Five Reasons Parents Should be Included in the Treatment of Children and Adolescents With Eating Disorders

Parents Should be Included in the Treatment of Children and Adolescents With Eating Disorders

I had the honor of presenting a workshop yesterday along with Therese Waterhous, PhD/RDN, CEDRD. and Lisa LaBorde, Outreach Director for Families Empowered and Supporting Treatment of Eating Disorders (FEAST) at the IAEDP Symposium 2016. Our workshop was entitled, From “Worst Attendants” to Partners in Recovery: Empowering Parents as Agents of Change for Children and Adolescents …

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Condiments, the Final Frontier of Eating Disorder Recovery

By Katie Grubiak, RDN, Director of Nutrition Services Katherine Grubiak is a Registered Dietitian with a focus on blending Western & Eastern philosophies regarding nutritional healing.                                     In our work with clients with eating disorders, we help them to …

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Unintentional Weight Loss as a Trigger for Anorexia.

Unintentional Weight Loss as a Trigger for Anorexia

Some of the biggest misunderstandings about Anorexia Nervosa center around it being an intentional illness and related to vanity. A paper by Brandenburg and Andersen in 2007 entitled Unintentional Onset of Anorexia details case histories of 5 individuals who were deemed to have anorexia precipitated by “unintended weight loss” as opposed to the “more typical …

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FBT Insights from the Neonatal Kitten Nursery

FBT Insights from the Kitten Nursery

I recently began volunteering at the Best Friends Neonatal Kitten Nursery. Best Friends Los Angeles opened its neonatal kitten nursery in February 2013.  The nursery is staffed with a dedicated coordinator and supported by volunteers who sign up for two hour feeding shifts 24 hours a day to help the kittens grow and thrive. If …

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Parental direction works, but don’t expect your kid to be happy about it: Research on The Family Meal in FBT

Parents charged with helping their children to recover in Family-Based Treatment often wonder 1) how to actually get their children to eat and 2) whether they will harm their children or the parent-child relationship by requiring them to eat. A recent study addressed these concerns by looking at the family meal.         …

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Recognizing and Managing the Subtler Signs of Starvation in Children with EDs

Signs of Anorexia

This interaction on twitter caught my eye: Watching cooking shows, collecting and reading recipes, and cooking for others (but not eating it oneself) are some of the earliest signs of anorexia that are often missed and misinterpreted by parents.  In Keys’ landmark study “The Biology of Human Starvation” male volunteers were put on starvation diets.  …

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Highlights from #ICED2014: The FBT Debate

Drs. Le Grange and Strober

ICED 2014 in New York provided a wonderful opportunity to connect with colleagues from around the world who share a commitment to providing treatment to those suffering from eating disorders. Among the highlights for me were the well-attended, first-ever tweetUP and my official appointment as Board Director for Outreach of the Academy for Eating Disorders. …

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FBT Meal Strategies Gleaned from Ziplining

FBT Meal Strategies Gleaned from Ziplining

Understanding and Responding to Your Youngster’s Fear: A Metaphor I often explain to parents that for a youngster suffering from an eating disorder, a meal can feel dangerous – like jumping out of an airplane. A couple of years ago I had the opportunity to (almost) live out this metaphor on a family vacation. This …

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Empirically Validated Treatments

Empirically Validated Treatments For Eating Disorders Today’s Los Angeles Times contained an article which highlights Family Based Treatment and Cognitive Behavioral Treatment, two treatments I provide: Today, doctors and therapists focus on a handful of treatments that have been validated by clinical studies. For teens with anorexia, the first-line treatment is something called family-based therapy, …

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Traveling With Your Anorexic

Traveling With Your Anorexic

Traveling With Your Anorexic [image description: photo of person looking out at Machu Picchu]By Lauren Muhlheim, Psy.D. and Therese Waterhous, Ph.D.

Families often ask whether they should proceed with a previously scheduled trip or take a well-deserved “break” during the refeeding process.  We advise that travel during Phase 1 of FBT be avoided if at all possible.  We know several families who have vacationed with a child well along in treatment for anorexia and found their child lost 5 to 10 pounds over the course of a week, erasing months of progress.  Children and young adults with anorexia have difficulty with change; if a child is having difficulty completing meals in the home, it is unlikely that they will be able to do so on vacation, where most meals will be eaten in an unfamiliar setting in the presence of non-family members.

During vacation, parents may be tempted to give in more easily to the anorexic thinking and behaviors because they do not want to upset other diners in a restaurant or because they “don’t want to ruin” the vacation after they’ve invested a lot of money in getting there.  The food may be different than that available at home, or it may be difficult to get the types of foods on which the family has been relying.  Children and young adults with anorexia are inflexible; if the food is different than that to which they are accustomed, they may refuse to eat at all.  Sightseeing often involves a lot of walking, which can burn a lot more calories and require even greater caloric intake to offset.  Many vacations occur in warm climates, where health problems related to malnourishment or dehydration may be magnified.  If families do travel during Phase 1 or Phase 2, they should be cautioned that it may cause a setback and prolong the recovery process.

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