Monday, February 12, 2007

Why do we settle for treatment that doesn't work?

This morning I'm feeling so grateful for the Maudsley approach of treating anorexia, which I am sure saved my daughter's life. While there may be a better treatment out there yet to be discovered someday, for now Maudsley is so much better for teens than traditional treatment that it's hard for me to understand how and why professionals could recommend anything else.

Especially pediatricians. They're the ones on the front lines. They're the ones who presumably know a child, watch his or her growth from infancy on. Who have a chance to see the growth curve and know when a child is "just thin" or "too thin." When thinness becomes pathological.

Often pediatricians wait far too long to flag a problem--very likely because they're watching for the opposite problem, overweight in teens. Our society has such a strong fat phobia that all of us, myself included, have to struggle to take off our "thin-is-always-good" glasses and see reality sometimes.

Some pediatricians will notice a drop in weight or off the child's growth curve, but then stall when it comes to treatment, letting months or even years go by while a child starves and anorexia becomes more entrenched. Why? Could it be that many pediatricians--especially women--have eating or body or weight issues themselves?

If your intuition tells you that your child might have a problem, get another opinion. Follow your gut. The treatment you pursue might save your child's life. And you don't have to settle for treatment that doesn't work. There is hope for anorexia. The vast majority of teens treated with the Maudsley approach are weight restored, fully recovered, and back to normal life--and stay that way five years down the line.

Don't settle for anything less than your child's best life.


Unknown said...

You said the most important word: HOPE.

If pediatricians (and the rest of us) knew that there is hope for recovery, hope for a healthy future, they would act faster and with more energy.

Thank you for spreading the word!!

Carrie Arnold said...

I also think that some of the problem lies in the fact that we have become accustomed to underweight standards vis-a-vis models and the like. There is a much greater tolerance on the part of parents AND pediatricians for what constitutes and individuals health body weight.

I gained weight before my growth spurt, putting me "overweight" for a year or so before things evened out. I did, of course, freak out and became borderline anorexic. I was at the 85th weight percentile as a kid...but the 95th height percentile. Duh. Perfectly proportionate.

Great point Harriet. I need to ask my friend who is in her peds residency (as well as being recovered from anorexia) if they actually got an information on the subject.

Geez...this is longer than your original post!

Harriet said...

I couldn't agree with you more, Carri. I notice this in myself (and I'm pretty sensitized to the whole issue). Last year I ended up watching a lot of network TV, which I usually don't do, because it helped my daughter during re-feeding. And after a few weeks of seeing overly thin women as the norm, my view of myself and other real women was definitely altered. I had to work to readjust my perspective. And that's after a few weeks. Imagine what a steady diet of these images does imperceptibly to your point of view.

Do ask your friend--I'm curious.

Carrie Arnold said...


The amount of ED training they get varies widely by hospital. The ped MD I work with in my speaking and presenting makes sure they get lots of hands on experience. My friend says it depends on your resident. Ergo, if the hospital where you train treats EDs, then you get the experience. The irony is that the pediatrician I work with is at a much less known hospital, but they have a pretty solid ED unit for medical stabilization and refeeding and they've begun using Maudsley.

My T is actually a Maudsley T, and it's nice to know that my mom feels comfortable with her.

Hope that helps (and I'm still trying to dig up the carrot cake recipe- my bro is moving to Boston ATM, so we shall see if it surfaces!)

Harriet said...

That's good . . . I guess. Sometimes, though, I wonder if experience with e.d.s can actually be a liability. I know of several pediatricians who present themselves as eating disorders experts; their strong opinions about treatment have definitely changed the course of treatment, and sometimes not for the better. I'm thinking of pediatricians who say things like "I don't believe in Maudsley" or "Your daughter couldn't possibly do that." When spoken in the voice of authority, these comments have huge influence.

So maybe what we really want is pediatricians who are well educated but not stuck in an old-fashioned treatment modality, who will read the research and who above all believe that empowering families is a key part of treating eating disorders.

Not much to ask for, huh?