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Understanding Eating Disorders

April 5, 2022

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Community Conversation: Meghan Feehan, PsyD, and Stephanie Levine, DO,

Eating disorders are serious illnesses that require prompt treatment. Experts from Atlantic Health System's Pediatric Eating Disorders Center joined a Community Conversation on February 23, 2022, to help parents recognize the signs of an eating disorder and learn where to turn for help.

What is an eating disorder?

Eating disorders are behavioral conditions characterized by severe and persistent disturbances in eating behaviors, according to Meghan Feehan, PsyD and Stephanie Levine, DO. Dr. Feehan added that eating disorders are often coupled with distressing thoughts and emotions. Examples of eating disorders include anorexia nervosa, bulimia nervosa, and avoidant restrictive food intake disorder (ARFID).

Who is affected by eating disorders? Is it more predominant in men or women?

Anyone can be affected by an eating disorder. There is a common misconception that eating disorders only affect affluent white women, Dr. Feehan said. In fact, eating disorders cut across all socioeconomic and ethnic groups. Although women are affected at higher rates, all genders can develop these conditions.

What treatment options and resources for eating disorders are available at Atlantic Health System?

Both doctors emphasized the multidisciplinary approach to treating eating disorders at Atlantic Health System. An expert team of physicians, nurses, psychologists, social workers, and dietitians provide specialized services tailored to the individual needs of each patient. Medical and psychological evaluations are performed to determine the level of treatment needed. Most patients access outpatient care, but programs at the hospital are available for those who are medically compromised and require more intensive care.

How are eating disorders identified?

Dr. Levine noted that it is easier to physically identify patients with anorexia, because they are more likely to present symptoms such as low weight. Other eating disorders, including bulimia, manifest in different ways, with both psychological and physical symptoms. She added that during adolescence, parents should be aware of unusual changes in the physical and mental health of their children. “Parents, it's really important that if you have some suspicion, the first step is to talk to your pediatrician,” said Dr. Levine. “Bring it up, don't be afraid.”.

Atlantic Health System offers a resource to quickly connect physicians with subspecialists in pediatrics.

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Has the pandemic increased eating disorders for adolescents?

Dr. Feehan said there has been a significant increase in the prevalence of eating disorders among the adolescent population. Many young people are suffering from anxiety and depression, which makes eating disorders worse. School closures have added an additional layer of stress. School provides structure and consistency for many adolescents and, when schools were disrupted during the pandemic, it created uncertainty.

“The kids we treat are very similar, they’re very perfectionistic, high achieving, driven kids. They really like predictability and certainty. And we are living in a time where they have none of that.”

In response to the increase in demand, Atlantic Health System is expanding its eating disorder program to offer more services and treatment options for individuals who desperately need care.

What is ARFID and is the condition more prevalent in individuals who have food allergies, like celiac disease?

ARFID stands for avoidant restrictive food intake disorder. Individuals who are affected by ARFID experience significant weight loss or fail to make appropriate weight gains. Unlike other eating disorders that stem from an individual’s concerns about body image or fear of weight gain, people who suffer from ARFID have often experienced an adverse result from eating, Dr. Feehan explained.

For example, they may have choked or become nauseated when eating, and as a result, limit their intake to a very narrow group of foods to avoid a similar experience or discomfort. Sometimes, this avoidance is related to food allergies, especially if an individual has had a very negative reaction to a specific type of food.

What are signs and symptoms of anorexia?

Dr. Levine said that in addition to weight loss, behaviors that may indicate anorexia include not eating with the rest of the family, skipping meals, avoiding friends, isolation, and disengagement. Dr. Feehan added that if you suspect your child is experiencing symptoms of anorexia, based on your observations, it is important to be direct with your concerns. Tell them you are worried for their health and “rely on your parental gut” about your child’s reaction.

What ages are eligible for the Pediatric Eating Disorders Program at Atlantic Health System?

Children and young adults up to age 21 can access care through our pediatric eating disorders program. Atlantic Health System also treats adults with eating disorders. Connecting with your primary care physician is the first step toward treatment. Dr. Levine emphasized the importance of developing a relationship with a primary care physician for your overall health and wellness. Find a doctor >

Is binge eating a type of eating disorder?

Dr. Levine said that binge eating is a newly recognized eating disorder that is not currently treated at Atlantic Health System, although referrals are provided for appropriate care.

Does treatment for eating disorders make a difference?

Eating disorders are curable and reversible, unlike most psychological illnesses that you simply learn to manage. Atlantic Health System uses family-based treatment, also known as FBT. It is the only evidence-based treatment for eating disorders and our Pediatric Eating Disorders Program is the only location in New Jersey to use FTB as their primary treatment. Dr. Feehan said “With this type of treatment, it's incredible, we see patients recover. When you see it, it’s so gratifying...it's phenomenal. We have data that we've been gathering since the program has opened and we have a very high success rate.”

What is the time frame for recovery?

Dr. Levine noted that there are many medical consequences to having an eating disorder. Weight restoration is a small step on the journey to recovery. The process of recovery using family-based treatment typically takes between nine and 12 months. Dr. Feehan said it is important to note that the path to recovery is not always a straight line and there may be setbacks along the way.

“We say it’s like walking up a sand dune. For every couple steps up, you slide back a little bit."

If a young adult is away at college, is the process of recovery more challenging?

Constant and open communication is important, and Dr. Feehan suggested that having a weekly meeting on the phone or via video conference is a valuable way to provide support to a college student. The school itself may be able to provide support through weight checks, therapy, and other resources. Parents should secure permission to speak with the child’s health care provider if they are over the age of 18.

What should I look for when choosing a doctor for an eating disorder?

Dr. Levine said it is important to find a specialist with experience. Explore your options, do research on different facilities and resources that are available, and ask questions that are specific to your circumstances.

What can I do if I have a teenager who refuses to see a doctor about an eating disorder?

Dr. Feehan advised sharing your concerns with your child. She said that the job of a parent is to make sure that their children are safe and healthy.

“I think just using that (language) and saying ultimately, ‘I need to make the best parental decision for you. And that sometimes involves making decisions that you might be unhappy with or uncomfortable with; but I know will benefit you in the long run,’” she said.

Dr. Levine added that it is important to not hide your intent to seek medical attention for your child’s condition. They need to feel safe and prepared for the medical intervention.

How can I get in touch with the Pediatric Eating Disorders Center?

We’re located at Overlook Medical Center in Summit, New Jersey and can be reached by phone at 908-522-5757. In addition, crisis hotlines are available at all our medical centers for any mental health issues. Learn more >

Learn more about the Pediatric Eating Disorders Center >