Eating Disorders in Pre-Adolescents

Kim McCallum, M.D.

Kim McCallum, M.D. – Medical Director & Founder of McCallum Place
December 15, 2016

EDH: Dr. McCallum is Founder of The McCallum Place and here to share her expertise. Welcome Dr. McCallum!

EDH: Please tell us a little bit about yourself and your current involvement in the eating disorder community.

Dr. McCallum: I am founder of McCallum Place, a child and adolescent psychiatrist, and a patient and family advocate

Dr. McCallum: I also train psychiatrists and other ED professionals how to evaluate and treat eating disorders

Dr. McCallum: We use Family Based Therapy, team based interventions, partial hospital and medication strategies to help patients with eating disorders

EDH: What are some of the issues that face adolescents dealing with eating disorders?

Dr. McCallum: Adolescent Brains are still rapidly developing, emotion regulation is emerging, more impulsive in action, mindsight not fully developed

Dr. McCallum: restrictive eating may disrupt this process

Dr. McCallum: Adolescent bodies are changing rapidly. They are gaining weight, height and shape is changing.

Dr. McCallum: Out of balance eating may change the natural trajectory of growth and development

Dr. McCallum: Hormones are surging, there is an increased interest in peers, sexuality, restrictive eating will blunt that surge and potentially suppress sexual interest

Dr. McCallum: Most teens are becoming more independent, and find themselves with less parental and teacher supervision

Dr. McCallum: This may increase anxiety, especially if prone to social anxiety

Dr. McCallum: A loss of family meals or sensitivity to parents dieting, concerns about weight gain or health can trigger unbalanced overly restrictive eating, precipitating anorexia or binge eating

Dr. McCallum: Schoolwork is more complicated, they are learning to balance activities, and social life.

Dr. McCallum: Teens with eating disorders often miss some school due to the need for monitored meal support and intensive treatment.

Dr. McCallum: School routines and coordinating efforts with the school staff are important for a successful transition back into the classroom

Dr. McCallum: Some teens adopt unwholesome eating strategies in a misinformed attempt to gain control

Dr. McCallum: These days many teens are involved in elite sport, coaches and parents may not understand that significant caloric needs required for intensive training.

Dr. McCallum: Kids are at risk of weight loss and injuries. Injuries can increase stress and lead to anxiety associated with prescribed rest.

Dr. McCallum: Teenagers may be adapting to a loss of pet/friend or family member, divorce, bullying, or changes in school that are unsettling and create more anxiety.

Dr. McCallum: Advertising focuses a lot, presenting the body ideal. Eating disorders complicate all of these changes

EDH: What are the early signs/symptoms that may indicate an adolescent is struggling with an eating disorder?

Dr. McCallum: Emotional symptoms of an ED might include numbness, irritability

Dr. McCallum: Mindset changes to increased preoccupation with body size , shape and weight, they may voice critical judgment or need to be reassured about appearance

Dr. McCallum: Family and friends may notice rigid eating, avoidance of certain foods, loss of flexibility around eating, preoccupation with calories or ingredients

Dr. McCallum: To hide behaviors teens may avoid eating around others and lie about eating meals away from family

Dr. McCallum: Some teens will begin purging, parents may notice that they run to the bathroom after eating, or find evidence of vomiting stored in bags or trash cans, vomiting can effect plumbing

Dr. McCallum: Binge eating can become a habit, typically teens are ashamed and will hide the behavior, families may find hidden food wrappers, food may disappear

EDH: What are early interventions for an adolescent developing an eating disorder?

Dr. McCallum: Comprehensive psychiatric and medical evaluation is key to clarify medical risk, possibility of malnutrition and screen for anxiety, depression is important

Dr. McCallum: Restoring appropriate nutrition is very important.

Dr. McCallum: If weight is suppressed, parents should monitor meals with a focus on full weight restoration, addressing unwholesome behaviors, reintroducing foods that have been omitted.

Dr. McCallum: Some find that advice from a dietitian is helpful

Dr. McCallum: family based treatment is typically a good first step.

Dr. McCallum: Once the eating is more stable, therapy typical focuses on adolescent development, identity, interpersonal and family concerns

Dr. McCallum: If symptoms are severe or there are medical complications, depression or PTSD partial hospital care with more intensive therapy, skills, family support, meal exposures and medical monitoring may be indicated

EDH: What encouragement might you offer parents/caregivers who have an adolescent with an eating disorder?

Dr. McCallum: With early specialized intervention, full recovery rates for teenagers are high

Dr. McCallum: Be prepared that treatment may take a while, typically over a year, requiring lots of support, but efforts and attention will pay off. Think marathon not sprint

Dr. McCallum: Parents are not to blame for EDs, but they can evaluate and challenge their own beliefs about body size shape and weight, exercise and eating behavior to create a wholesome environment for recovery

EDH: What services are offered at McCallum Place for adolescents?

Dr. McCallum: We offer comprehensive evaluation, iop and partial hospital services and residential level of care.

Dr. McCallum: Our programs integrate medical, psychological and nutritional therapies

Dr. McCallum: We design meal exposures to help introduce foods that have been omitted

Dr. McCallum: Interfere with unwholesome food rituals and support restoration to a safe natural weight

Dr. McCallum: We provide family therapy and support, coaching skills to support full recovery.

Dr. McCallum: We offer once a week individual family therapy, parent skills group, parent support groups and a monthly full day interactive family curriculum

EDH: If you are struggling with an eating disorder, we hope this might be a helpful resource for you.

EDH: Please stay tuned for future Twitter Chats from EDH, and visit us at www.eatingdisorderhope.com

EDH: If you are interested in learning more about McCallum Place, please visit their website at www.mccallumplace.com