A Powerful Eating Disorder Antidote

Louis Bell, MD, Chief of the Division of General Pediatrics, shares the latest in medical thinking on an important topic: childhood eating disorders.

At least 30 million people in the United States — including children as young as 5 — suffer from an eating disorder. Eating disorders lead to poor nutrition, which can cause many dangerous medical and psychological complications, especially for young people whose bodies are still growing.

But there is good news: Eating disorders are treatable. I asked the leaders of CHOP’s Eating Disorder Assessment and Treatment Program, a joint program between Child and Adolescent Psychiatry and the Craig-Dalsimer Division of Adolescent Medicine, to explain the benefits of family-based treatment (FBT), a form of therapy that enlists parental support to help children recover.

In FBT, family members play a critical role in supporting their child in eating at home. This approach has proved one of the most effective ways to achieve lasting recovery in children and adolescents. It entails weekly family therapy that initially focuses on normalizing eating and gaining weight and later focuses on promoting normal child and adolescent development.

“Parents are their kids’ best allies in treatment,” says Program Co-director Rebecka Peebles, MD. “They are the experts in their kids, and we are the experts in these illnesses. Together, we can help these kids return to wellness.”

What to do?

Peebles and Program Co-directors Eleni Lantzouni, MD, of Adolescent Medicine, and Laurel Weaver, MD, PhD, of Child and Adolescent Psychiatry, shared the following general tips:

• The earlier, the better. Early intervention with family-based treatment is key to preventing long-term consequences and achieving the best results in recovery.
• Don’t wait for rock bottom. You shouldn’t wait for a child to “want” to get better before you intervene. FBT can start regardless.
• Eating isn’t optional. Make eating a requirement in your home.
• Talk to kids. Have honest discussions with your kids, and trust your instincts.
• Pay attention to growth. It isn’t normal to lose weight in the teenage years, so if a child falls off personal height or weight curves, talk to your pediatrician — particularly if eating disorders run in the family.
• Know the signs. A preoccupation with weight, loss of appetite, diets that become more restrictive, over-exercising, changes in mood and social withdrawal can be emotional and behavioral signs of an eating disorder.
• Get more information. Learn about CHOP’s Eating Disorder Assessment and Treatment Program at chop.edu/eating-disorders.