What is the Family Outpatient Program for Eating Disorders- Dr. Tony Paulson
Family Outpatient Program is unique in that the focus of the treatment is to provide families with the tools and resources they need to facilitate their loved ones' recovery. Our philosophy in this program is recovery happens at home. The intensive treatment day is intended to give families the knowledge and tools they need to insure their loved ones recovers from their eating disorder. In addition, this program is designed to minimize any disruption to school or work schedule. For example, the intensive treatment day occurs on a Saturday so patients do not have to take time away from school and family members do you have to take time away from work or other commitments.
When do you know you are in the right type of treatment? -Dr. Tony Paulson
This is a common question as patients and their loved ones struggle to find the best type and level of care. The goal of treatment is recovery so if you see improvement and movement toward recovery that would be an important consideration. Another thing to consider is whether the treatment is helping in your long term recovery. In other words are you learning things in treatment that will help you recover and stay recovered? The relapse rate for people suffering from eating disorders is nearly 50%. Why is this so high? Why do so many people after leaving treatment relapse? Part of the answer has to do with the level of family involvement in the patients treatment. Are the family members learning how to help their loved one sustain his or her recovery when she is no longer in treatment? I tell patients and their families that the combination of family involvement and treatment that leads to abstinence from their eating disorders is the right level of care for them as long as they do not need acute medical care. If the combination of family involvement and treatment is not producing a change in their eating disorder behavior a change in the treatment is warranted and can include more intensive family involvement or higher levels of treatment.
Fear and Guilt: Parent’s often feel helpless in addressing their child’s eating disorder
Parents of children and adolescents suffering from an eating disorder often feel helpless in addressing their child’s eating disorder symptoms and behaviors. Parent’s will often report feeling they don’t what to do or say to their child for fear that they will make it worse. This state of fear and anxiety in parents results in walking on egg shells and sometimes accommodating their child’s eating disorder. Parents often blame themselves for their child’s eating disorder or report they feel blamed by treatment providers. Many parents report feelings of guilt for not realizing their child had an eating disorder sooner. First of all, you did not cause your child’s eating disorder. We now know that eating disorders are the result of many factors. Environmental and societal factors may contribute; however, we know they are not causal. Most parents do not pick up on eating disorder behaviors and changes in their child early on as these changes are often attributed to development and adolescence. It is not uncommon for practitioners to miss the signs of eating disorder until there is significant changes in growth patterns or lab abnormalities.
Secondly, your feelings of fear and helplessness are real and valid. Eating disorders are the second most deadly of all psychiatric illnesses, and there is not a lot of practical help and support for parents and families. Parents report feeling terrified as they watch their child change and virtually disappear into their eating disorder. You likely have noticed changes in your child’s temperament and behavior such as food refusal, no longer eating with the family, hiding food, lying about eating and other eating disorder behaviors. It is important to remember that although you feel helpless, responding in anger or frustration will only exacerbate your child’s desire to hide and be dishonest about their eating disorder. Empathy and validation such as “I know this is hard for you, you might feel like you no longer have control against your eating disorder” and “I get this is hard and you do not have to be all alone with your eating disorder anymore” will likely go much farther in improving honest communication about what they are feeling. Speak about your child’s eating disorder separate from your child by externalizing the eating disorder. Remember that your child is still in there, but that their eating disorder has taken over the driving.
When your child is dishonest about hiding food or argues about eating speak about their eating disorder separately by asking “Is your eating disorder voice loud today?” or “I get that your eating disorder wants to argue about portions today”.
Food and Mood- By Shanley Schoenhofer, RD
A trending topic in nutrition as of late has been food and mood, as in, how what we eat can alter more than our physical health, but our mental health as well. In short, what we choose to put into our body can do amazing things, such as decrease inflammation, stabilize blood sugars, keep our hormones regulated and our gut microbiome (the trillions of bacteria living in our bodies) healthy and thriving. Research is suggesting that each and every one of those things I just listed may play a crucial role in our mood, potentially lightening and/or preventing depressive symptoms. Curious about what the research is saying we should include in our weekly and daily dietary intake?
- Fruits and Veggies, with primary focus being consuming a variety of color. So what does that mean? If you notice you are eating green apples and celery all the time, get crazy and add a banana, a red bell pepper and some mushrooms as well. Each different color of fruit and vegetable provides our body with different essential nutrients
- Omega-3 fatty acid, preferably from marine sources (fish, seaweed). You can achieve this from adding salmon to your dinners a couple nights a week, or you could purchase a fish oil supplement (with recommendation being you take 2 grams or 2,000 mg)
- Vitamin D, which has been given a lot of praise for reducing depressive symptoms, and in turn, if you are low in vitamin D the risk of depression may increase. Ways to achieve vitamin D is through sunlight, egg yolks, oily fish (salmon and sardines), milk, fortified orange juice or a vitamin D supplement.
- Folate. Folate is found in whole grains, green leafy vegetables, nuts and seeds and fortified foods, such as whole grain cereals
- Magnesium is one of the most essential minerals in the body, connected with brain biochemistry. Consuming nuts and seeds, beans, whole grains, fruits, vegetables and dark chocolate (60-70% cocoa) can help prevent a magnesium deficiency.
- Dairy, such as yogurt. This provides your body with probiotics, protein and calcium. Moderate amounts of dairy may help with low moods.
Here’s a sample meal plan to show you just how easy (and delicious) adding these nutrients into your daily life can be!
Breakfast – whole wheat toast (folate, magnesium) with avocado (omega-3) and scrambled eggs (vitamin D) and a glass of orange juice (vitamin D and fun fact: orange juice can also count as a “dairy” in the sense that it is fortified with an adequate amount of calcium)
Lunch – Canned Tuna (omega-3, vitamin D) on mixed greens with tomatoes, bell peppers, cucumbers and carrots (fruits, veggies, folate, magnesium) and balsamic vinaigrette. And a serving of multigrain crackers (folate)
Snack – Greek yogurt (dairy, vitamin D) and berries (fruit, magnesium)
Dinner – Burritos made with bean (magnesium), chicken and cheese (vitamin D, dairy) tortilla (folate) with veggie or side salad (veggies, magnesium, folate). Top your burrito with salsa (fruit/veg) and guacamole (fruit/veg and omega-3)
Snack – Dark chocolate almonds (magnesium, folate) and strawberries (fruit)
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