Childhood Eating Disorders Blog

Dear Readers,

Last weekend I attended the 17th Annual Renfrew Center Foundation in Philadelphia. I had heard that this was one of the best eating disorders conferences out there, and was not disappointed. There were so many great speakers and topics that it was difficult to choose which sessions to attend. In the next several blogs, I’ll be reporting bits and pieces of what I learned.

The title of the conference was “Feminist Perspectives and Beyond: Exploring Eating Disorders Recovery.” Workshops included complex discussions on the role of genetics and cultural factors in the onset of an eating disorder; spirited discussions on the Maudsley method of treatment (in which parents take the lead role in refeeding their eating- disordered child, and which Marcia and I discuss extensively in The Parent’s Guide to Eating Disorders), and the ever popular discussion of how and where the war on obesity intersects with the war on eating disorders.

In this blog, I’ll just tell you a few things that struck me about the workshops that I attended. Later I’ll blog in more detail. I heard a lot about the situation in which an eating-disordered child is trying to get well, but is hampered by a parent, either mom or dad, who also has an eating disorder. Sometimes this parent is terrified of trying to help her child recover because she has been unsuccessful in treating her own eating disorder. She doesn’t know what portion sizes are normal, she doesn’t know how to fix a balanced meal. One nutritionist asked, “What do you do when your trying to help your patient who is away at college and her mother calls her on the phone and says, “I had pickles for lunch!” Or the child who just can’t recover while living with parents who prize thinness over all other qualities. Sometimes the parent will either consciously or unconsciously sabotage a child’s recovery. One nutritionist brought up the situation where her college-aged patient was terrified of going home for break because she knew it would mean being around mom, and inevitably succumbing to the disordered-eating behaviors that ruled the home.

Another topic that I heard a lot about was the desperate need for more transitional, or step-down care for patients who are coming out of an inpatient facility. Their risk of relapse is so high at this point because the patient has been coaxed, often against her will, to restore normal body weight. Often these patients are sent home without knowing how to shop for food or stick to the food plan. Often parents are equally clueless. Without boundaries and guidelines, relapse follows.

Another message I was struck by was the plea by so many professionals to take the focus off weight and dieting and to put it onto to health. That means not obessing about pounds and BMI, but on eating and exercising to stay fit and healthy. The slogans “fat and fit” or “healthy at all sizes,” were phrases I heard more than once.

I’ll be blogging on these and other topics I learned about at the Renfrew Conference, so stay tuned!

 Be well,

Nancy 

Dear Readers, 

In The Parent’s Guide to Eating Disorders, Marcia and I devote a whole chapter to “disordered eating,” behavior that isn’t severe enough to be called a full-blown eating disorder, but nevertheless can ruin a person’s life. We tell the story of one patient, Rosalind, who is in her mid-twenties and has been seriously dieting since the age of 13. Her weight loss has never been great enough for her to be classified as an anorexic, yet Rosalind suffers from lack of periods, one of the class symptoms of anorexia. Rosalind’s life has revolved around her eating disorder for the past 10 years. She’s thin, yet she has such a negative view of her own body that she refuses to date. She’s got a great new job at an ad agency, but it’s hard for Rosalind to make friends because she turns down any invitation that involves food. She looks totally put-together, her hair stylishly cut, dressed head-to-toe in the latest looks. Yet Rosalind feels anything but at ease. Her kitchen is a mess, and at any given moment, she is either dieting or living on junk food. Although her “binges” are small, she feels miserable when she eats four croissants for dinner. Occasionally she makes herself throw up or uses laxatives to purge. 

What Rosalind is engaged in is “disordered eating,” a chaotic and haphazard pattern of food consumption that makes her feel out-of-control and anxious all the time. She worries about her weight. She worries that she’s eaten too much, or that she hasn’t eaten the right foods. Despite her outward polish, Rosalind’s life is in shambles.

What Marcia has found with her patients is that when a child or adult learns to eat regular meals and snacks in a patterned yet carefree way, these anxieties fade. (See Part Four: Healthy Eating Guide of our book for more information on learning and sticking to the Food Plan.) Adopting a pattern of regular meals and snacks not only lessens anxieties about food, eating and weight, it lessens all anxieties, allowing you to live a more organized life.

Just recently, Marcia received a call from her patient Christie’s mom, who reported that her daughter’s grades have never been better. Mom is sure that Christie, a junior at a small Vermont high school, feels better and is more energetic because of the regular eating patterns she has recently adopted with the help of the Food Plan.  Both mom and Christie are amazed at how, miraculously, when Christie’s eating became more organized, the rest of her life became less chaotic and more manageable as well.

This close connection is especially visible with children, for whom disorganized eating can affect the quality of their lives, their health, and, as Christie’s example shows, even their school work. I was reminded of the link between chaotic eating and chaotic living recently when I spoke to my friend Deborah Kawashima (www.creativeOrganizer.com), a Los Angeles-based personal organizer.  Deborah told me, “Eating healthy requires organization, and being organized is a skill that anyone can learn. For parents, or whoever is shopping for food, being organized with your food means making a healthy shopping list (for ideas, see Part Four, Chapter 14 of our book), so that when you shop, you are shopping for those specific items, not impulsively buying whatever looks yummy at the moment. This way, you have healthy foods available at home or on the go.”Deborah explained that when hunger strikes, kids – and adults – tend to grab whatever is at hand. All too often, what happens to be at hand is junk food. “As part of your kids’ homework routine,” she suggested, “schedule snack time right before they do their homework. This will give them energy and is a nice transition from school to homework time. I create a ‘Snack Area’ for my clients in the kitchen (on a kid-level shelf or in a basket) where kids can easily choose a healthy snack when they are hungry. I include a place for plastic cups and plates for even the youngest child to reach. It’s just as easy for them to get into the routine of eating an apple or cheese stick as it is to grab a bag of chips.”

 What Deborah and I realized was that our areas of interest overlap. “Organizing your food and eating routines are part of being an organized family,” Deborah said. “There is definitely a connection between organized eating and being organized with homework routines!” 

Be well, Nancy