In honor of National Eating Disorders Awareness week, here’s some advice from our experts at the Pediatric Eating Disorders Center at Atlantic Health System, based at Overlook Medical Center in Summit, NJ:
Q: Are parents responsible for their children's eating disorders?
It is not uncommon for parents to feel guilt or blame when they discover that their child has an eating disorder. Unfortunately, this myth was perpetuated in the earlier days of diagnosing and treating eating disorders -- so much so that parents were often excluded from their child's treatment. Through extensive research on these illnesses and enhanced understanding of the underlying mechanisms that originate eating disorders, we now know that parents do not cause eating disorders and in fact are vital to helping a child recover from them.
While there is not one specific factor that has been identified as the cause for eating disorders, research suggests that such illnesses have a biological underpinning. Differences in the brain have been found with individuals who develop eating disorders. Moreover, individuals with eating disorders have certain personality traits that are evident in childhood and persist after recovery. These traits may make individuals susceptible to eating disorders.
Parents are essential in the recovery process for a child with an eating disorder. Evidence shows that when parents play an active role in treatment, there is greater likelihood for their child to make a full recovery. That is why the Pediatric Eating Disorders Center at Atlantic Health System uses Family-Based Treatment, also known as the Maudsley Method. Family-Based Treatment is an outpatient form of treatment for medically stable patients with eating disorders that puts parents in charge of nourishing their child with the therapist acting in a coaching and supportive role. All of our staff is trained in Family-Based Treatment, and most of our therapists are certified in the program by the Training Institute for Child and Adolescent Eating Disorders.
The Pediatric Eating Disorders Center at Atlantic Health System is one of the only programs in the state that uses Family-Based Treatment in all levels of care. For those individuals who are not medically stable, we offer Family-Based Treatment within our Partial Hospitalization Program and our Intensive Outpatient Program. We also offer Family-Based Treatment as an outpatient service.
The Pediatric Eating Disorders Center at Atlantic Health System, based at the Goryeb Children's Center at Overlook Medical Center in Summit, is the only multidisciplinary program in New Jersey exclusively for children and adolescents. The program offers education and treatment for anorexia nervosa, bulimia nervosa and related disorders in our partial hospitalization program and intensive outpatient program.
- Meghan L. Feehan, Psy.D., clinical coordinator
Q: Are eating disorders a choice?
That is one of many very common myths about eating disorders. Eating disorders actually are potentially deadly, biologically-based mental illnesses of unknown origin. Recent research has suggested that they may be inherited, but families do not cause eating disorders and they are not the result of a choice on behalf of the patient.
Types of eating disorders include anorexia nervosa and bulimia nervosa, among others. These conditions affect millions of Americans of all ages, both male and female, and most commonly begin in adolescence. As the illness progresses, mental health and quality of life may diminish, leading to poor self-esteem, anxiety and depression.
The good news, however, is that eating disorders are treatable and families can be a powerful tool in that process. Earlier this month, we marked National Eating Disorder Awareness Week, however more work must be done all year long to increase awareness about this illness. To start, it's important to understand some of the myths about eating disorders, including:
- Eating disorders are a choice
- Parents cause eating disorders
- An eating disorder is not that serious
- Only really thin people have eating disorders
- If my child is eating, they can't have an eating disorder
- A person with an eating disorder needs to be motivated in order to recover
- The "cause" of the eating disorder needs to be uncovered before a person can get better
- Eating disorders are a female illness
- My child is too young to have an eating disorder
- My child with an eating disorder can get better on her/his own
The Pediatric Eating Disorders Center at Atlantic Health System, based at the Goryeb Children's Center at Overlook Medical Center in Summit, is the only multidisciplinary program in New Jersey exclusively for children and adolescents. The program offers education and treatment for anorexia nervosa, bulimia nervosa and related disorders in our partial hospitalization program and intensive outpatient program.
- Meghan L. Feehan, PsyD, clinical coordinator
Q: One or two tips for parents whose children may be struggling with an eating disorder?
Healthy eating has become a huge priority in our society. That is a wonderful thing – but there can be a potential to become very limited in what foods we see as healthy and necessary, especially in growing children and teens. Growing bodies need to incorporate all foods in order to function properly and active young people especially require large amounts of calories in order to meet their bodies’ many needs at this time. Encouraging young people to add healthy components to their diet (such as more fruits and veggies) and be respectful of the rest their bodies need (plenty of sleep at night as well as rest between work outs) encourages moderation rather that elimination. And of course – eating disorders do not always look or act the way we expect them to – if you have a child whose eating or exercise habits have changed drastically, or is failing to continue to gain weight (as expected for all children and teens through puberty to adulthood) take this seriously and consult a specialist. Eating disorders are sneaky illnesses and it is often up to those closest to the child to identify even minute changes before consequences become catastrophic.
- Patricia Gazzola, APN-C, psychiatric nurse practitioner
Q: What are strategies for athletes struggling with an eating disorder or those who fear they are headed that way?
It is very difficult for individuals to recover from eating disorders without therapeutic intervention. Once a susceptible individual loses weight, the eating disorder can take on a life of its own. Eating disorders, specifically anorexia nervosa, are also ego-syntonic illnesses, which means that individuals who are affected may not recognize they are ill or may lack motivation for recovery. In fact, this is part of the criteria for the diagnosis of anorexia nervosa. Therefore, supportive figures in the athletes’ lives may need to intervene in order to guide the athlete towards treatment. To that end, it is essential that coaches are aware of the psychological and physical warning signs of eating disorders as well as the factors that can place athletes at risk.
- Meghan L. Feehan, PsyD, clinical coordinator
Q: Do males develop eating disorders?
There is a common misconception that eating disorders are an illness that affects primarily females. While it is true that estimates suggest a higher prevalence of eating disorders among females, males represent up to 25 percent of individuals diagnosed with anorexia. Moreover, research suggests that the mortality rate associated with anorexia may be higher among males.
Although the current research on males diagnosed with eating disorders is limited, there are several distinctions that have emerged. Males may be more likely to exercise excessively or have been overweight prior to the onset of their eating disorder. Moreover, males may be diagnosed at a later age. This is thought, in part, to be due to a delay in seeking treatment as a result of the gender stereotypes that exist. In fact, it was only in the publication of the most recent DSM (Diagnostic and Statistical Manual of Mental Disorders V, 2013) that a major change was made to the diagnostic criteria for anorexia. The criterion of amenorrhea (loss of period) was removed, which means that males are now more likely to receive an accurate diagnosis.
It is important to understand that these illnesses can oftentimes manifest differently in males – for example, there is often a drive for leanness and increased muscularity in male eating disorder patients rather than the traditional desire for thinness we see in females. This is also reflected in male patients being more likely to engage in excessive exercise, increase protein intake, or take dietary supplements in order to build muscle rather than counting calories.
At the Pediatric Eating Disorders Center at Atlantic Health System, we treat both males and females who are diagnosed with anorexia, bulimia, and related disorders. Since opening our Adolescent Partial Hospitalization Program in 2010, 6% of our adolescent patients (ages 13-21) have been male. However, within the past six months, males have comprised 13 percent of our adolescent patients. Moreover, since opening our Child Partial Hospitalization Program in 2015, 20 percent of our child patients (ages 8-12) have been male. This suggests that awareness is increasing as to identifying eating disorders as an illness that can affect all individuals, regardless of gender. The perception of these illnesses is thankfully moving away from one of which only affects females or being an issue directly tied to appearance and dieting.
- Meghan L. Feehan, PsyD, clinical coordinator and Patricia Gazzola, APN-C, psychiatric nurse practitioner
For more information on eating disorders and the program, call 908-522-5757.