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Help Without Harming...A Fine Balance in the Treatment of Childhood Eating-And-Weight Related Behaviors


Thursday, March 23, 2017: 8:30 AM-9:45 AM

Background: Mayo Clinic reports one-third of adolescents diagnosed with an eating disorder were initially overweight. Is the fight against childhood obesity creating eating disorders? This presentation will explore an integrated approach to address the spectrum of weight-related disorders aimed at preventing risk factors for obesity, disordered eating, and eating disorders.

Objectives: 1. The language used to help without harming when dealing with eating and weight related disorders. 2. Risk factors that are shared between all eating and weight related disorders. 3. The value of body composition analysis and metabolic testing when evaluating children and adolescents that struggle with eating and weight related concerns.

<>I.Introduction <>A.   Prevalence of childhood obesity <>1.     Increased incidence over the past 30 years <>B.    Prevalence of eating disorders in our youth <>1.     Incidence of eating disorders, not meeting DSM-IV criteria <>2.     Incidence of disordered eating behaviors in youth <>3.     Incidence of eating disorders in youth that were initially overweight

C. Shared risk factors for both weight related disorders

          1.  Dieting

          2.  Media

          3.  Body dissatisfaction

          4.  Teasing

D. Integrated approach to addressing weight related disorders

          1.  Shared risk factors

          2.  Heath promotion <>II. Understanding childhood obesity <>A.   Definition <>1.     Statistics

2.  Genetic factors

3.  Other contributing factors

          B. Medical causes of childhood obesity

                    1.  Thyroid disease

                              a)  Definition

                              b)  Diagnosis

                              c)  Treatment

                    2.  Polycystic Ovary Syndrome (PCOS)

a)  Definition

                              b)  Diagnosis

                              c)  Treatment

                    3.  Hormonal factors

                              a)  Digestive hormones

                              b)  Insulin resistance <>III. How to determine a healthy weight <>A.   History of growth and development

B. Family’s weight for health history

C. BMI

D. Body composition analysis <> IV. How to address weight related concerns without increasing risk for developing an eating disorder

A. Identify patients at high risk for developing an eating disorder

1. Family history

          2. Personality traits

          3. Self-esteem

          4. Co-morbid factors

          5. Emotional eating  

B. Incidence of overweight/obese children that develop eating disorders

C. Ways to discuss body weight with a body positive approach

D. Referral to Registered Dietitian

V. Nutrition Intervention

          A. Initial nutritional assessment

          B. Metabolic testing

                    1. Definition

                    2. Application

          C. Body Composition Analysis (BCA)

                    1. Definition

                    2. Application

          D. Interpretation of results of metabolic testing and BCA

          E. What are risk factors for weight-related disorders?

                    1. Dieting patters

                    2. Activity level

                    3. Drive for thinness

                    4. Body dissatisfaction

                    5. Psychological factors

                    6. Socioeconomic factors

          F. Health promotion

VI. Case Studies

VII. Conclusion

          A. Research supporting an integrated approach

          B. Guidelines for weight related prevention programs

          C. Questions & Answers

Childhood obesity is increasing at an alarming rate, since 1980 the obesity rate has tripled. According to the CDC (5/2015), 1 in 6 children are obese. Also of great concern, the Mayo Clinic reports one-third of adolescents diagnosed with an eating disorder were initially overweight or obese. These two diseases are plaguing our youth, but is the fight against childhood obesity creating eating disorders?

What are intended to be messages promoting health and well-being can trigger an eating disorder. It is much more of a complex problem than just what is being said. This is a very controversial topic for obesity experts and eating disorder clinicians. Well-intentioned school based programs such as label reading, diet analysis, and BMI testing are looked at by many obesity experts as a way to address the obesity epidemic. However, to the child that is at high risk of developing an eating disorder it can lead to the development of an obsession about food and weight.

Annual physicals are meant to be healthy interventions, not to trigger eating disorder behaviors. However, for many their eating disorder is linked to these visits. Public Health research suggests all children need a mindful integrated approach to addressing eating and weight related concerns by focusing on health not weight. Studies suggest obesity prevention and treatment approaches integrate strategies used to prevent and treat eating disorders. Addressing these concerns from a prevention focus will reduce the risk of trying to treat one problem without causing another.

This presentation will help clinicians identify the shared risk factors for both obesity and eating disorders. An integrated approach which addresses health promotion for all youth will help reduce the risk of the development of unhealthy behaviors. The health and wellness of our future generations depend on how these issues are addressed. Professionals need to come together to help improve treatment outcomes.

Primary Presenter:
Carolyn Hodges Chaffee, MSRDN, CEDRD

Carolyn Hodges Chaffee, MSRDN, CEDRD is founder and owner of the Upstate New York Eating Disorder Service. Outpatient clinics are located in Elmira, Syracuse, Ithaca, and Binghamton. The partial hospitalization program, Sol Stone Center is located in Elmira, New York. The Upstate New York Eating Disorder Service serves more than 400 patients a year. She is nutrition consultant and case manager for Cornell’s eating disorder program, serving approximately 400 students annually. Carolyn co-authored “Measuring Health From the Inside” (Friesen Press, 2015). Member of AED, ANAD, AND, ASDAH, BEDA, iaedp, NEDA, SCAN, STDA, and board member for Ophelia’s Place.



Co-Presenter:
Mary Bucknam, R.P.A.C.

Mary Bucknam, R.P.A.C. has been a primary medical provider for Cornell University's eating disorder treatment program for the past 6 years. The Cornell Healthy Eating Program (CHEP) services more than 400 patients annually using an integrated treatment model. In addition, for 17 years she worked with the pediatric population managing eating-and-weight related behaviors, depression, anxiety, bipolar disorders, and substance abuse issues. She co-authored two publications in the Journal of the American Geriatrics Society and is a member of iaedp, AED, and AAPA.



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