston Children’s clinic for binge eating disorder
- Multi-service Eating Disorders Association (MEDA)
- Academy for Eating Disorders
- Center for Young Women’s Health
Learn more about Boston Children’s Outpatient Eating Disorders Program.