|Counseling and Psychiatric Services for Adolescents and Young Adults
Wednesday, May 15th, 2013
As a parent, do you know the warning signs of eating disorders? (Photo credit: Wikipedia)
Millions of people in the U.S. are impacted by eating disorders every year. This includes those suffering from the eating disorder as well as their family members and friends. Unfortunately, many people who have these disorders do not get the help, support, and treatment they need to be healthy. Recent research indicates that as many as half a million teenagers may be suffering from an eating disorder but according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD) on average only 1 in 10 people with these conditions get treatment. This means we all need to do a better job of identifying those who are in trouble, preventing disorders from developing, and treating those who are struggling; the consequences of doing any less are simply too high.
Prevention and early detection are critical to minimizing the long term damage suffered by those who are dealing with these potentially life-threatening conditions. The key to early detection is to know what to look for and what actions to take if you suspect that someone in your life is suffering from an eating disorder. To help, here are the most common immediate symptoms of the most prevalent eating disorders.
- Unusual eating habits or patterns, may skip meals and/or avoid certain foods
- Eating only small amounts
- Weighing and measuring food
- Obsessive calorie counting
- Excessive exercise
- Intense fear of gaining weight
- Bingeing or eating excessive amounts of food in a single sitting
- Inability to control their bingeing
- Self-induced vomiting
- Abuse or misuse of laxatives or diuretics
- Skipping meals
- Excessive exercise
- Intense fear of gaining weight
- Bingeing or eating excessive amounts of food in a single sitting
- Inability to control their bingeing
- Eating to discomfort and eating when not hungry
These behaviors and symptoms can indicate the presence of an eating disorder and if you are concerned that your teen may be struggling with any of these disorders, you should make an appointment to discuss your concerns with their doctor.
The longer term symptoms and consequences of these eating disorders, which are outlined below, are increasingly more serious which underlines why prevention and early detection is so critical.
- Dehydration and electrolyte imbalance
- Constipation, bloating, and diarrhea
- Dental problems including loss of enamel, gum disease, and cavities
- Throat and esophageal problems including tears and ruptures
- Dry skin
- Vomiting blood
- Irregular heart beat
- Low blood pressure
- Heart failure
Binge Eating Disorder
- Type 2 Diabetes
- High blood pressure
- High cholesterol
- Gallbladder disease
- Heart disease
- Specific kinds of cancer
Wednesday, May 1st, 2013
Do you struggle to find the words to talk with your teen about their weight? (Photo credit: Gaulsstin)
The conflicting messages our society sends about size and weight are all around us. Whether you are browsing the tabloid rack at the grocery store or flipping through the channels, you can find some super thin celebrity explaining how this system or that system made it incredibly easy to get the body they have. Every news outlet is talking about how the obesity epidemic is endangering the future of our country while parents wrestle with competing concerns about what is best for their child. On one hand, they are focused on preventing the development of eating disorders, keeping their teen from being bullied, and worrying about how to get them into a healthier lifestyle. On the other, they know how important it is to boost their self esteem, be supportive, and be accepting, no matter their size or shape.
If you are wondering how to help your teenager change their habits and adopt a healthier lifestyle without damaging their self esteem, you are not alone. The truth is most of us adults could do with a healthier lifestyle too. If you are overweight, self-conscious about your size, always on a diet, or have simply given up, that is the behavior you are modeling for your child. They see you struggle, give in, and give up while the picture perfect person on TV talks about how easy it is to drop 60 pounds in just 6 weeks with only 60 minutes a day. The messages that are getting through are not the ones they need in order to do the work required to create and maintain a lifestyle that supports good health.
While talking about weight with your teen may not be any more comfortable than talking about sex with them, it can be just as important. Most experts recommend a low-key, life encompassing approach. Rather than having an intervention-style sit down serious talk about weight concerns, look for natural opportunities to discuss good health, healthy weight loss, and to offer assistance and support. You don’t need to focus on the fact that your teen is overweight, they already know that. Focus instead on how you can provide a better model to follow and on letting your teen know that you are there for them, are concerned for them, and are willing to help and support them with this struggle. To help guide your conversation, here are some do’s and don’ts that can make talking to your teen about weight less of a minefield.
- Do talk about making healthy choices whenever the opportunity naturally arises. Shopping for groceries, making meals, planning menus, and doing something active together all provide great natural times to talk about what it takes and means to be healthy.
- Do talk to your teen’s doctor about any concerns you have.
- Do pay as much attention to who your teen is as you do to what size they are, how they look, or what they are putting in their mouth.
- Don’t sugar coat. No matter what anyone else says, losing weight is hard and it isn’t fun. Despite the wide range of products that promise otherwise, there is no quick fix and no short cut. It takes time, patience, and perseverance, commitment, dedication, and focus.
- Don’t talk about dieting. Keep the focus on eating healthy and being active.
- Don’t be a food cop or a weight watcher. You teen needs support, encouragement, and advice not constant monitoring, questioning, and criticism.
If you have any questions about how to best talk with your teen about weight, please don’t hesitate to give us a call and speak with a registered nutritionist.
Wednesday, April 17th, 2013
What messages are you sending to your teen impacting their self-image? (Photo credit: Tammy McGary)
When it comes to preventing a child or teen from developing an eating disorder, the best place to start is with their parents. According to the National Eating Disorder Association (NEDA), studies have shown that eating disorder prevention programs can help keep disordered eating from developing by shifting perspectives, changing attitudes, and discouraging disordered eating behaviors. As parents play an important role in establishing and developing healthy attitudes about food and weight, their influence can make a real difference as their child moves through adolescence.
Follow these suggested tips and strategies to make sure you are doing everything you can to try and prevent your child or teen from having to deal with an eating disorder.
- Take a long look in the mirror. Your attitude about your own weight has a direct impact on child. Your attitudes about exercise, food, and weight will shape how your child feels about these things. If you are obsessed with your weight, participate in yo-yo dieting, avoid any physical activity, talk negatively about other people’s bodies, or have a disconnected perspective of your own weight, your child may, too.
- Watch what you say. Whether you are making disparaging comments about your own weight, your child’s weight, or the weight of that celebrity on television, you are telling your own child that weight is somehow related to worth.
- Focus on what you want. Whether you are worried that your daughter wants to be too thin or that your son is overweight, the best approach is to focus on what you want for them rather than on what you don’t. This means keeping your focus on developing and maintaining behaviors that promote health rather than focusing on how much they weigh.
- Make sure you send the right message. We, as people, are less likely to feel pressured to change to meet the ideals of others if we feel like we are fine just the way we are. This is the most important message parents can give their kids to keep disordered eating from developing.
- Be a role model. Actions speak louder than words and if you want your child to live an active lifestyle filled with healthy food and healthy attitudes, you need to live in that world first and show them how.
- Don’t be a food dictator. Help your child develop healthy eating habits by supporting their exploration into their own tastes. Encourage them to stay tuned in to their body so that they can learn how to eat when they feel hungry and to not eat when they don’t. Instead of requiring clean plates, suggest smaller serving sizes. Rather than counting their calories, get them involved in meal planning and preparation and choose healthy nutritious options together.
- Be accepting. Help your child develop a strong sense of their own self-worth by showing them it is ok to be who they are, no matter what that means. Be accepting of other people and celebrate differences so that your child grows up understanding that who people are is more important than how they look.
Monday, April 8th, 2013
DBT looks very different than you might imagine therapy sessions in your mind.
When most of us think of therapy, we picture a scene similar to the one most commonly portrayed on TV. There is a wood paneled office featuring a therapist in a chair and a patient on a couch. In reality, therapy can look very different depending on the kind of therapy that is going on. There are several types of therapy that can be very beneficial in helping teens overcome their mental health challenges. DBT, which stands for Dialectical Behavior Therapy, is a specific kind of therapy that can be very beneficial for a variety of issues.
DBT was originally developed as a treatment for borderline personality disorder (BPD). DBT combines several different therapeutic approaches in an effort to help participants develop more comprehensive and extensive coping mechanisms. This approach uses individual cognitive behavioral therapy techniques, mindfulness, reality testing, distress tolerance, assertiveness training, and group sessions to facilitate modifications in behavior.
A foundational part of DBT is building a relationship between the mental health practitioner and the teen that focuses on creating an alliance rather than making enemies or acting adversarial. By offering validation and acceptance, the mental health practitioner creates a safe space for the teenager to express feelings that can then be redirected into healthy behavior changes.
DBT incorporates both individual therapy sessions and group sessions. This two-pronged approach is part of the reason DBT can be so successful. The group sessions give teens the skills they need to overcome challenges like regulating emotions, practicing mindfulness, increasing effectiveness, and tolerating distress. Interacting with others their age also gives them the opportunity to practice utilizing these skills with their peers. The individual sessions provide time to deal with emotional issues in a one-on-one setting. By incorporating both types of therapy, DBT ensures that teenagers get the individual attention they need while they build and practice the skills they need to self-manage.
Across the different approaches to therapy, DBT is the approach that puts the most focus on developing coping skills. DBT has been used for 40 years and in the last decade has become an integral part of most, successful eating disorder treatment programs. DBT breaks the teen’s life up into four main areas, relationships, thoughts, feelings and behaviors. Because all of these areas are typically deregulated during the course of the illness, DBT is tailor-made for treating eating disorders.
In addition to helping those dealing with eating disorders, DBT can also help teenagers who are engaging in self-harm and struggling with suicidal thoughts. This approach helps teens develop the skills they need to regulate their emotions, control their behavior, and become more resilient when faced with difficult situations. The benefit of taking DBT approach is that troubled teens can get the help they need to overcome maladaptive behaviors.
Tuesday, April 2nd, 2013
Do you know all the variables that can cause an eating disorder in your teen? (Photo credit: andrefaria)
When a teenager is diagnosed with an eating disorder one of the most common questions parents ask is what caused the disorder to develop. This is an understandable response, but the unfortunate fact is that there isn’t a simple answer to this question. Disordered eating is a complex problem and there are many factors that can contribute to its development. According to the National Eating Disorder Association (NEDA), eating disorders evolve out of a combination of behavioral, biological, emotional, psychological, interpersonal, and social factors. This means that each individual that is diagnosed has their own set of circumstances within those common factors that lead to the development of their disorder.
Many people assume that when a person struggles with disordered eating it is about the food, their weight, or even their appearance. On the surface the outward symptoms of an eating disorder might support that assumption. For example, someone who is suffering from anorexia nervosa may seem obsessed with their weight and their caloric intake. They might track every calorie they ingest, worry about getting fat, and obsess about exercising. All these seem to support the assumption that the person has an issue with their weight. However, most experts agree that many people with eating disorders use food and their control over food as a coping mechanism. The exertion of extreme control over their diet can help them feel in control when other things are out of control, overwhelming, or too emotionally charged to handle.
Although there is often no clean, simple cause to blame when an eating disorder is diagnosed, there are some common factors that are known to contribute to their development.
- Some people that suffer from eating disorders have a chemical imbalance in their brain associated with the neurological chemicals that control things like appetite and hunger.
- There appears to be a significant genetic component to disordered eating.
- More research needs to be done in this area to study how genetics and neuro-chemicals can contribute to disordered eating.
- There is evidence that stressful times, major life changes, and traumatic events can lead to the development of an eating disorder. If you consider that disordered eating is about establishing a feeling of control over one’s life, it makes sense that events that shake up a person’s world or alter it altogether could lead to the development of these conditions.
- Issues with self-confidence, self worth, and self-esteem can contribute to disordered eating.
- Feelings of hopelessness, inadequacy, anxiety, and loneliness can also lead to the development of a disorder.
- Mental health conditions like depression and anxiety might also precede or go hand in hand with the development of an eating disorder.
- Problems interacting with other people and trouble with personal relationships can be a contributing factor along with struggling to express emotions and difficulties dealing with feelings.
- A history of being bullied, especially if the bullying behavior centered on weight.
- A history of some form of abuse including physical, sexual, or emotional abuse.
- Cultural messages that value beauty over other attributes and that associate beauty with a specific body type.
- Stress related to prejudice, discrimination, bullying, or other forms of harassment and abuse.
Eating disorders are very serious, often life-threatening. A person struggling with an eating disorder needs professional help; they can’t win this battle on their own. If you know someone you suspect may be struggling with an eating disorder, or if you have any questions about how to know for certain, please give us a call. We would love to help. Their life could depend on it.
- This Month Eat Right, Your Way, Every Day (doorwaysarizona.com)
- What Causes Eating Disorders? (doorwaysarizona.com)
- Eating Disorders Affect Everyone in Your Family (doorwaysarizona.com)
Monday, February 25th, 2013
This week, February 24 – March 2 is National Eating Disorders Awareness Week. KPHO CBS 5 AZ talks with Certified Eating Disorders Specialist, Rachel Brogan from Doorways Arizona about the prevalence of eating disorders amongst today’s teens and adolescents. 62% of teen girls in Arizona are on a diet when less than 30% are overweight.
Sunday, February 24th, 2013
Do you know someone who struggles with food? Since millions of us are battling eating disorders, odds are that you do, even if you don’t realize it. Helping raise awareness about eating disorders is the goal of Eating Disorder Awareness Week which begins on February 24th this year. Organized by the National Eating Disorder Association (NEDA), Eating Disorder Awareness Week offers a chance for everyone to educate themselves about eating disorders and then do just one thing to spread the word and increase awareness about these life threatening disorders that too often go untreated.
Regardless of who you are and whether or not an eating disorder or disordered eating has touched your life, there are things you can do to help spread awareness and precipitate change.
The first is to know the facts. Clinically significant eating disorders will affect 20 million American women and 10 million American men at some point in their lifetime. These disorders are real and take real, long-term help to overcome. They can have significant, serious, life-long and even life threatening consequences. They impact every area of a person’s life and can be debilitating both physically and mentally.
The second is to know the most common disorders and the signs that someone is struggling with them.
- Anorexia Nervosa - When a person participates in self-starvation, depriving the body of calories in order to become thinner. People who struggle with Aorexia Nervosa lose excessive amounts of weight, are preoccupied with food and obsessive about calories, fat, and dieting. For more information about Anorexia Nervosa, click here.
- Bulimia Nervosa - When a person goes through cycles of binge eating followed by activities like purging or excessive exercising to “make up for” the binge. When someone is struggling with bulimia nervosa there may be external clues that indicate the presence of bingeing and purging behavior like large amounts of missing food, empty food wrappers, or packaging from laxatives or diuretics. For more information about Bulimia Nervosa, click here.
- Binge Eating Disorder – When a person participates in regular episodes of binge eating that is not accompanied by other behaviors intended to compensate for or get rid of the extra calories. When someone is struggling with binge eating disorder, they will consume large amounts of food within a short time frame and may avoid eating with others to hide this behavior. For more information about Binge Eating Disorder, click here.
- Eating Disorder Not Otherwise Specified (EDNOS) – Some people who struggle with disordered eating exhibit a range of symptoms that prevent them with being diagnosed with each of the three primary disorders above. In these cases, a diagnosis of EDNOS enables those people to get the help and support they need even though they don’t fit the criteria for a specific eating disorder. For more information on EDNOS, click here.
The third thing you can do to help spread the word and raise awareness about eating disorders is to do “just one thing” during this year’s Eating Disorder Awareness Week. For more information about eating disorders and for ideas on how you can get involved, visit the National Eating Disorder Association.
Eating Disorders Awareness Week
Thursday, February 14th, 2013
An image problem can kill a politician, and as it turns out, a little girl.
For millions of females with eating disorders, the stakes couldn’t be higher. Because anorexia has the highest mortality rate of any mental illness. To learn more, go to myneda.org.
Wednesday, February 13th, 2013
What’ll we lose on this diet? Lots of people every year.
People with Bulimia don’t just induce vomiting. They induce heart arrhythmias, intestinal bleeding, and rupturing of the esophagus. It can be life threatening, but it can also be treated. For more information, go to myneda.org.
Tuesday, February 12th, 2013
The monster isn’t under the bed. It’s in the fridge.
People with eating disorders often distort the size of their food so they’ll eat less. They distort the size of their body so thin looks fat. Which yields a fact that isn’t distorted at all- without treatment, many won’t survive. But, to read about those who have, go to myneda.org.