Eating disorders treatment now: Are we still in the dark ages?

I spoke recently with Dr. Julie O’Toole, founder and medical director of the well-respected Kartini Clinic in Portland, OR. Kartini treats kids up to about age 22 who have eating disorders, using a family based method that relies heavily on parent participation in the child’s recovery.

                Dr. O’Toole is on the same page as Marcia and me: “Parent’s don’t cause eating disorders,” she said, “they are no more responsible for a child getting an eating disorder than they are for a child getting diabetes. Far from being the problem, parents are the only sensible partners that you have to adequately treat a child with an eating disorder.”

                Probably the biggest obstacle that this pediatrician and her team face is that of dealing with what she calls “affected or partially affected parents,” meaning the mom or dad who either has overcome an eating disorder in the past, is still dealing with one, or is grappling with body image or eating problems that have remained untreated or even unacknowledged.

                As Dr. O’Toole points out, we know that eating disorders are highly “heritable,” meaning that kids can inherit the genetic predisposition toward an eating disorder. Yet often parents of a child with anorexia or bulimia who have eating problems of their own feel ashamed, as though they were weak-willed, or bad parents.

                As we have pointed out many times before, there is still a stigma attached to having an eating disorder. This is one reason why Kartini has been working with scientists at Vanderbilt University on a genetic study of eating disorders. “I’ve always taken extensive, detailed family histories,” Dr. O’Toole said, “and our therapists are trained to watch for [multi-generational eating problems]. In this sort of more genetic, or scientific way, we hope to de-stigmatize eating disorders.” Her hope is that one day, parents will look at their eating problem just as objectively as the parent whose child has diabetes, is screened and found unable to fully metabolize sugar: no one blames the child or parent for their condition, we feel sorry for them for having inherited these particular genetic traits.

                One day, there will be a more effective treatment for eating disorders than the mix of medical intervention, education, and family, behavioral and nutritional therapy that is now used. “Right now, it’s like we’re treating tuberculosis in the pre-antibiotic era,” said Dr. O’Toole. “We can structure the environment so [patients] don’t get sick or worse, but we can’t really change the brain chemistry yet.”

                The future holds great promise, though, when it comes to solving eating disorders. “The brain science isn’t here yet,” said Dr. O’Toole, “but it will be.”

Take care,

Nancy

  

Comments

[Laura]

Interesting post! Thanks.

[Nancy Matsumoto]

Thanks for following us, Laura!

[DrBaylac]

I do not think that the origin of eating disorders is in the brain. Eating disorders end up affecting the brain over time but originally bulemia or anorexia is a learnt behavior, a response to the demands of the environment. Our culture is dissociating the body and the mind, creating the perfect terrain for the desire to control the body. Women are more affected than men because the body image is more compelling for women than for men. The family is partially responsible at the same title as society. I found that parents of patients with bulemia or anorexia had an issue with food or body image or that in some way the family was dysfunctional. Eating disorders are a hallmark of this modern society who does not value healthy food and family meals. It is the result of fast food restaurants, TV dinners and processed food. It is a complex illness that requires time and a multidimentional approach to be treated successfully. At Hawaii Naturopathic Retreat center, we have a family type setting retreat center that offers raw food nutrition, exercise, swimming, hiking, psychotherapy and spiritual counseling. We try to involve the family in the healing process.
www.mindyourbody.info
www.rawdetox.org