Treatment of Pediatric Binge Eating Disorder: Thinking Outside of the Box

Moshtael, Naghmeh

Saturday, February 9, 2019: 4:00 PM-5:30 PM

Desert Salon 5/6 (JW Marriott Desert Springs Resort and Spa)

Background: Given the increasing recognition of the close relationship between obesity and binge/lack of control overeating (LOC), binge eating disorder (BED), and binge/LOC eating among children and adolescents with overweight and obesity have become the areas of research focus. Studies reporting the prevalence of binge eating and LOC eating among children and adolescents with overweight and obesity continue to accumulate. To our knowledge, most treatment modalities focus on psychological and/or stepped wise approach or overemphasize weight loss. This presentation will review a novel approach to treatment of BED in children and adolescents in consideration of both their medical and psychological needs.

Objectives: Following the presentation the participants will:

Gain a better understanding of the epidemiology of binge eating disorder, lack of control over eating (LOC) in children and adolescents and the current neurobiological basis of binge eating disorder
Identify existing treatment modalities for binge eating disorder
Recognize the unique medical complications affecting children and adolescents diagnosed with BED such as metabolic disorders (insulin resistance, hyperleptinemia)

Overview of Binge Eating Disorder:
- Epidemiology – binge eating, loss of control overeating (LOC) and binge eating disorder (BED)
- Current neurobiological basis of binge eating disorder
Current treatment of binge eating disorder
- psychological approach – step wise approach
- pharmacological approach – use of stimulant
- hyperfocus on weight control/weight stabilization
Case study one: 11 yo girl with BED
Case study two : 17 yo male with BED
Treatment of binge eating disorder in partial hospitalization program
- Ordered eating
- State not weight
- Evaluation and treatment of comorbid diagnoses
- Family based Treatment
Questions and Answers

Binge-eating disorder (BED) is the most prevalent eating disorder and is now included in the main section of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Despite its high prevalence, the etiology of BED remains understudied, and the underlying neurobiological features of the disorder are poorly understood. Given the increasing recognition of the close relationship between obesity and binge/lack of control overeating (LOC), binge eating disorder (BED), and binge/LOC eating among children and adolescents with obesity have become the areas of research focus. Studies reporting the prevalence of binge eating and LOC eating among children and adolescents with obesity continue to accumulate. To our knowledge, most treatment modalities focus on psychological and/or stepped wise approach or overemphasize weight loss. In this presentation, we will review the prevalence of BED in children and adolescents, the current neurobiological basis of BED and our novel approach to treatment of BED in children and adolescents in a partial hospitalization program. Using two case studies, we will share our treatment approach including the implementation of “ordered eating,” diagnosis and treatment of co-morbid metabolic disorders, and focus on “state not weight” in our family based treatment model.

Primary Presenter:

Naghmeh Moshtael, MD, FAAP, CEDS

Naghmeh Moshtael, MD, FAAP, CEDS is the Medical Director at Kartini Clinic in Portland, Oregon. She joined the Kartini Clinic in July 2005 and became the first full time partner with Julie O’Toole, MD, MPH, CEDS in 2008.A board certified pediatrician, Dr. Moshtael is also a fellow of the American Academy of Pediatrics, and a member of AED, CREDN, and iaedp. Along with the rest of the staff at Kartini Clinic, Dr. Moshtael exclusively treats children and adolescents with eating disorders.

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