It can be both painful and frustrating to watch an adolescent struggle with an eating disorder. Parents often express that it feels like there is a stranger in their house and they just want their child back.

It may be hard to imagine, but recovery is possible when you seek help from professionals who are experienced treating eating disorders in teens. They work with the adolescent and their families to navigate the complexities and challenges of the eating disorder.

How eating disorders work

If we look at the science behind how an eating disorder works, we can begin with the fact that our brains are inherently wired for connection. An eating disorder works to drive disconnection by becoming the control center, decision maker, and regulator of a person’s brain. This can lead to an obsession with food, manipulating weight, and consistently comparing one’s body to others particularly those seen across social media.

While this may not be logical to someone without an eating disorder, it does make sense in the context of someone’s personal and scary world of judgment when living with an eating disorder.

Empathy as a healer for eating disorders in adolescents and teens

At Clementine and all Monte Nido & Affiliates programs, we believe in the healing power of empathy as the base of human connection. When a client feels seen and heard, they often visibly relax and become open for connection and self-discovery. That’s why we provide a homelike setting that allows adolescents to feel emotionally safe as they manage the fears and other emotions associated with recovery.

As a caregiver, it’s important to work on understanding instead of forcing logic. Recognize that someone in the depths of their eating disorder is not able to think their way out. Offer an empathic connection which might open the door for them to reconnect with their own motivation. If you are genuinely curious and seek to understand your loved one who is suffering, they may appreciate your interest in them beyond their eating disorder thus nurturing your relationship.

It’s also important that you have your own support system to help you navigate this process. Find others with whom you can share your own experience realizing that it will be different from your loved one who is working toward recovery.

How recovery from eating disorders requires family support

Adolescents’ brains are not fully developed and continue to develop into adulthood. That’s why it’s important to consult with your treatment team to determine reasonable goals for your adolescent because every person and every eating disorder is unique.

At Clementine, we understand that the eating disorder interrupted your parenting journey, and our team is here to help you better understand the eating disorder and, in the process, reconnect you with your loved one while we give them the tools to recover.

Recovery is possible, and together, we can navigate the non-linear journey and introduce self-regulation skills to replace the regulation provided by the eating disorder. We work toward nourishing their body while reestablishing connection with their own sense of agency and values. With empathy, understanding and support, we can help your loved one move toward a healthier and happier life.

Clementine Houston is here to help

If you think your teen may have an eating disorder, we are here to help. Our Clementine Houston eating disorder programis located just north of Houston in Conroe, Texas. This residential treatment program is for adolescents seeking treatment for anorexia nervosa, bulimia nervosa, binge eating disorder, or exercise addiction. It’s here that adolescents receive the highest level of medical and psychiatric care outside of a hospital within the comfort of a home.

Our treatment approach is thoughtful integration with personalized clinical and nutritional care and comprehensive academic and family support. Our team is knowledgeable and sensitive to the developmental needs of teens, and our treatment is therapeutically grounded, incorporating state-of-the-art approaches, research, and outcomes data.

Please reach out if you’d like to learn more about if Clementine Houston is right for your family.

Erika St. Germain, MA, LPC, NCC (she/her) joined Monte Nido in 2019 and recently moved into the role of Clinical Director at Clementine Houston. She is dedicated to holding a healing space for clients to share their unique stories, confront their eating disorders, and reconnect to their authentic selves.  Erika is passionate about building and maintaining a strong treatment team and strives to lead from the heart. She also has experience in outpatient, PHP, and IOP eating disorder settings and is deeply grateful for the opportunity to serve so many courageous clients and their families.

The post How Clementine Houston Treats Adolescents with Eating Disorders appeared first on Clementine - Adolescent Eating Disorders.

With a mental health disorder with as many risk factors as anorexia nervosa, the margin of error for successful treatment is very small – and that’s why parents need to know what type of treatment is necessary. Better outcomes are often the result of early intervention, so getting started early is essential. Just as importantly, the adolescent who gets the treatment also needs to know what to expect when they go in for residential, the most intensive form of treatment.

Day Treatment or Residential Treatment?

The simplest way to determine if an adolescent needs residential anorexia nervosa treatment is to assess the physical and emotional risks they carry. A doctor and psychiatrist should be consulted for an official diagnosis. There are also various, less formal checklists and questionnaires that may be able to give parents a head start. If a parent is concerned about their child’s eating habits, they should talk to their child before making any moves – it’s usually not best to suddenly spring intense psychiatric treatment on anyone.

In the early stages, the signs of anorexia nervosa are often subtle – dieting, excessive exercise, and some weight loss may not seem incredibly harmful, but when they progress, they can endanger their health. People with anorexia nervosa often obsessively count calories and are preoccupied with attaining a “perfect” body. Eating disorders often cooccur with other mental health symptoms; parents should be aware of potential triggers like depression, anxiety disorders, and especially PTSD. When the disordered behaviors surrounding the disease are endangering the teen’s life, parents should seek out a residential program.

How to Talk about Anorexia Nervosa Before Deciding on a Course of Action

The number one point to remember when speaking to a teenager (or anybody) about a sensitive subject like this is to always remain judgment-free. The idea that a mental health disorder is somehow “bad” or shameful can wreak havoc on an adolescent’s mental state; it can even worsen the condition by triggering negative emotions that lead to disordered coping behaviors. When talking to a teenager about anorexia nervosa, don’t immediately react with a statement like “You have to start eating more” or even “But your body is nice!” These kinds of statements impose a value on what they are saying rather than just letting them be heard.

Instead, ask open-ended questions, and be prepared to simply listen to their answers. Some things may be hard to hear, and even harder to simply accept. Always remember to keep their agency in mind. Instead of proclaiming “You’re going to get treatment!”, ask “How can we help you with this?” Some other pointers about this discussion might include:

• Start with open-ended questions – Instead of diving right into a lecture about the dangers of anorexia nervosa, ask them about how their feeling. Are they feeling anxious or depressed? How do they feel about themselves? Is there anything that’s been bothering them? Remember that eating disorders are often paired with low self-esteem and negative feelings about their body, so be careful not to react sharply or accuse them.
• Keep the discussion focused on feelings, not food –Eating disorders aren’t about food as much as a person’s body image and mental state. Very often people with anorexia have a strong sense of perfectionism added to negative body image; although nutritional education and meal planning are major parts of treatment, more time is spent on psychotherapy and behavioral therapy. Stay focused on how they feel rather than what or how much they are eating.
• Validate their statements – Remember, there is no such thing as a “wrong” feeling. One way to show your teen that you are listening and to help them feel validated is to listen, then restate their sentiments. For example, “I understand. You are feeling that your body is too big and you want to lose weight.” Again, remember to be judgment-free. Understanding their point of view will help you understand what they are struggling with. With time and counseling, you can begin to help them replace disordered thoughts with healthier ones.
• Make a plan – before talking about a difficult subject like anorexia nervosa, think about what you’re going to say and how you’re going to say it. It’s all too easy to get caught up in an emotional response, especially if your child is emotional as well. Remember to never be accusatory or demanding. Instead, think about how you can be supportive, caring, and calm when broaching the subject at hand. A little preparation goes a long way.

How to Prepare Teens for Residential Anorexia Nervosa Treatment Programs

Residential treatment centersprovide clients with the ideal recovery setting, separating them from the pressures of their day-to-day lives and making it easy to focus on treatment in a structured and safe setting. This kind of treatment by design puts the adolescent in a safe, focused setting so that all their energy can be focused on recovery.  However, these are major lifestyle changes and can be disruptive – so the teenager and her family should be ready. As you are preparing for treatment, make sure to learn all you can about the center, its programs, and what treatment will be like.

What Is Residential Treatment Like?

Residential anorexia nervosa treatment, sometimes called inpatient treatment, isn’t the cold, fluorescent-lit hospital that often pops up in the imagination. That’s a Hollywood misconception. Normally, the facility will be comfortably appointed with furnished rooms and shared spaces, including entertainment rooms, classrooms, and kitchen/dining rooms.  A feeling of safety and comfort is essential for creating a conducive environment for treatment, so quality facilities will feel more like a home than an asylum.

Day-to-day activities are centered around moving steadily forward in treatment. There will be daily therapy sessions, and frequent group sessions which allow for peer support and growth, and for adolescents, there are normally educational programs as well. Continuing the teen’s education is key – some of the best centers even have certified teachers on hand to teach classes. Finally, experiential therapies like hiking, gardening, attending concerts, or going food shopping also round out the activities involved in residential treatment.

How to Prepare Before Entering an Anorexia Nervosa Treatment Center

Managing expectations – positive and negative – is important for teens about to go into residential treatment for anorexia nervosa. Because they will be entering a highly structured environment, teens should understand that they may have designated free time and/or designated phone and visitation hours.

While parents should always listen carefully to their child’s fears, especially when making a major life change like entering residential treatment, they should frame the discussion about treatment in a positive way. This can help calm their nerves and give them an idea of what to expect over the next several weeks. It’s also important to find out what items can and can’t be brought to the facility, and how much outside contact will be allowed.

Some key facts to discuss with teens as they prepare for eating disorder treatment include:

• The length of the treatment program
• Therapy options available during treatment
• How their progress will be monitored
• When they can expect to phone/visit with family
• What an average day in treatment may look like

Make Sure to Answer Their Questions – and to Have Your Questions Answered

It’s also important to give children the opportunity to ask questions about the recovery process and the benefits of residential treatment programs. Parents should let them voice their concerns and do their best to provide accurate information. If necessary, it’s perfectly acceptable to reach out to the treatment facility for additional information.

Admissions specialists are available to help parents answer as many questions as possible before committing to treatment. The kinds of practical questions listed above should certainly be discussed but admissions specialists can also help you local a local therapist or psychiatrist to make a formal diagnosis, to help you make travel arrangements, to discuss tutoring and continuing education, and to help navigate insurance and other financial considerations. If your adolescent is struggling with anorexia nervosa or another eating disorder, reach out to a center’s admissions staff today – it’s the first step to a happier, healthier life.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.

The post When Do Adolescents Need Residential Anorexia Nervosa Treatment? appeared first on Clementine - Adolescent Eating Disorders.

Risk Factors of Binge Eating Disorder

Binge eating disorder, like other mental health conditions, is not caused by one single factor, but rather a combination of several. These might include:

Negative Body Image

A decreased sense of self-worth can greatly increase the risk of binge eating disorder in adults, teens, and children. Individuals who are worried about their weight, shape, or any other aspect of their physical selves may feel pressured to make a change. Without the ability to cope in a healthy manner, these individuals may turn to disordered thoughts and behaviors.

Low self-esteem is a particularly problematic risk factor as eating disorders can cause people to have a distorted body image. This serves to fuel their condition, making it difficult to reach out for help in starting eating disorder treatment. The treatment process will need to revolve around eliminating those misleading self-perceptions and replacing them with positive ones.

Genetics

Certain gene patterns are thought to be influential in the development of BED. Researchers at Boston University have been able to identify a gene that may predict whether a person is likely to feel urges to overeat or eat beyond a sense of satiety. When people have this gene, called CYFIP2, it’s not a guarantee they will develop BED, but it statistically points to an increased chance of the disorder appearing.

Trauma and PTSD

Binge eating episodes, especially those where fatty or sugary food is eaten in bulk, cause dopamine to be released. Dopamine, which is the brain chemical that affects mood, satisfaction, and pleasure, can lift the mood when released. In many cases of BED, the negative emotions caused by past trauma or PTSD lead a person to look for ways to alleviate the stress. Binge eating episodes, releasing dopamine, serve as a coping mechanism, and may lead to a cycle of PTSD and overeating.

Frequent Dieting Behaviors

Frequent dieting is both a potential cause and a sign of binge eating disorder. Engaging in regular dieting behaviors also points to dissatisfaction with body size and shape, contributing to the risks.After the development of binge eating disorder, people may engage in frequent dieting behaviors as a way to compensate for overeating. They may restrict their daily food intake heavily until they have a chance to binge. This vicious cycle can make it very difficult to break away from disordered behaviors and illustrate the need for the individual to acquire help at binge eating disorder treatment centers.

Behavioral and Physical Signs of Binge Eating Disorder

Getting started on eating disorder treatment early is the best way to attain a full recovery. Family and friends should keep an eye out for these indications that their loved one has a disorder and seek out options for treatment quickly if they see any:

• Intense Focus on Food: As disordered thought patterns arise, people with binge eating disorder may feel overwhelmed by thoughts about food. Their intense focus on food may make it difficult to talk about much of anything else. They may obsess about when and what they will eat in an attempt to control the distressing sensations they feel.
• Food Gone Missing: While engaging in binge eating behaviors, individuals tend to consume a large volume of food in one sitting. Parents or other family members should be on the lookout for large amounts of food suddenly going missing, or lots of wrappers in the trash.
• Perfectionism and Feeling Loss of Control: As binge eating disorder causes an inability to control food intake, people with the disorder tend to display perfectionism and a need to control other aspects of their lives.When things get out of control, it may result in an attempt to calm those feelings by binge eating, fueling the repetitive cycle of negative emotions followed by disordered behaviors.
• Avoiding Public Meal Settings:Frequent engagement in fad or crash diets associated with binge eating disorder may cause people to avoid eating meals with their family and friends. They may even avoid eating in public due to a fear of losing control and the shame that arises with overeating.
• Frequent Talk About Body Image Concerns: People with eating disorders often feel preoccupied with their body image and size. They may frequently make negative comments about their appearance in a serious or joking manner as a way to vent and gain support. They may start to pull away and isolate, however, as the binge eating disorder symptoms worsen.

Treatment for Binge Eating Disorder

As binge eating disorder has come to greater prominence in recent years, its treatment has become more specialized. Although many treatment methodologies for binge eating disorder are similar to those used for other eating disorders such as anorexia nervosa or bulimia nervosa, there are often subtle changes in their specifics. One major difference is that weight-restore programs which are often used when an individual is deemed medically underweight are often unnecessary or counterproductive for an individual with binge eating disorder, Instead, a HAES (healthy at every size) approach that foregrounds the individual’s health over a specific weigh figure is recommended.

HAES and the idea of treating behaviors and emotions rather than attempting to force ideas about weight are important factors in addressing a common issue in the eating disorder recovery field. Because the stereotypical image of a person with an eating disorder is that of a person who does not eat and has become underweight, a person with binge eating disorder may feel overlooked or ostracized in a treatment setting. Modern treatment methodologies thus focus on mindfulness, restoring the individual’s relationship with eating, and behavioral modifications as standard curricula rather than putting the spotlight on gaining or losing weight.

Psychological treatments for binge eating disorder most often include Cognitive behavioral therapy (CBT) as their bedrock. This method involves gradually, through talk therapy sessions, helping an individual understand how emotions affect thinking, which in turn affects behavior. Becoming more mindful of emotions and thought help the individual experience them without acting on them. These sessions extend into replacing disordered behaviors with more healthful ones, resulting (hopefully) in long-term recovery.

Offshoots of CBT such as DBT (used for cases involving mood disorders or extreme emotions like depression or borderline personality disorder) or CPT (used specifically to treat PTSD and help people process trauma) are also often used in treating binge eating disorder. Depending on the specific triggers and root causes of an individual’s disorder, they can be useful additions to their recovery toolbox.  A successful recovery plan is usually one that takes an individual’s background into account and is designed specifically for that person.

Treatment for Binge Eating Disorder Is Available

Although binge eating disorder has been added to the disorders listed in the DSM more recently than other eating disorders, it is the most common form of eating disorder in the United States. Accordingly, treatment has become widespread and specialized. If you or a loved one is struggling with binge eating disorder, don’t despair – treatment is both available and effective. For the best outcomes, don’t hesitate – recovery is a long process and the sooner you get started, the better. Reach out today and reclaim your recovered self.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.

The post What Are the Risk Factors for Binge Eating Disorder? appeared first on Clementine - Adolescent Eating Disorders.

One way you can help to answer some of these questions is to look at the facility’s outcome data. This information outlines the effectiveness of the program’s efficacy in a macro sense by looking at the statistic about clients’ recoveries. Of course, these statistics can’t hope to tell the whole story – every person is different, and every eating disorder requires a different, individualized treatment plan. However, the data can provide some insights to people entering a treatment program, and that can help them make informed decisions about which program to enter.

Below, we’re outlining some of the results from our adolescent treatment programs at various locations throughout the United States. We encourage people looking for eating disorder treatment to ask about the outcome data at their potential choice; you should also speak to a representative to discuss the non-statistical aspects of the program. These might include details about the location, the amenities, the treatment philosophy, academics, and other important factors. With no further ado, here I some outcome data about Clementine programs that might help you decide:

Clementine Atlanta

• 97% of clients with Anorexia Nervosa – restricting demonstrated clinically significant weight gain and reported decreased urge to restrict.
• 100% of clients with Bulimia Nervosa reported improvement in or complete cessation of compensatory behaviors.
• 91% of all clients improved in eating disorder symptoms on the Eating Disorder Examination Questionnaire (EDEQ) global score, 88% improved in trauma (based on improvement on PCL5 if they had PTSD at Admission), and 80% of clients improved on depression symptoms.
• 17% of clients received Cognitive Processing Therapy to relieve trauma symptoms and, of these, 88% demonstrated significant improvement in their trauma symptoms (as measured by PCL-5 scores) that could be considered remittance of symptoms.

Clementine Woodlands

• 95% of clients with Anorexia Nervosa – restricting demonstrated clinically significant weight gain and reported decreased urge to restrict.
• 100% of clients with Bulimia Nervosa reported improvement in or complete cessation of compensatory behaviors.
• 90% of all clients improved in eating disorder symptoms on the Eating Disorder Examination Questionnaire (EDEQ) global score, 77% improved in trauma (based on improvement on PCL5 if they had PTSD at Admission), and 81% of clients improved on depression symptoms
• 60% of clients received Cognitive Processing Therapy to relieve trauma symptoms and, of these, 78% demonstrated significant improvement in their trauma symptoms (as measured by PCL-5 scores) that could be considered remittance of symptoms.

Clementine St. Louis

• 100% of clients with Anorexia Nervosa – restricting demonstrated clinically significant weight gain and reported decreased urge to restrict.
• 100% of all clients improved in eating disorder symptoms on the Eating Disorder Examination Questionnaire (EDEQ) global score, 75% improved in trauma (based on improvement on PCL5 if they had PTSD at Admission), and 75% of clients improved on depression symptoms.

Our sister programs also track their outcome data; while they are not solely focused on adolescents like Clementine, they feature connected philosophies and methodologies in their programs. Here is some data from Monte Nido:

Monte Nido East Bay

• 77% of clients with Anorexia Nervosa – restricting demonstrated clinically significant weight gain and reported decreased urge to restrict.
• 100% of clients with Bulimia Nervosa reported improvement in or complete cessation of compensatory behaviors
• 88% of all clients improved in eating disorder symptoms on the Eating Disorder Examination Questionnaire (EDEQ) global score, 87% of clients diagnosed with PTSD at admission improved in symptoms of trauma, and 91% of clients improved on depression symptoms.
• 35% of clients received CPT. Of these, 87% demonstrated significant improvement in their trauma symptoms (as measured by PCL-5 scores) that could be considered remittance of symptoms.
• 100% of clients with Binge Eating Disorder improved to the same extent as clients with other diagnoses on measures of eating disorder symptom severity, quality of life, and depression.

Monte Nido Chicago

• 76% of clients with Anorexia Nervosa – restricting demonstrated clinically significant weight gain and reported decreased urge to restrict.
• 91% of clients with Bulimia Nervosa reported improvement in or complete cessation of compensatory behaviors
• 96% of all clients improved in eating disorder symptoms on the Eating Disorder Examination Questionnaire (EDEQ) global score, 92% of clients diagnosed with PTSD at admission improved in symptoms of trauma, and 85% improved in depression symptoms.
• 32% of clients received Cognitive Processing Therapy to relieve trauma symptoms and, of these, 86% demonstrated significant improvement in their trauma symptoms (as measured by PCL-5 scores that could be considered remittance of symptoms.

Monte Nido Roxbury Mills

• 70% of clients with Anorexia Nervosa – restricting demonstrated clinically significant weight gain and reported decreased urge to restrict.
• 100% of clients with Bulimia Nervosa reported improvement in or complete cessation of compensatory behaviors.
• 97% of all clients improved in eating disorder symptoms on the Eating Disorder Examination Questionnaire (EDEQ) global score, 82% % of clients diagnosed with PTSD at admission improved in symptoms of trauma, and 86% of clients improved on depression symptoms.
• 19% of clients received Cognitive Processing Therapy to relieve trauma symptoms and, of these, 79% demonstrated significant improvement in their trauma symptoms (as measured by PCL-5 scores) that could be considered remittance of symptoms.

What Treatment Looks Like Beyond the Data

For people, especially adolescents, entering a residential eating disorder treatment program, the immediacy of the situation takes precedence over lists of data and figures. As wonderful as it is to know how effective the program is in a clinical sense, what often matters more is what the day-to-day or even minute-to-minute experience will be like. Parents also have various concerns and questions about the treatment experience.

To that end, Clementine Programs is devoted to providing as much information as possible to potential clients and their families. Our admissions specialists are also available to provide detailed answers about the admissions process, the facilities, nutrition, academics, and financial considerations and insurance. Here are some of the things to expect from a Clementine treatment program:

Academics and Education

It’s important not to let residential treatment interfere with your life more than it has to; although clients will need to take a leave of absence from work or school, there are often ways to alleviate the disruption. For adolescents, the worry is often that they will fall behind in academics. At Clementine, we believe in preparing our clients for returning to daily life, and academics is a big part of that. Clients can expect:

• Two hours of daily work on content areas
• Personalized education plan with state-certified educators on-site
• Ongoing, weekly communication and coordination with parents and schools
• Referrals to specialty tutors available on request
• School and life balance and college readiness
• A successful return to an adolescent’s home academic environment.
• Consideration of covid-related coordination with home schools

Nutrition

Restoring one’s connection to food and eating is paramount for a full recovery. At Clementine, we base our nutrition programming on mindful eating with a focus on the developmental needs of the individual. Using principles of mindful eating, we normalize food and eating, offering therapeutic opportunities to utilize family support and increase autonomy in recovery. Here are some of the nutritional aspects of our program to expect:

• Kitchens that are open and accessible as in a home-like setting; at any time throughout the day, individuals can request and be provided with more food for satiety
• Recognition that healthy, recovered people come in all shapes and sizes
• Recognition that all bodies deserve to be nourished and experience satiety
• Behavior-focused, rather than weight-focused, philosophies
• Belief that weight loss attempts and focus are contraindicated for recovery from all eating disorder diagnoses

Family Involvement

Treatment is focused on the individual to be sure. However, those closest to an adolescent in treatment must also be involved in the process. Because of this, families are a fundamental part of orientation.  From meeting with the treatment team upon arrival, to learning what the more encompassing plan for care will be. This “family roadmap” provides an understanding of how the family component is integrated into the program and what the client and family can expect:

• Weekly family therapy (on-site or remote)
• Weekly multi-family group (on-site)
• Parent education program every other weekend (on-site) | Psychoeducational seminar | Parent-only support group | Nutrition planning, meal preparation, portioning, and behavior management skills
• Varied and individualized exposure opportunities to practice meals and support the reintegration of the adolescent into family mealtimes after discharge

Treatment for Eating Disorders at Clementine Programs

We hope that we’ve been able to provide some helpful information about the effectiveness and experience of treatment at Clementine programs. If you or a loved one have been diagnosed with an eating disorder and are looking for treatment, we hope you consider our programs and learn as much as you can before making your decision. You can see more about the program here, and more research data here. We’re always available to talk you through the admissions process; our admissions specialists can be reached at +1 (888) 228-1253. We hope to hear from you and help you begin your journey to a full recovery.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.

The post Outcome Data Doesn’t Always Mean Everything – But It Can Help You Make Informed Decisions About Eating Disorder Recovery appeared first on Clementine - Adolescent Eating Disorders.

bulimia nervosa is a terrifying prospect for everyone involved – a life-threatening disorder that can endanger a person’s well-being, requires intensive treatment, and sets students back academically while they enter a residential program.  This mental health disorder affects about 1.5 percent of women in America at some point in their lives. It seems like a small figure, but it will have an impact on millions of people’s lives. (Please note that not only girls and women get bulimia nervosa – it can happen to boys and men, too.)

It also tends to first appear and worsen during adolescence, which puts the pillars of that age, academics, socialization, and personality development at greater risk. Especially when it comes to schoolwork, an eating disorder that takes 30 days or more can set them back if there isn’t a program in place to continue education at the bulimia nervosa treatment facility.

That’s why any residential bulimia nervosa treatment program worth its salt will have an academic component – to keep the client apace at school while saving their life with the eating disorder program.

What Are the Signs Bulimia Nervosa Treatment Is Needed?

The first symptoms of bulimia nervosa (and other eating disorders) normally first appear in mid-to-late adolescence – that is, from age 13 to 18. It’s a severe and deadly behavioral health disorder, following only anorexia nervosa in terms of the death rate. The behaviors that define bulimia nervosa are well-defined by the DSM-V; a person with BN will binge eat regularly and then purge that food to remove the calories taken in during the binge eating episodes. Before the binge-and-purge eating disorder behavior begins, there are several warning signs of bulimia nervosa to be aware of in children:

• Preoccupation with weight and body size
• Engaging in dieting early and frequently
• Distorted or negative body image (often perceiving themselves as overweight)
• Eating only certain types of food (no carbs, etc.)
• Developing food rituals (moving food around on the plate, etc.)

While none of these behavioral symptoms is a guarantee that bulimia nervosa is present, when added to one another they present a warning sign of a potential problem. It’s important that these symptoms are addressed sooner rather than later by a professional.

These initial warning signs can lead to a full-blown case of the disorder if they are left untreated. Bulimia nervosa signs and symptoms include:

• Repeated and compulsive binge eating episodes
  • Consuming a large amount of food in a short period
  • Experiencing feelings of guilt and shame afterward
  • Secretive behavior and frequent dieting
• Purging behavior following the binge eating episodes
  • The most common is self-induced vomiting; be aware of frequent trips to the bathroom (especially after meals) and the sounds and smells of vomit
  • Using purging drugs like laxatives – check for pillboxes in the trash
  • Excessive exercise – burning calories after a meal, even past the point of pain or discomfort
• Distorted body image and low self-esteem
  • People with bulimia nervosa tend to think they are fat or overweight, even if the opposite is true
  • Sense of shame or dislike of their body

What Does Eating Disorder Treatment Entail?

While adolescent programs often have specialists in child psychology on hand, in general, treatment programs for eating disorders are similar in nature. They rely on clinical, nutrition, and psychiatric treatment methods that are tried and true with decades of proven effectiveness behind them. This is what’s meant by the term “evidence-based”; the methodology has shown through evidence to work more often than not.

Teenagers are growing fast, and their bodies need proper nutrition to stay healthy. An adolescent bulimia nervosa treatment program must have nutritionists and dieticians on hand to help their clients maintain a balanced nutrition plan while they work on restoring their relationships with food and eating. Meals are planned based on the doctor’s recommendations for weight restoration, nutritional balance, and other essential segments of a HAES-oriented eating plan.

Psychiatric care is also essential. Bulimia nervosa is a serious psychiatric disorder, and specialists are necessary to develop treatment modalities that work with adolescents. Although there are no psychiatric medications for eating disorders, they may be prescribed for co-occurring disorders such as clinical depression, anxiety disorders like PTSD, and others such as OCD or borderline personality disorder. Treating co-occurring disorders must be part of the recovery program; leaving them untreated can lead to relapses or recurrence of the eating disorder.

Psychological treatments include both individual and group therapy sessions that focus on the client’s emotional state and life experiences. Many recovered clients report that these sessions are their favorite part of treatment, and they are conducive to peer ponding and breakthroughs. More focused therapies such as Cognitive Behavioral Therapy and Cognitive Processing Therapy are also used to rehabilitate behavior and process PTSD, respectively. All combined these aspects of treatment allow adolescents the best chance to recover from bulimia nervosa and regain their recovered selves.

If My Child Goes Into Residential Bulimia Nervosa Treatment, Won’t They Fall Behind?

With all the activities mentioned above, it might seem like there is no time for anything else. However, schooling is a key part of an adolescent’s life, and a quality residential treatment program must take that into account. Especially in an era when academics are harder than ever to maintain, taking 30 to 90 days off from school can cause all kinds of setbacks, even with distance learning. Especially in the high school years, it is essential for parents seeking bulimia treatment to find an eating disorder treatment center that focuses on bulimia nervosa but also makes academic integration a part of the program.

The best eating disorder treatment programs for adolescents will provide several avenues to continue their clients’ educations, especially in the middle school to high school years. To avoid interruption of their existing curriculum, they should coordinate the student’s homework and reading assignments with her regular school and teachers. The residential program should also include regular daily study and lesson time. Finally, if possible, they should have certified teachers and tutors on-site to make sure the education isn’t self-guided, but instead remains the highest quality.

If you’re considering adolescent eating disorder treatment, make sure you consult with the facility about their academic programming. Will they provide tutors? Will they set aside time for education during the treatment program? Will they coordinate with your child’s teachers and school administrators? With these provisions in place, a teenager in eating disorder recovery doesn’t have to fall behind. Reach out today to get started.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.

The post Academic Programs at Bulimia Nervosa Treatment Centers Are More Necessary Than Ever appeared first on Clementine - Adolescent Eating Disorders.

Meditation Therapy

For centuries, meditation has been thought to help people achieve a calmer state of being in which they can achieve mental clarity, find renewed energy, and focus on overcoming personal emotional obstacles. Meditation as part of bulimia therapy is beneficial because individuals often struggle with overcoming feelings of anxiety and stress that can trigger their eating disorder behaviors.

Body Awareness Therapy

Body awareness therapy can come in many different forms, and some form of this therapy type is usually used as a bulimia treatment option. Body awareness therapy is designed with a focus around recognizing the bodies feelings and movements. Studies of body awareness therapy suggest that using this as a therapeutic tool during treatment for eating disorders could help people establish a more realistic body image, which is something that people in bulimia treatment centers tend to struggle with the most. Negative portrayals of the self-image in the mind can drive bulimic behaviors and thoughts, so through body awareness therapy, individuals are better capable of seeing their own bodies in a clear way.

Yoga Therapy

Yoga is a form of physical exercise, but it involves slow and calculated movements, focused breathing, and absolute concentration on the body’s movements. Therefore, yoga as part of a bulimia nervosa treatment plan can be a highly useful tool. Bulimia treatment centers like Monte Nido have daily yoga sessions as bulimia treatment options for clients because the yoga can be so beneficial to the recovery process.

In a study of how yoga affected women, the participants saw changes and improvements in:

• having a positive body image
• making better dietary choices
• having a positive sense of well-being

All of these ideas are things that people in bulimia treatment centers tend to struggle with most. Therefore, yoga could be a powerful tool to help people overcome some of their struggles during treatment.

Massage Therapy

There is no question why massage is beneficial for the body; it helps to relax the various parts of the musculoskeletal system. However, massage therapy can also be beneficial for the mind, so it is also a useful tool for recovery. Massage can be used as part of a therapeutic approach because it induces a calmer state, helps to override anxious thoughts, and encourages relaxation. Massage therapy has the ability to do things like lower stress hormones and increase dopamine levels, which can help an individual feel better on an emotional level and focus on getting well.

General Approaches Used in Eating Disorder Treatment

Although each and any of the above techniques can be used as a supplement to an eating disorder recovery plan, the core of recovery is similar for most cases. Eating disorders such as bulimia nervosa, binge eating disorder, and anorexia nervosa are all complex disorders that affect a person’s physical, mental, and emotional health. As such, a multifaceted approach is necessary for recovery; treating only one aspects leaves an individual at risk for relapse.

To address the physical, mental, and emotional health needs of each client a treatment plan is created by the facility. Although each aspect is intertwined, they can generally be broken down into three categories:

• Physical – Eating disorders like bulimia nervosa can take a toll on a person’s health. There can be weight fluctuations, malnutrition and a wide array of other health risks at play. When entering a recovery center, the first priority is to stabilize the client medically. This might involve medication or hospitalization. In almost every case, nutrition and meal planning is essential to the recovery process. Dietitians will work with clients to plan meals that the client is comfortable eating, which also help restore their nutritional balance. Proper nutrition greatly affects mental function as well, so getting back on track nutritionally helps the recovery process. Many people with eating disorders also struggle with disordered exercise patterns, so mindful movement is usually also part of a recovery plan.
• Mental – Mental health is perhaps even more complex than physical health. For people with eating disorders, treatment can involve therapy, psychiatric practices, and personal growth. On a psychiatric basis, there are many co-occurring disorders commonly affecting clients, such as OCD, anxiety, and depression. Although these disorders might have available medications (which are certainly useful in treating eating disorders patients), there are no medications specifically designed for eating disorders. However, psychiatric techniques like Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are proven techniques as viable for eating disorder recovery as they are for addiction recovery.
• Emotional – Addressing a client’s underlying issues, which have helped to trigger their eating disorder, is essential to long-term recovery. Chief among these is treating PTSD, as trauma is a powerful trigger for coping mechanisms like disordered eating. Cognitive Processing Therapy (CPT), a therapy technique designed to help soldiers process their trauma, has become widespread in mental health treatment on a larger scale. Other traditional talk therapy like individual sessions and group encounters are also cornerstones of eating disorder treatment. They help a person understand themselves and their place in the world, and how their relationships with their body and food have been affected.

Seeking Help Is Easier Than You Think

Overall, bulimia nervosa therapy should include a vast array of different treatment options and methods, and the best treatment centers work to incorporate many alternative and traditional treatments in their plans. Monte Nido uses all of these therapy types in their facilities in different ways, in addition to a number of other methods to create the most comprehensive recovery plan possible. If you would like to know more about Monte Nido’s treatment options for bulimia nervosa recovery, reach out to us for more information.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.

The post A Look at Alternative Treatment for Bulimia Nervosa appeared first on Clementine - Adolescent Eating Disorders.

What Is Day Treatment for Eating Disorders?

While many parents have heard of day treatment programs for those with substance abuse issues, this type of treatment is also used to help individuals with eating disorders begin the path to recovery. Children and adolescents with common eating disorders like anorexia nervosa and bulimia nervosa can benefit from this type of outpatient care if they are already medically and psychiatrically stable.

Day treatment centers are typically a good fit for clients who do not need access to 24-hour care but can still benefit from regular counseling sessions, meetings with a nutritionist, group therapy, family therapy and more. Day treatment centers usually provide some combination of the following eating disorder treatment services:

• Personalized treatment plans
• Relapse prevention planning
• Individual counseling/therapy
• Cognitive Behavioral Therapy (CBT)
• Family-Based Therapy (FBT)
• Co-Occurring disorder counseling (drug and addiction education)
• Creative therapy
• Aftercare plans
• Aftercare groups
• Group therapy
• Recreational activities

Who Is a Good Candidate for Eating Disorder Day Treatment?

Day treatment programs for adolescents are usually geared towards clients who have busy schedules that include important school, work, and sports commitments. In some cases, day treatment programs may even offer an educational component to help clients stay up-to-date with their studies. If adolescents have already completed a residential or partial hospital treatment program, day treatment can also help them to slowly transition back into their regular routine. Additionally, day treatment programs are often less expensive because clients do not require room and board as part of their recovery plan.

One of the greatest benefits of day treatment programs for teens is the fact that they are highly individualized. Depending on each adolescent client’s needs, there may be options available for treatment sessions that include family and close friends. While other forms of treatment may include meeting several times a week with a therapist that specializes in eating disorders.

Identifying Common Eating Disorders

If a teen or their parents believe that they may have an eating disorder, it is important to seek professional help as soon as possible. Early intervention is often crucial in terms of long-term recovery. If teens are unsure whether they may have an eating disorder, taking a look at recent behaviors can help. Some of the most common signs of eating disorders include:

• Obsessive thoughts surrounding food, dieting, body weight, body shape, etc.
• Hiding or hoarding food
• Avoiding mealtimes
• Fear of eating around others or eating in public
• Yo-yo or fad dieting
• Excessive exercise, laxative abuse, self-induced vomiting after meals
• Gastrointestinal issues
• Developing food rituals such as only eating foods in certain orders and avoiding certain food groups.

Learn More from Clementine Day Treatment Center

Interested in learning more about the benefits of comprehensive day treatment for adolescents? At Clementine, we provide the highest quality of care available outside of a hospital setting.  For more information about our adolescent eating disorder treatment options, call +1 (888) 228-1253 today to speak with one of our admissions specialists.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.

The post What Can Adolescents Expect in Day Treatment for Eating Disorders? appeared first on Clementine - Adolescent Eating Disorders.

There are many approaches to eating disorder counseling available, which can vary considerably depending on the age, gender, medical history, type of disorder, and the specialty of the center for eating disorders. Specialization is key – every program should be tailored for the individual receiving the treatment. For example, a program designed around making a person with anorexia nervosa more comfortable with eating larger portions will not be effective in helping a person with binge eating disorder.

For these reasons, age-appropriate eating disorder counseling is urgent when addressing various eating disorders in adolescence. The years when a child becomes an adult are crucial developmental times, bringing with them special needs that cannot be ignored.

Nutritional Needs

As an adolescent’s body undergoes rapid changes in size and shape, there are many necessary nutrients. Without nutrients like calcium, a variety of vitamins, and low-fat proteins, teenagers can begin to experience distorted or stunted growth. If denied the proper nutritional balance for their age, teenagers can experience a shortfall in the development of muscle mass, bone density, and body fat.

These deficiencies can cause complications in later life and adulthood, including anemia, diabetes, and osteoporosis. To prevent later nutritional deficiencies and the complications that come along with them, adolescent centers for eating disorders normally include both planned nutritional meals and training for how to prepare them. The latter aspect helps alumni continue to ensure proper nutrition after they have completed formal eating disorder treatment.

Medical Complications

The onset of eating disorders in adolescence is not always gradual; sometimes severe symptoms and their attendant health complications arise very quickly. These symptoms can cause medical conditions requiring emergency care as well as long-term complications. Any disorder which reduces the amount of nutrition taken in, whether due to food restrictions or because of purging (a la bulimia nervosa), can cause the delay of puberty or even its arrest. These complications, if left untreated, can take years to correct.

Depending on the type of eating disorder, other complications can occur, which vary in severity. Teens with anorexia nervosa may face the growth effects mentioned above as well as symptoms of malnutrition such as losing hair, dry and brittle skin, anemia, and low body temperatures. Those with bulimia nervosa and binge eating disorder may experience complications such as heart disease, high blood pressure, sleep apnea, and diabetes.

Psychosocial Considerations

Most teens that enter a center for eating disorder treatment have a distorted or negative self-esteem and self-image. In many cases, their body dissatisfaction leads to the kinds of self-harming behaviors that define their eating disorder. The flawed perception that they are “too fat” is the main self-identity dissatisfaction behind the caloric restriction of anorexia nervosa. In a similar vein, poor or warped self-image often leads to extreme fad diets, which perpetuate a cycle of binge eating and purging.

The adolescent years are when people begin to compare themselves to their peers (and far too often) the photoshopped, idealized images in the media. The negative thoughts and feelings that can arise from these may become solidified as a central part of an adult’s identity if eating disorder counseling is ignored during these formative years. Because teenagers’ identities are so malleable, early intervention is crucial to healthier psychosocial development.

Getting Help Early Counts

The factors above should outline what a critical time adolescence is in both natural development and the onset of disordered eating behaviors. The upshot of this is clear; if you have suspicions that your daughter is experiencing an eating disorder, it’s better to contact a center for eating disorders sooner rather than later. This lets the professionals design an appropriate treatment plan and nips a developing disorder in the bud.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.

The post Three Things That Make Eating Disorders in Adolescence Different appeared first on Clementine - Adolescent Eating Disorders.

Considering some of the other health risks involved with a bulimia nervosa diagnosis – malnutrition, heart, liver, and kidney failures, insomnia, the ending of menstruation – you might think a few cavities aren’t a huge issue. However, the damage done to the teeth can be irreversible and very painful. To better understand this link, use this guide to learn how bulimia nervosa can impact dental health and how timely treatment can help prevent dental problems.

Binging, Purging, and Dental Health

Bulimia nervosa is defined by a repeated binging and purging cycle, most commonly involving self-induced vomiting. This beings gastric and other stomach acids into the mouth frequently. Upon contact with the teeth, these acids begin to wear down their protective enamel layer.

Enamel can be protected to a certain degree by specialized toothpaste and options available from the dentist, but repeated exposure to the acids will inevitably begin to etch away at the teeth. This can cause cavities and the removal of the exterior layers, leaving the nerves and soft interior exposed.

Over time, many dental health effects come into play, such as:

• Dry mouth
• Sore throat
• Swollen glands
• Bleeding gums
• Damage to the soft palate
• Difficulty swallowing

Many quality eating disorder treatment centers that specialize in treating bulimia nervosa will include a dental consult or even a dentist on-staff to help with the dental health consequences of BN.

How Quickly Does Bulimia Nervosa Cause Dental Issues?

Erosion of the tooth enamel can happen quite quickly when people with bulimia nervosa frequently engage in self-induced vomiting. It’s not unusual to see permanent damage to the exterior levels of enamel occur within 6 months of repeated purging. This period can be incredibly painful as the softer interior levels are exposed.

At this point, cavities can easily form deep in the dentin and root of the tooth, often necessitating a root canal or other restorative procedures. Beyond this point, it may become necessary to extract and replace damaged teeth with dentures. Although the pain can be intense, it’s also important to remember that these procedures are extremely expensive and time-consuming, making the need for early intervention even more important.

Complications Caused by Enamel Erosion

There are psychological risks centering around damaged teeth as well. As enamel erosion damages the enamel and stains them yellow or brown, self-confidence levels might drop and the person may begin to feel “ugly,” a common contributing factor in many eating disorders. This can exacerbate existing body image issues and trigger disordered thought patterns and behaviors. The person also may begin to socially isolate even more than before as their disorder becomes more difficult to hide.

The erosion of tooth enamel exposes nerves within the tooth, increasing sensitivity to hot and cold, especially liquids, increasing the risk of pain for many people. Tooth decay, erosion, and cavities can also make daily activities like eating, brushing the teeth, and flossing excruciating. If tooth maintenance is abandoned due to pain, the decay can easily accelerate.

All of these problems tend to continue to worsen over time unless steps are taken to slow or stop the decay – and the best way is to stop exposure to gastric acids caused by bulimia nervosa behaviors.

Getting Help from Eating Disorder Treatment Centers

Thankfully, enamel erosion from bulimia nervosa is preventable. Through care at eating disorder treatment centers, people can stop engaging in the disordered eating behaviors that cause enamel erosion to accelerate. Without gastric acids coming up and affecting the teeth, enamel erosion and many of the other dental complications stop progressing. Dentists can then repair the damage using restorative techniques to resolve dental problems caused by bulimia nervosa.

If you or a loved one is dealing with a case of bulimia nervosa, remember not to lose hope. Many of the symptoms are easily diagnosable and the worst of the complications can be avoided by securing treatment early. Reach out to a trusted eating disorder treatment center, check out their programs, and speak to an admission specialist. They can help you secure a fully integrated eating disorder treatment program today.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.

The post Dental Problems Might Be Caused By Bulimia Nervosa – Be on the Lookout for These Risk Factors appeared first on Clementine - Adolescent Eating Disorders.

For parents of adolescents struggling with disordered eating behaviors, Thanksgiving can also be a trying time. How do you balance creating a bountiful holiday meal for a large group with prioritizing your child’s discomfort at mealtimes? This is far from an uncommon problem – some estimates show that 2.7 percent of teenagers will experience an eating disorder at some point, a figure that totals in the millions in the United States alone. Even after they have undergone eating disorder treatment, mealtime and food-centric activities can be distressing for these individuals.

So, as a parent, how can you make Thanksgiving as stress-free and non-triggering as possible for your child when they are struggling with food and eating? There are a few tried-and-true ways. These are mostly focused on people who have already received some treatment for their eating disorder and are currently in recovery, but any of them can also apply as generally good ideas Here are seven tips that can help parents manage Thanksgiving for adolescents with eating disorders.

1. Don’t Normalize Disordered Behaviors

Disordered eating behaviors usually center on binge eating, food restriction, and/or purging behaviors depending on the type of disorder a person is experiencing. One important way to prevent these behaviors at thanksgiving is to avoid normalizing them. Before a big meal like Thanksgiving, many people will fast the day before (because they don’t want to put on weight) or talk about how they plan to eat way too much. These kinds of statements might act as triggers for a person with anorexia nervosa or binge eating disorder, respectively. Avoiding this kind of normalizing behavior and asking guests to follow suit will help prevent inadvertently signaling to your child that food restricting or binging is all right.

2. No Judgment About How Much (or Little) They Eat

At Thanksgiving or at any other time, “no judgment” should be the mantra for supporting a person with an eating disorder. Most eating disorders are accompanied by feelings of guilt or shame, both about the food that’s eaten and about the disordered eating behaviors. Acting judgmentally reinforces those feelings and can drive an adolescent further into disordered eating, with the added negative that they may withdraw from discussing it with you. Never say things like, “You’re not eating enough” or “Don’t eat so much!” Especially, don’t talk about their weight or body at the meal – if it’s becoming a serious issue, save that conversation for a less stressful time.

3. Stick to Your Regular Eating Schedule

T’s natural to make a big deal about Thanksgiving dinner. People look forward to it all year, and the typical meal is a grand affair with weeks f planning and hours of prep needed to pull it off successfully. For people with eating disorders, though, it might be best to treat it as just another meal. Many programs for recovery stress eating three balanced meals per day, and deviating from that schedule can be a disruptive factor. As an example, a person with bulimia nervosa is prone to binge eating and then purging that food. Treating Thanksgiving dinner as an excuse to binge eat is a potential pitfall for their recovery. Or for a person with anorexia nervosa, the idea of eating a huge meal may be too much to overcome. It’s better in both cases to allow your adolescent to eat three normal-sized meals throughout the day, no matter what everyone else is doing.

4. Give Them Space If they Need It

Even recovered individuals can become overwhelmed by the stresses and sheer food-centric nature of Thanksgiving. If your child is sitting at the table, surrounded by their “fear foods” and constant talk about food, eating, and often weight gain, they may be putting on a brave face. Allow them to release the safety valve any time they want. If they ask to leave the table for a bit, absolutely let them go. They might need a little time alone. You can always check on them if they’re gone too long. Similarly, if they have become withdrawn at the table or seem out-of-sorts, don’t push them too hard. Just ask if they’re all right, and listen to what they have to say.

5. Ask Them What Their Boundaries Are Beforehand

Boundaries are important in the mental health recovery process. Much of the recovery process consists of improving mindfulness and self-awareness, so if your adolescent has been in treatment, they will know what their triggers are and how to defang them. It helps them to manage the big occasion to ask them what their boundaries might be before the guest arrive. You may discreetly ask guests not to discuss weight gain or how “fat they feel,” or try and change the subject if someone starts talking about a potentially triggering subject. As noted earlier, if they feel their boundaries are being pushed, always let them leave the table for a moment to clear their head. Finally, if they don’t want to eat a certain food (or have seconds of a particular item), don’t press the issue. One meal doesn’t really matter in the long run, and maintaining personal comfort is more important than meeting someone else’s idea of how a person should be eating.

6. Help Them Eat Intuitively, For Nourishment and Enjoyment

Intuitive eating is another core tenet of eating disorder recovery. It means eating what nourishes your body and brings you pleasure without worrying about the calories or other triggering aspects of food. At Thanksgiving, you can help your adolescent eat intuitively by encouraging them to eat whatever they want without pressing the issue. They don’t want to eat the green beans? No problem. They legitimately hate pumpkin pie and would rather just have a cup of coffee or some fruit for dessert? Perfect. Thanksgiving is about expressing love and gratitude for life’s pleasures, so if the pressure to eat a certain way, or eat certain foods is getting in the way of their enjoyment, it’s counterproductive to the point of the holiday. If they’re really struggling on the holiday and binging or restricting – take time afterward to discuss their experience. Thanksgiving can be tough on a person with an eating disorder, and you can always help them get back on track when the stressful day is done.

7. Plan Activities for After the Meal

This tip is especially useful for teenagers in recovery from bulimia nervosa (where individuals purge following a large meal), but it works for anyone that struggles with an eating disorder. Sometimes the best way to cope with urges to use disordered behaviors is to just think about something else for a while. After Thanksgiving dinner, some individuals might “get in their head” about the meal and their emotions concerning it. Help them get their mind off those thoughts and feelings by planning a group activity afterward. If they’re a football fan, perfect! You’ve got a built-in activity every Thanksgiving. Try to find something they like to do – you might organize a boar game or deal the cards, you might play music or jam together, or you can take a walk in the brisk autumn air. Something to do on Thanksgiving that doesn’t center completely on food can be a lifesaver.

Eating Disorder Recovery Is a Long but Worthwhile Process

Whether your child is in recovery from an eating disorder, is about to go into treatment, or is simply struggling with body image as well as eating, parents should do what they can to ensure their relationship with food and eating is a positive one. Sometimes that means eating disorder treatment. Like any mental health disorder, eating disorders often require months or years of emotional, behavioral, and psychiatric therapy. It’s often a long process, but one that’s necessary for their well-being. Eating is central to our experience as human beings; creating a healthy relationship with it is a core part of our happiness.

If your child is struggling with an eating disorder, there are myriad resources available. Virtually every therapist, adolescent-specialized or not, can identify an eating disorder and provide referrals for more specialized treatment. If that treatment is warranted, you can consider specialized eating disorder treatment from a professional facility. They normally come in residential, day treatment, and virtual levels of care. Reach out to one as soon as you can if an eating disorder is disrupting your child’s happiness and health.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.

The post For Parents – Seven Tips for Managing Thanksgiving for an Adolescent with an Eating Disorder appeared first on Clementine - Adolescent Eating Disorders.