|Emerging Eating Pathologies: What & Why?|
This presentation will discuss how historically clinical presentations of eating disorders were stable and recently have morphed and diversified. Three eating pathologies that have recently emerged will be discussed and these include The Dual Diagnosis of Eating Disorder and Diabetes Mellitus Type 1 (ED-DMT1), Avoidant /Restrictive Food Intake Disorder (ARFID) and Atypical Anorexia Nervosa. In addition, the presentation will explore why the acceleration in a variety of presentations may be occurring.
For more information visit: http://iaedp-az.org/ce-breakfast/
Ovidio Bermudez, MD, FAAP, FSAHM, FAED, F.iaedp, CEDS
Sr. Medical Director – Childhood & Adolescent Services, Chief Clinical Education Officer & Executive Ambassador, Eating Recovery Center
Ovidio Bermudez, M.D. is the Senior Medical Director of Child & Adolescent Services, Chief Clinical Education Officer and Executive Ambassador for Eating Recovery and affiliates. He holds academic appointments as Clinical Professor of Psychiatry and Pediatrics at the University Of Colorado School Of Medicine and University of Oklahoma College of Medicine. He is Board certified in Pediatrics and Adolescent Medicine.
Dr. Bermudez is a Fellow of the American Academy of Pediatrics, the Society for Adolescent Health and Medicine, the Academy for Eating Disorders, and the International Association of Eating Disorders Professionals. He is Past Chairman and currently Senior Advisor to the Board of Directors of the National Eating Disorders Association, Co-Founder of the Eating Disorders Coalition of Tennessee and Co-founder of the Oklahoma Eating Disorders Association. He is a Certified Eating Disorders Specialist and training supervisor by the International Association of Eating Disorders Professionals.
Dr Bermudez has lectured nationally and internationally on eating pathology across the lifespan, obesity, and other topics related to pediatric and adult healthcare. He has been repeatedly recognized for his dedication, advocacy, professional achievement and clinical excellence in the field of eating disorders, including Lifetime Achievements Awards from NEDA and IAEDP.
This presentation will highlight recent neuroscience findings in eating disorders. There will be a focus on set shifting, learning, habit formation, and reward pathways that underlie the symptoms seen in Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder with a focus on the corresponding functional pathway changes seen in the brain. We will discuss how these neuroscience findings can be translated into treatment modalities for treating eating disorders including nutritional interventions, medications, transmagnetic stimulation, and therapeutic interventions (CBT, DBT, MBT, CRT). There will be an in-depth discussion of the effects of malnutrition on the brain and the interaction between nutrition and mood/emotional regulation and how nutrition can be effectively utilized as a tool in treating these difficulties. The overall goal is for attendees to have an understanding on brain changes in functions and structure that occur in treating disorders and how knowledge of this can drive the appropriate interventions. 8:30-8:50 am Registration/Networking 8:50-9:00 am Announcements/Intros 9:00-10:30am Presentation 10:30-11:00 Questions/Networking Sheraton Crescent Crestview Room 2620 West Dunlap Ave (I-17 & Dunlap) Phoenix, AZ 85021 **Breakfast Included**
When your child is diagnosed with an eating disorder, your natural inclination is towards more information. You want to know: How long? Why is this happening? When will it stop? What can I do? But these answers, frustratingly, may be slow to surface. You want to understand what your teen is experiencing to offer the necessary support for their improvement. Yet, they may hold feelings and experiences close to their chest like cards in a game of poker.
Perhaps you’re aware how complicated and bewildering eating disorders are. Perhaps the symptoms of bulimia or anorexia have been plaguing your child for years, and now, along with an official diagnosis, you are feeling pangs of frustration and guilt. Maybe you’re angry or scared. These emotions are ALL completely natural responses. It’s hard and often scary to see someone you love suffering. Their journey to recovery will not be an easy process, and as you walk alongside them in this journey, neither will yours.
“Transformation is a process, and as life happens there are tons of ups and downs. It’s a journey of discovery – there are moments on mountaintops and moments in deep valleys of despair.”
— Rick Warren
So what can you do? How can you support and walk alongside your teenage child in this difficult time?
1. Educate yourself.
The first step you can take is to learn as much as you can about eating disorders. Remember that natural inclination towards more information? Use it. By educating yourself with facts, first-hand accounts, and helpful tips you’ll start to feel a weight lift as your fears begin to diminish. Much of your anxiety is probably a result of the not knowing. So learn what you can so that you do know.
2. Get help from professionals.
You don’t have to travel this road alone. According to the National Eating Disorder Association (NEDA), professional treatment can reduce the chance of significant psychological and health ramifications. Simply put, identifying and treating an eating disorder as soon as possible can save lives. Professional intervention can help you both understand the disorder and why it exists. Doorways offers outpatient treatment in Phoenix, Arizona for teens and young adults (13-25) with eating disorders, as well as family counseling. If your teen or young adult is struggling with an eating disorder, contact us for a free consultation. 602-997-2880.
3. Don’t over-simplify.
The solution may seem simple to your non-disordered brain. “Just eat.” However, this advice isn’t helpful and only serves to isolate your loved one further. Instead of oversimplifying, use meaningful communication to express your concern and your willingness to see the situation from their eyes. In fact, voicing your own mistakes or weaknesses will go a long ways in allowing your child to feel comfortable in doing the same.
4. It’s not your fault.
Finally, an eating disorder isn’t caused by a single factor. They are incredibly complex. So, this eating disorder isn’t your fault. We’ll say it again. This is not your fault. Your shortcomings as a parent didn’t produce an eating disorder. But we understand you may be feeling like they did. However, we encourage you to set these feelings aside and focus on presence. Stay involved. And continue to walk alongside your loved one through this deep valley…helping them to reach a new mountaintop.
If you know anyone who may benefit from either of these specialty programs, please don’t hesitate to give us a call at 602.997.2880 or email us at IOP@doorwaysarizona.com.
We are also contracted with Aetna, Blue Cross Blue Shield, Cigna, and United Behavioral Healthcare for our IOP’s.
The following is a description of the three major kinds, anorexia nervosa, bulimia nervosa, and binge eating disorder.
Young people with anorexia nervosa suffer from a distorted body image. They see themselves as being overweight, even though it’s obvious to everyone around them that they are actually dangerously thin. They may refuse to eat entirely, especially in front of others, and exercise compulsively. They end up with significant weight loss and may even starve to death.
Unlike anorexics, individuals with bulimia nervosa eat large quantities of food, then purge themselves of that food, often in secrecy. They may stick their fingers down their throat to induce vomiting, use laxatives, diuretics, or enemas, and exercise a lot. After bingeing, they feel ashamed and disgusted and are only relieved of these negative emotions by getting rid of the food. Unfortunately, a vicious cycle happens – purging to get rid of excess calories and psychological pain, then bingeing again in an effort to escape that pain.
Binge Eating Disorder
Just like individuals with bulimia, those with binge eating disorder frequently indulge in eating that’s way out of control. However, unlike bulimia sufferers, binge eaters don’t purge their bodies after eating.
Who Suffers From Eating Disorders?
Anorexia and bulimia in young people primarily affect girls, but boys can also be vulnerable (about a quarter of preadolescent anorexics are boys). Binge eating disorder is about equally distributed among boys and girls
How Do Eating Disorders Start?
Certain personality traits and psychological factors may predispose some young people to develop eating disorders. For instance, anorexics tend to be perfectionists (they want what they see as the perfect body), while bulimics are often impulsive. Eating disorders usually evolve from somewhat less severe eating behaviors. Individuals with anorexia and bulimia have often followed stringent diets with resulting weight loss. Binge eating disorder may start with just occasional bingeing and then become more compulsive.
What are Some Triggers for Eating Disorders?
Young people who end up with eating disorders may have been teased by family members or friends about their bodies. They may be participating in gymnastics, figure skating, or ballet, activities where slimness is emphasized. Traumas such as abuse or a family member death can act as triggers. Even a supposedly happy event, such as the arrival of a new baby can serve as a trigger because of the stressful impact on the older sibling.
Treatment for Eating Disorders
A large proportion of young people suffering from eating disorders never get any help. The Journal of the American Academy of Child & Adolescent Psychiatry (JAACAP) reported that only one in five affected adolescents receive treatment for anxiety, eating, or substance use disorders. But, not treating eating disorders can lead to serious physical and mental consequences. For instance, Child & Adolescent Psychiatric Clinics states that individuals with anorexia have a mortality rate eighteen times higher than their unaffected peers. Sadly, this mortality figure includes many suicides.
Does Treatment for Eating Disorders Work?
The short answer is yes. Cures are not instant, but most young people with eating disorders can be helped over the long term. What must be understood is that abnormal eating patterns if allowed to continue become more deeply ingrained and more difficult to treat.
In the Phoenix, Arizona area, Doorways provides outpatient treatment for ages thirteen to twenty-five. If you have a family member with an eating disorder falling within this age group, contact us for a free consultation – 602-997-2880. Remember, the sooner you get your young person into treatment, the better.
To begin with, the idea of labeling certain foods as “dirty” as opposed to “clean” can be a dangerous concept. If someone is eating anything other than vegetables, fruits, and lean proteins, does that mean that what they are eating is “dirty?” For those struggling with weight and diet issues, this can quickly turn into obsessing over everything that one consumes according to the Huffington Post. This could potentially lead to an eating disorder. If you notice that your teen has gotten caught up in the “clean eating” trend, here are some ideas on how you can encourage healthy eating habits instead.
- Everything in moderation.
While there are some foods that we know we shouldn’t eat all the time, like a box of cookies, the danger of labeling certain foods as off-limits it that it causes them to be more tempting to eat. Explain to your teen that it is perfectly okay to have a cookie occasionally. Everything in moderation.
- Don’t fall prey to the trends out there.
Between food bloggers, social media, etc. all new diet trends are put out there and largely discussed-particularly when they have been successful for weight loss. “Clean eating” might be all the rage right now, but down the road society will likely shift gears onto the next trend. Talk to your teen about the importance of not always following the crowd and evaluating what is right for them.
- Focus on the nutrients that your body needs.
As stated by the Huffington Post, nourishment isn’t just the physical, but also about the mental and emotional satisfaction that food can provide. Eating a salad with grilled chicken, and light dressing is a satisfying and healthy meal, but that doesn’t mean that your mom’s homemade pasta dish isn’t just as satisfying. There is a time for comfort foods. Remind your teen of that.
Encourage your teen to take cues from their body as to what nourishment they need and to be diligent about not obsessing about whether the foods they are eating are “clean” vs “dirty.” If you are concerned that your teen’s fixation with food is dangerous, please consult one our specialists here at Doorways.
Doorways offers individual and group programs for teens and young adults who are struggling with eating disorders. Our certified eating disorder experts are here to help your teen get their life back again.
According to a recent report from Common Sense Media, teens are spending an average of about nine hours on social media daily and this does not include what they may be using at school.
Social media sites like Facebook, Instagram, and Snapchat have become an integral part of teenager’s lives, something that many teens feel they can’t live without. One of the more negative sides of social media use is how these media are serving to influence a teen’s personal body image.
Proud 2 Be Me, is an online community that was created by teens for teens. Their goal is to promote positive body image. Proud2BeMe posed the question to their community of whether social media sites help or hurt self-esteem and body image. The answers were enlightening:
Teens indicated that it’s all about getting the coveted “like” on social media. Teens crave that positive attention. And the more likes the better. To get likes, teens, especially females, will often oversexualize themselves. One teen said, “The less clothes you have on, the more popular you are.” –-Dayton, 17.
The problem is that the more of these oversexualized pictures the teens see, the more that look becomes the norm, rather than the exception. And teens start comparing themselves to these images that they are bombarded with, resulting in a false idea of what it is normal to look like. In a way, social media is like an online beauty contest that never ends. And unfortunately, most teens feel like they can’t win this contest unless they do something drastic such as crash dieting to try to lose a lot of weight fast.
What is a parent to do about this? It’s not realistic to ban your teen from using social media. You can help combat this negative influence by encouraging your teen to share what’s on their social media accounts with you. Then you can discuss the pictures and the impact they have on our body image and self-esteem.
If your teen is struggling with body image and is engaging in unhealthy activities to alter their appearance such as extreme dieting, there is help.
At Doorways, we have caring, confidential, nutritionists and counselors on staff who are experts in teaching teens how to make healthy lifestyle choices. We offer a free consultation to any parent seeking help. Just call us at 602-997-2880.
If your teen is struggling with body image, weight or food issues, the holidays make it so much more stressful. This is particularly true at Thanksgiving, which is a completely food centered holiday.
According to The Huffington Post, some 10 million Americans are fighting an eating disorder. For them, the amount of food around the holiday can be downright painful. For those with anorexia, the food at Thanksgiving can be scary since there is an expectation to eat the food and enjoy it. For those suffering with bulimia or a binge eating disorder, they may be having difficulty controlling their desire to purge being surrounded by so many triggers. However, there are ways that you can not only help your teen survive the holiday, but enjoy it.
While you may be busy cooking, cleaning, or visiting with family throughout the day, don’t forget to check in with your teen and see how they are doing. Additionally, you might suggest that they reach out to a friend that they can check in with throughout the day to give them an outlet to vent. Make sure they know that they are not alone.
The Huffington Post says that your teen should have a game plan. Encourage your teen to eat a healthy breakfast. Maybe they decide to avoid the pre-meal snacks so they can focus on the main meal. At the main meal, they can then make choices that are deliberate.
Ignore the Diet Talk
There is no avoiding the diet talk. As everyone is over indulging at the dinner table it is almost certain that someone will bring up how much they will need to exercise after the meal. Or how they are going to starve themselves after consuming a week’s worth of calories. It is important to talk to your teen about the possibility of this happening so that they can remind themselves that other people’s food issues are not also theirs. Encourage them to not feel guilty about what they are eating nor deprive themselves either.
Focus on Gratitude
While it may seem like it is all about the feast, it is really about thankfulness. Help redirect your teen’s focus from the feast to something or someone that they are thankful for. Maybe have everyone go around the table and say what they are grateful for to help further cement that focus.
Encourage your teen to enjoy their Thanksgiving meal and the special time with friends and family and most importantly, their thankfulness. If you find that your teen needs additional support, reach out to someone that specializes in eating disorders. Happy Thanksgiving!
As a guide in your teen’s healthy growth and development, it is especially important that you do not unintentionally do any harm while you are encouraging a healthy lifestyle for your teen. Here are four ways the National Eating Disorders Association recommends to positively reframe your conversations about weight and health with your teen:
When you talk about food, focus on health, strength, and nutrition rather than weight loss
The ways that you discuss food and exercise can definitely affect your teen’s eating habits and may also impact how they view their body. In fact, according to a study in the Journal of Adolescent Health, weight-related comments from parents or siblings were highly linked to disordered eating habits geared toward unhealthy, unsafe weight loss measures, particularly in teen girls.
Whether your teen is underweight, normal weight, or overweight, your words matter to them when speaking about their bodies. To ensure that you do not unintentionally harm your teen, you should focus on talking about health, strength, and nutrition rather than weight loss or diets. For example, saying, “Fresh fruits and vegetables help your body and mind stay healthy and strong.”, will be more helpful for your teen than saying, “You need to lose some weight, so eat all your vegetables”. The distinction of focusing on eating for health and strength will help your teen develop a better relationship with food and understand the importance it plays in a healthy lifestyle.
Ensure everyone in your family speaks the same way about health, food, and exercise
To make certain that your family practices healthy eating habits, and talks about food, weight, and exercise in positive ways, everyone needs to use the same language. You and your spouse, as well as any siblings in the household, need to all talk about these things in the same way.
Emphasize the importance of health over weight
When you want to talk about weight with your teen, pause and remember to speak about health instead. Speaking about the value of eating well for good health and energy to do all the things you enjoy, rather than the importance of being a particular weight will ultimately help your teen develop a more positive body image and relationship with healthy food.
Demonstrate your words in your body and life
Speaking positively about food, health, and exercise with your teen is very important. However, it is equally vital that you live the example of your words, and make sure you are not silently demonstrating unhealthy eating patterns or body image views to your teen.
If your teen is struggling with body image or an eating disorder, then speaking with a professional teen counselor can help you learn more ways to promote healthy eating and lifestyles in your home and your words.
Participating in athletics is a fantastic way for your teen to stay healthy and fit, while learning the value of teamwork, respect, and hard work. Playing sports can also build self-esteem and help your teen form healthy bonds of friendship as they learn how to handle success and defeat.
However, as you teen begins to develop athletic skills and pursuits, they will also become more aware of their bodies and how they compare to their peers and any athletic icons they look up to as role models and motivation.
Unfortunately, this heightened body scrutiny and comparison can give way to unhealthy body image issues and evolve into eating disorders very quickly if your teen is not equipped with a strong sense of what it means to be healthy, strong, and athletic. In fact, according to the National Mental Health Institute, 2.7 percent of teens age thirteen to eighteen have struggled with some type of eating disorder.
According to the National Eating Disorders Association, here are four ways that you can help support a healthy body image in your teen athlete to protect them from developing dangerous, unhealthy eating or training habits:
Understand eating disorders and other body image issues your teen may face.
It is important to understand that eating disorders do not stem solely from eating or not eating in unhealthy manners. Eating disorders are a symptom of a much deeper mental, emotional, or psychological issue that may be plaguing the happiness and well-being of your teen. Make sure that you do the research on what different body image issues and eating disorders exist, and fully understand how they may impact your teen as they strive to excel in athletics.
Know how to identify if your teen is struggling with their body image or suffering from an eating disorder.
To keep your teen healthy and safe, know the warning signs and symptoms to look for that may provide you early warning into a potential problem. Most teenagers will not come forward openly with their body image or eating disorder problems, so you will need to begin the open, honest, supportive conversation if you witness the warnings. According to the Mayo Clinic, warnings of an eating disorder may include:
- Abnormally low body weight
- Fear of weight gain
- Distorted body image
- Expressions of self-hatred or loathing
- Excessively limiting calories or food intake
- Escaping to the rest room immediately after a meal
- Refusing to eat
- Vomiting after meals
- Use of weight loss pills or laxatives
Talk to your teen about their athletic role models, and help them identify healthy bodies and training regimes.
As the Summer Olympics quickly approaches, your teens will be watching with added excitement and attention as the very best competitors in their favorite sports compete for medals. This is a great opportunity to point out healthy, strong bodies and talk to your teen about the best ways to accomplish their fitness goals in a safe manner.
Additionally, there are many athletes who have overcome eating disorders. Sharing these stories of triumph and success can help encourage your teen to open up and seek help if they have been experiencing issues with their body or are developing an unhealthy relationship with eating.
Intervene with support, positivity, and straightforward help when you suspect body image issues or eating disorders in your teen.
If your teen exhibits the warning signals of poor body image or a potential struggle with an eating disorder, you should intervene immediately. When you bring up this topic with your teen, do not speak in judgmental or negative terms. Be open, positive, and straightforward as you encourage your teen to speak openly while you listen. If your teen continues to display unhealthy behaviors after you’ve intervened, it can be immensely helpful to consult the advice of a professional teen counselor to help you reach your teen with tools for an active and healthy approach to athletics and life.