Eating Disorders and Disordered Eating Behaviors Part III: Treatment

In my previous newsletters I discussed disordered eating behaviors and eating disorders, what they are, their symptoms (https://www.drzeynepokurguner.com/post/tweens-and-teenagers-learning-how-to-take-care-of-themselves-disordered-eating-behaviours-and-eat) and how we can minimise the possibility of our children developing them (https://www.drzeynepokurguner.com/post/disordered-eating-behaviors-and-eating-disorders-part-ii-prevention).

We know that eating disorders are quite sneaky and dangerous to the point of being lethal. They are the mental health disorders with the second highest mortality rate, first being the opiod crisis. Studies show that treatment outcomes are quite succesful, when the patient is younger than 18 years old and have been suffering from eating disorders for less than 3 years. So, let’s see what we should be doing, if we see symptoms of eating disorders or disordered eating behaviors in our families.

The most important thing is to trust your gut. If you think that there is something going on, talk to your child. Dr Kelly Bhatnagar, who is an expert on eating disorders, states that early treatment is crucial. It is essentially quite different to treat a patient who has developed disordered eating behaviors than a patient with a full-blown eating disorder. With early detection and treatment it is posible to have a full recovery, she says.

If we have seen some unusual things going on such as finding wrappers in our child’s bedroom or they have been excessively exercising, first, we should talk to them in a non-judgemental way. Dr Bhatnagar suggests what she calls ‘observe and describe’ method. A simple, ‘Hey I have found wrappers of chocolate bars in your bedroom and wanted to ask you about it” would be more than enough to start the conversation. Then, wait for their answer… They can simply say ‘ohh I was studying for my exams late at night and needed to eat chocolate for energy.’ You may be convinced that this is nothing serious. So you can simply talk about what other, preferably, healthier options to eat late at night etc…However, when people are hungry or depleted of food for long, their capacity of higher thinking declines and therefore they show lack of insight. This is one of the most common effects of starvation and it is therefore very common in people with disordered eating behaviors and eating disorders. This is also the reason why simply talking about food and telling our children ‘you are not fat’ does not work if they already have gone down that route. Therefore, if you are not convinced by their answer, or your gut feeling is still telling you that there is someting wrong going on, YOU DO NOT WAIT! Dr Hildebrandt suggests that we should openly tell them what concerns us and say “It is not your fault but it is my duty to help you deal with this.” Then, book an appointment with your pediatrician or GP. Talk to your medical practitioner about what concerns you and ask for some tests and check ups to make sure that your child does not have any health problems due to starvation or malnutrition. If, following their consultation, your pediatrician is concerned, they can probably refer you to the right people who are expert in eating disorders.

Eating disorders are complex mental health conditions and they need to be treated by mental health professionals who are expert in these conditions. Over the past 25 years, there have been significant changes in the way of treating eating disorders in adolescence. One of the most effective treatments was developed here in London, Maudsley Hospital and it is called ‘Maudsley Approach’ or ‘Maudsley Family Therapy’. Studies repeatedly show that this treatment is succesful both in short term and long term (5 year) in recovery especially with Anorexia Nervosa. This is mainly a family based treatment which uses parents as a resource of support for the patient. The therapists teach parents how to support and encourage their children eat more food without being seen intrusive or controlling by their children. This approach mainly aims first to help the child start eating and recover from the physical and psychological effects of the starvation with the support of parents. Once this is achieved, further steps towards full recovery are taken. This approach is effective, if the child has a strong, healthy family unit which can provide this support. However, there are also many other treatments for eating disorders, if family based treatment may not be available or suitable for the adolescent patient.

In any case, make sure that the professionals you work with conduct research supported treatments and methods. Do ask them about their methods, ask them about research and scientific sources about the condition your child is dealing with. It is paramount that we find the right type of support in a timely manner, if need be.

If you wish to read furtheron this topic:

Raising Good Humans Podcast by Dr Aliza Pressman: How to Prevent Eating Disorders and Disordered Eating with Dr Tom Hildebrandt (Spotify)

Eating Disorders with Dr Kelly Bhatnagar - Dr Lisa Damour

Maudsley Center For Child and Adolescent Eating Disorders: Family Based Therapy

Le Grange, D., (2005), “The Maudsley Family Based Treatment for Adolescent Anorexia Nervosa”, World Psychiatry, 4(3), 142-146