Eating Disorders/Body Image

This document outlines the hospital admission criteria for adolescents with eating disorders at St. Louis Children’s Hospital, emphasizing medical stabilization through renourishment and monitoring for complications. Admission is justified by factors such as severe underweight, dehydration, abnormal labs, cardiac issues, failure of outpatient treatment, food refusal, dangerous behaviors like binging and purging or coexisting serious psychiatric or medical conditions.

Avoidant/Restrictive Food Intake Disorder (ARFID) is a feeding disorder where individuals avoid certain foods due to sensory sensitivities, past negative experiences, or lack of appetite, leading to nutritional deficiencies and potentially serious health issues. Inpatient treatment involves a multidisciplinary medical team providing medical care, nutritional rehabilitation, and cognitive behavioral therapy with graded food exposures to support recovery.

The most effective treatment for Avoidant/Restrictive Food Intake Disorder (ARFID) is Cognitive Behavioral Therapy (CBT), which includes graded exposure to feared foods through a fear hierarchy, helping children gradually overcome their food anxieties. Treatment involves planned, prolonged, and repeated exposures with incentives to motivate the child, promoting habituation and confidence in trying new foods.

The document emphasizes the importance of a gradual and supervised return to exercise during eating disorder recovery, starting with low-impact activities and progressing carefully. It highlights the benefits of healthy exercise while warning against unhealthy exercise behaviors that can worsen physical and mental health, advising consultation with medical professionals as needed.

Family-Based Treatment (FBT) for eating disorders is a structured approach involving three phases: weight restoration led by caregivers, gradually returning control of eating to the adolescent, and establishing a healthy adolescent identity. It is most effective for children under 18 who have been ill less than three years, requires strong family commitment, and involves close supervision of eating with support from trained therapists over several months.

The document emphasizes the importance of vigilant, structured support in family-based treatment for eating disorders, including closely monitoring meals, enforcing firm boundaries without negotiation, and using natural consequences to encourage healthy behaviors. It encourages parents to be a protective presence and consistent guide, creating a safe environment that helps their child navigate recovery successfully.

St. Louis Children's Hospital

The document outlines the levels of care for eating disorder treatment, ranging from the most intensive inpatient hospitalization to outpatient therapy, each with specific focuses and durations tailored to the patient’s needs. It emphasizes that treatment is personalized and may progress from more to less intensive care, with decisions guided by medical teams based on various factors including symptom severity and available resources.

The document provides guidance for managing common gastrointestinal symptoms in children recovering from eating disorders, emphasizing consistent meal timing, symptom-specific strategies and maintaining empathy while encouraging regular eating. It also highlights that digestive issues often improve with proper nutrition but advises consulting a medical team if symptoms are severe or persistent.

Refeeding syndrome is a potentially serious condition that can occur when nutrition is reintroduced to malnourished individuals, causing rapid shifts in electrolytes like phosphorus, potassium, and magnesium due to insulin-driven metabolic changes. To reduce risk, St Louis Children’s Hospital uses gradual meal plans, supplements key nutrients, monitors labs daily, and adjusts treatment as needed to prevent complications affecting the heart, lungs or brain.

This document outlines how to support adolescents in returning to regular eating by providing consistent, balanced meals and snacks every 3-4 hours, served in a supportive environment without focusing on calories or body size. It emphasizes compassion, firm encouragement, normal portion sizes, and including enjoyable foods to help improve their overall well-being and aid recovery from disordered eating.

This document outlines typical teenage eating behaviors, such as seeking independence in food choices and experimenting with diets, while highlighting warning signs of eating disorders like rapid weight changes, secretive eating, and medical issues. It emphasizes the importance of early detection, open communication, and consulting a medical provider for concerns about an adolescent’s eating habits.

This guide from St. Louis Children’s Hospital outlines the multidisciplinary inpatient treatment approach for eating disorders, emphasizing medical stabilization, nutritional rehabilitation, and Family Based Treatment (FBT) involving parents in refeeding. It also provides practical caregiver tips, meal supervision guidelines, activity restrictions, and resources to support recovery during hospitalization and beyond.

Starvation negatively affects mental health by causing emotional distress, cognitive difficulties, social withdrawal, and altered behaviors around food. Timely treatment, especially in adolescents, is crucial for brain development and recovery, as physical renourishment often improves insight and reduces rigid thinking.

Starvation causes a range of gastrointestinal symptoms and serious physical effects, including muscle loss, weakened heart function, bone density loss, hormonal imbalances, and abnormal blood tests. Timely treatment with gradual nutritional rehabilitation is essential to prevent worsening complications and support recovery.