Pediatric eating disorders: A healing environment has an impact on treatment

Posted on 09/17/11 09:05:am


Shortly after launching a new treatment program at Rogers Memorial Hospital, Dr. Tracey Cornella-Carlson was already seeing more children and families enjoy a quality of life that seemed lost within the tight grip of an eating disorder.

Even as young as fourth grade, children are becoming concerned with calories and fat grams and subjected to emotional bullying about their appearance.

Dr. Cornella-Carlson said that parents come to Rogers Memorial Hospital, not just because they are worried about their child’s health, but because they feel that they have lost their child emotionally. The disorder affects the child’s ability to participate in day-to-day activities with their friends and families.

The new child and adolescent inpatient program was developed under her leadership to provide a safe, nurturing environment where children and teens could be treated for medical and emotional stability by a specialized team comprised of physicians, dietitians, therapists, nurses, and other trained professionals.

Inpatient environment addresses behaviors

The Rogers Memorial Hospital inpatient program was designed to provide medical, nutritional, and emotional stability as it affects the needs of children and young teens.

Dr. Cornella-Carlson says that many children and teens being treated for eating disorders on an outpatient basis find it hard to eat what they should. “They really try,” she said, “They promise that they’ll eat their snack, pack it, but then ‘forget’ to eat it or say that they just weren’t hungry.” The inpatient program guides patients while eating and addresses any related behaviors.

“Once their nutritional intake is increased, they have a better ability to understand their situation, that they are separate from their disorder and are able to express themselves in a healthier way,” Dr. Cornella-Carlson said.

Jessica Witt, RN, CPNP, clinical services manager for the program, explained how the treatment team at Rogers Memorial Hospital continually monitors patients to pinpoint their diagnosis and manage any other medical issues common to eating disorders. “Patients may have developed symptoms that affect their gastrointestinal system, bones, heart or limit their physical activity,” she said.

“We work to stop the behaviors and provide an environment where they can heal while they discover that they are separate from their disorder.” One of the key elements of the program, Witt added, was the group therapy component.

Complex and challenging disorder

Dr. Cornella-Carlson explained that certain characteristics of eating disorders make it especially complex to treat them in children. Individuals with eating disorders often suffer from obsessive-compulsive disorder or other anxiety disorders and are more likely to focus on a thought pattern that compares them to others in a negative light.

Group and cognitive behavioral therapy are used to help patients recognize and change the distorted thought patterns. In a group therapy setting, they are able to see how their behavior looks from the outside and begin to recognize it from the inside.

Dr. Cornella-Carlson said that patients with eating disorders are highly attuned to their environment and behaviors. They find it hard to relate to those who do not understand food or activity in the same ways.

As a result of their disorder, they tend to be withdrawn and avoid mealtime, a common social point for patients. They are often perfectionists and intellectualize certain aspects of treatment. An example might be a patient who wants to satisfy their sweet tooth with an apple, instead of ice cream.

Knowing they’re not alone

Within the specialized eating disorder program at Rogers Memorial Hospital, patients can be with others their age who have first-person experience with eating disorders and can support each other. Mealtimes are supervised by trained dietitians who observe which mealtime issues patients struggle with and also ensure that patients are eating the right amount of food.

Dr. Cornella-Carlson also said that a key element of the program, which admits patients from throughout the United States and Canada, is the education and involvement of the patient’s family. “They may bring food in so they can eat together, participate in the recovery process and improve communication,” she said.

Dr. Cornella-Carlson said that parents are relieved to see their son or daughter’s unique personality reemerge and interact with the family again. “So many parents say, ‘Thank you for bringing our child back.’”

When patients leave the program, they have a much better understanding of how they can control their behaviors in a healthy way, explained Dr. Cornella-Carlson. “We teach them skills and techniques that we hope will help them for the rest of their lives.”


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