TEEN HEALTH: Eating Disorders in our Midst
by Dr. Ann L. Engelland
Ask Dr. Engelland a question
22, 2004) Eating disorders are creating major medical problems
across the country –and right here in Larchmont. Though we’re
relatively savvy and sophisticated in Westchester, kids and
their parents can get caught up in unhealthy eating patterns
that lead to anorexia, bulimia, binge eating and obesity.
In my own practice of adolescent medicine, I see all types
of disorders at all stages from the “picky eater” to
the full-blown anorexic. If we intervene early and effectively,
many patients can be “turned around” before they
head towards a lifetime struggle with potentially serious
and life-threatening consequences, including bone disease,
infertility, and hormone disorder.
It may start like this...
You notice your 12 year-old daughter, until now a typical
Hommocks seventh grader, is unhappy with her stomach. She
has begun to eat a lot of salad, push the pasta around her
plate and walk the dog twice a day –without you even
What should you do?
- Talk to your child about your observations and concerns.
- Don’t be afraid to say: “You know, I’m
concerned that if you keep eating this way (picking at
food, restricting calories, eating in secret, skipping
thinking this way (expressing excessive concern about weight,
exercising too much) you may develop an eating disorder.”
What if you get stonewalled?
“Mom, you’re exaggerating, as usual. I’m
fine. Do you think I have anorexia or something?”
Remember, it is not uncommon for kids with eating disorders
to persuasively deny that there is any problem. Keep your
What if things don't improve?
Her dinner behavior continues.
Her usual packed lunch comes home from school
not had her first period, even though the doctor told her
last year she would probably get it before now.
- Schedule a checkup for your child. Notify her doctor
ahead of time about your concerns. Arrange for another
4-6 weeks if you are still worried.
- If you are still worried,
consider contacting a pediatrician with known interest
and expertise in the field, or a specialist
in eating disorders or adolescent medicine. Eating disorders
are tricky for patients, parents, and medical providers.
Even doctors may hesitate to “call a patient’s
bluff” or alarm a family, particularly if they are
unfamiliar with handling eating disorders.
- Most people with
a confirmed eating disorder need a medical provider,
a psychologist (or psychiatrist) and a dietician
to manage their care.
- Try not to be hobbled by guilt. Eating
disorders develop insidiously and often remain undiscovered
for many months before families realize what is happening.
When I first see a patient in my office, much of what we
do at first is to de-mystify and educate about eating disorder
and figure out how we will work together. Taking action
may take courage, but help is out there.
- Your local pediatrician or internist
- Local therapists-ask specifically if they have managed
eating disorder cases
- Adolescent Medicine Providers are specially trained
in managing and coordinating care for patients
with eating disorders.
- Center for Eating Disorders and Recovery, located
in Mt Kisco and Scarsdale
- New York Hospital/Cornell Westchester
- North Shore/LIJ Hospital, Division of Adolescent