Childhood Eating Disorders Blog


Archive for June, 2008

Check out Our Los Angeles Times Op-Ed: “Starved for Adequate Care”

Saturday, June 28th, 2008

Dear Readers,

There is an interesting court case about to start in Los Angeles involving the parents of a 26-year-old anorexic, Janell Smith, who committed suicide after her insurance company cut off coverage for her hospitalization. It’s amazing how this is still happening, and how insurance companies are still getting away with it. 

Marcia and I, along with the esteemed David Herzog, M.D., who besides teaching psychiatry at Harvard Medical School, heads the Harris Center for Advocacy in Eating Disorders at Massachusetts General Hospital, wrote this op-ed piece on the court case, published in today’s Los Angeles Times.

We’d love to hear any of your eating disorder-related health insurance stories.

 Take care,

Nancy

At What Age Should You Start Worrying about Your Child’s Weight?

Tuesday, June 17th, 2008

Dear Readers,

The issue of rising obesity among young children has been a difficult one for those in the eating disorder field. Yes, the increase has been frightening, and something should be done about it. But the fear is that approaching the problem too zealously, or without giving a child the right information and tools to manage weight, well-meaning parents and health care professionals could be putting the child at risk for an eating disorder as she or he grows up.

I saw this issue addressed again recently in a June 10 article in The Wall Street Journal, “The War on Obesity Targets Toddlers.” The article discussed parents of mere 3-year-olds who were informed their toddler was overweight and told something needed to be done. Hospitals and clinics, in turn, have duly responded to this “crisis.”

The Cincinnati Children’s Hospital Medical Center, for instance, reports the Journal, now has a weight-management group for 2- to 5-year-olds, and there are a number of pre-school programs across the nation aimed at increasing physical activity for both overweight and normal-weight kids.

Here’s Marcia’s reaction to this trend of labeling younger and younger kids as obese and trying to teach them better eating and exercise habits: “These kinds of programs do make me nervous, but I am aware that research has been done showing that good weight loss programs for children and teens don’t cause eating disorders.”

An University of Minnesota study published this year that found that when parents correctly realized that their child was overweight they tended NOT to react in constructive ways such as offering more fruits and vegetables, fewer high-sugar drinks, snacks and fast foods; cutting down on tv viewing; increasing family meals and exercise, and teaching kids how to make healthful food choices. Instead, the parents in this study simply put their kids on a restrictive diet. We know that such diets do not work, especially for girls, who are more likely to develop body image problems and/or an eating disorder. Of course this Minnesota study targeted adolescents, not 3- and 4-year-olds, but still this finding is likely true for parents of toddlers who are overweight as well.

The key seems to be to make sure that whether you are working with a younger or an older child, you have the proper nutritional supervision as you embark on a weight-loss program. It’s important to remember that your child is still growing, and needs a variety of foods: protein, fats, carbohydrates, fruits and vegetables. The Journal article points out that kids up to about age 5 need a higher percentage of fat in their diet than adults do, as well.

Marcia herself has worked with many overweight children with good success. “What I’ve found is that these kids end up protected from eating disorders because they have learned healthy ways to manage their weight,” she says. “I also talk to my young patients about body image and genetics AND the dangers of eating disorders.”

Marcia’s advice to parents: “Make sure any weight loss program you enroll your children in addresses these important issues.” A child who knows that weight and size are largely genetically determined, that body acceptance is important to maintaining a stable weight, and that starving oneself can lead to an eating disorder is a child who has a better chance at healthy weight management.

Take care,

Nancy

New Hope for Insurance Coverage

Thursday, June 5th, 2008

Having spent a good part of the day writing reports and requests in my never-ending battle to get insurance companies to cover nutrition treatment for eating disorders, I was heartened to read the news that a lawsuit  by parents against Aetna has led this insurance company to improve its coverage for eating disorders. Unfortunately, coverage for nutrition treatment was not included. I am hoping that this development is the first step towards getting decent coverage for eating disorders. I encourage parents and professionals who are fighting insurance company to reference the Aetna lawsuit. Peace, Marcia