The Medical Minute: Eating disorders

By: Martha Peaslee Levine, Richard Levine,
Susan Lane-Loney and Louise Albrecht

Eating disorders have always been a concern, but there is a disturbing new trend. Younger and younger patients are being affected by these deadly diseases. Anorexia is being seen in patients prior to puberty, which previously was an unheard of phenomenon. Eating disorders, in particular anorexia nervosa, rank as the deadliest of the psychiatric disorders. So what does the medical community do when patients as young as 8 are demonstrating eating disorder symptoms?

The answer at Penn State Milton S. Hershey Medical Center is to develop an intensive treatment program for these at-risk individuals.

Many more pre-teens and teens are being affected by eating disorders. While clearly eating disorders have genetic risk factors -- meaning that the risk is increased if eating disorders are present in other individuals within the family -- it is clear that society is having an impact. One cannot turn on the TV, open a magazine or look up at a billboard without seeing signs of anorexia in many of the models. Anorexia is not only accepted in this level of advertising, it also is socially acceptable as evidenced by the number of young stars who struggle with eating disorder issues. Teens and children get pulled into this behavior at a very impressionable age. The impact of pictures has a huge effect on younger children, who may not read any of the associated articles which could outline the concerns and risks of the anorexic behavior. What they see is what they strive for.

Weight loss in this young population is very concerning. This age group can be at more risk from weight loss than other eating disorder patients. Even if children maintain their weight, it still may mean that they have an eating disorder, because they should be gaining weight to keep up with their growth spurt. If they restrict their eating during this growth phase, and they aren't gaining weight when their weight should be keeping pace with their height, then they are at risk of stunting their growth. They also put themselves at risk for brittle bones from osteoporosis.
Poor growth, weak bones and shrinking of the brain are some of the medical risks of eating disorders at this stage of life. In addition, at a time when young children should be learning how to make social contacts, they can become isolative, depressed and anxious. These emotional disorders can then have dramatic effects on their future self-esteem.

The good news is that the earlier treatment is offered for eating disorders, the better the prognosis. The longer the eating disorder behavior is present in an individual's life, the more entrenched this behavior becomes and the more difficult it is to treat.

For this reason, Penn State Milton S. Hershey Medical Center has implemented of a new Child Partial Hospitalization Program, as a new part of the Eating Disorders Clinic. This program is one of the few programs in the country that will treat children as young as 8 who demonstrate eating disorder behavior. With early intervention improving long-term prognosis and the presence of one of the first child partial hospitalization programs at the Medical Center, this is an important Medical Minute.

Treatment in this new program follows the tenets of the entire Eating Disorders Clinic:

-- Eating disorders are not just about the food. Individualized psychiatric treatment and group therapy focuses on the issues underlying the eating disorders.

-- Eating disorder treatment requires a multi-disciplinary team. The new program combines psychiatric, nutritional, medical and psychological treatment to address all facets of the illness.

-- Eating disorders affect not only the patient, but the family. Families are included in the treatment processes to support their efforts to help their children, to provide guidance as they re-feed their children and to address issues within the family domain that may affect the eating disorder behavior.

-- Eating disorder recovery takes time. Once individuals complete the Partial Hospitalization Program, referrals for psychological and nutritional therapy are provided and all patients continue to receive medical treatment in the Eating Disorders Clinic. This ensures that if slips in recover occur, they can be addressed quickly to minimize the risk of complications for the individual and family.

Clearly one of the goals at Penn State Hershey Eating Disorders Clinic is to help prevent eating disorders before they happen. In the meantime, the clinic wants to provide treatment for individuals of all ages who suffer from eating disorders. Not only can early intervention decrease the medical risks of these disorders, it can help young teens focus on their dreams instead of diets. Early treatment can help inspire confidence rather than calorie counting. It can help cement family bonds instead of the faulty thinking that causes individuals to believe that "thinner is better." What is the best, is health, happiness and holistic attention to the many complications of eating disorders.

For further information, call (717) 531-7230.

Martha Peaslee Levine, Richard Levine, Susan Lane-Loney and Louise Albrecht  are members of the New Child Partial Hospitalization Program, Eating Disorders Clinic at Penn State Milton S. Hershey Medical Center.