Eating Disorders in Children and
Adolescents
Gretchen Dubes MSN, RN
Learning Objectives
Participants will be able to:
Define eating disorders delineated in the diagnostic and
statistical manual of mental disorders fifth edition (DSM-V)
Recognize the pathophysiology, clinical features, assessment
processes, and treatment modalities related to adolescents at
risk of Anorexia Nervosa and Bulimia Nervosa
Identify the supportive role of the nurse in the management of
eating disorders which include effective communication
strategies to empower patients to take charge and
responsibility for their behavior.
True or False about Eating Disorders
Eating Disorders are complex illness, and successful treatment often
requires a multidisciplinary approach from professionals including
(psychologists, nutritionist, nurses, pediatricians, psychiatrist and
social workers) Tor F
Early intervention is important and a predictor for full recovery Tor F
More people die from eating disorders than any other psychiatric illness T
or F
Persons with Anorexia are up to ten times more likely to die as a result of
their illness. The most common complications that lead to death are
cardiac arrest, electrolyte imbalance and suicide T or F
Binge Eating Disorder is the most common ED in the U.S. T or F
Purging is a fairly effective way to lose weight T or F
It is possible to fully recover from an ED T or F
ED’s are primarily about food & weight T or F
Case Study-Suzie
Anorexia Nervosa
Suzie is a Fourteen-year-old who has been losing weight for 8 months.
At first her mother thought this was normal teenage dieting as she
was trying to lose weight since joining the dance team for high
school. She is 5 ft 8 inches and weighs 100 lbs. She has stopped
eating with her family because she is becoming a vegetarian and
her family eats meat and processed foods. She enjoys baking
cookies and desserts for her family but does not eat them. She
carries with her a book of calories with a list of foods she is willing
to eat. She is on the honor role at school. She is getting straight
“A’s” and says she does not settle for anything less. She eats an
apple for breakfast, a cup of ramen noodles for lunch and 4 leafs of
lettuce with a half a cup of cheese cubes and salad dressing. She
snacks on raw carrots and is proud to say her evening snack consists
of one oreo cookie. She admits that she eats the same meal
everyday.
Her daily exercise routine is going for a five mile run but this has
decreased in the past few weeks because her energy is diminished.
She does sit ups before bed and has been ignoring calls from her
friends. When her mother encourages her to eat she becomes
defensive and angry shouting she is “ok”, “looks fine” and is
eating.
Case Study-Sally
Bulimia Nervosa
Sally is a 16 year old who has been excusing herself from the dinner
table after eating. Her mother reports that she has been hearing
Sally throw up for quite sometime. She said Sally was overweight
since age 8 and since joining soccer she has lost weight. She
recently was asked to a dance and believes she needs to lose10 more
pounds to look good in a dress. Her mother reports finding various
food wrappers in Sally's waste basket from the snacks she
purchases every week and has to go shopping more often as a result.
In addition, her mother reports that she has found empty packages of
Laxatives hidden in her closet. Sally has complained at times to her
mother that she feels her heart is racing. She is 5ft 4 inches and
weighs 135 lbs. She has callouses on her knuckles and says this is
due to her playing soccer. She is often anxious about school and
fitting in with her peers. She is often commenting on her weight
and thinks she would look better if she weighed 10 pounds lighter.
COMMON QUESTIONS
This presentation will cover the following questions:
1. What are the risk factors that increase the probability of developing an
eating disorder?
2. Which screening questions can be used to detect Eating Disorders?
3. What is the difference between Anorexia Nervosa and Bulimia
Nervosa?
4.What are the signs and symptoms of an eating disorder?
5. What are medical complications from an eating disorder?
6. What is the treatment and criteria for hospitalization of an eating
disorder?
8. What is the role of the nurse when working with patients suffering
from an eating disorder?
What are the risk factors that increase the
probability of developing an Eating Disorder?
Gender
More females than males
Age
Pre adolescent begins to show some signs however, teens and 20’s most
likely
Location
Westernized societies valuing thinness
Personality
Anorexia-Sensitive, persevering, self-critical features, perfectionistic
Bulimia-Unstable mood, impulsivity, and anxious
Family History
Depression, obesity, eating disorders, substance abuse
Interest groups
Ballet dancers, gymnasts, wrestlers, models, jockeys
Onset of drive for thinness
Fifty one percent of girls age 9-10 feel better about themselves if on a diet
What are the risk factors that increase the probability of
developing an Eating Disorder?
Warning signs of high risk behaviors:
Reading diet books
Evidence of visiting various website about anorexia
Sudden decision to become a vegan, or vegetarian
Eliminating various food groups
Skipping meals
Going to the bathroom after eating
Purging in the shower
Notice large amounts of food missing in the cupboards and refrigerator
When to intervene: ACT NOW
Fasting and skipping meals
Refusing to eat with the family
Argumentative when expressing concerns
Refusing to eat with family and friends
Discovery of laxatives and diet pills
Weighing and measuring food
Persistent refusal of food
Excessive exercise
Excessive calorie counting
Lock, J & Le Grange, (2015). Help Your Teenager Beat and Eating Disorder. NY:
Guilford Press. Pg. 24
Which screening questions can be used to detect Eating Disorders?
To better identify eating disorders, the American Academy of Pediatrics (AAP)
advocates the routine use of screening questions for all preteen and adolescent
patients.
Weight History
Maximum weight and when? Desired Weight?
How does the patient feel about his/her current weight?
How frequently does he or she weigh him/herself?
When did the patient begin to lose weight? What weight methods have been
tried?
Diet History
Current dietary practices? Ask for specific amounts, food groups, fluid
restrictions.
Any binges? Frequency, amount? Any purging? Frequency, amount?
Abuse of diuretics, laxatives, diet pills?
Exercise History-types, frequency, duration
Menstrual history-age of menarche, regularity of cycles
Physical exam-dizziness, bruising, cold intolerance, vomiting, diarrhea, bloating,
epigastric pain, hair loss, dry skin, cold intolerance, weakness, chest pain,
palpitations
2.Which screening questions can be used to detect Eating Disorders? Cont.
To better identify eating disorders, the American Academy of Pediatric (AAP)
advocates the routine use of screening questions for all preteen and adolescent
patients.
Psychological symptoms/history
Adjustment to pubertal development
Body image/self esteem
Anxiety, depression, obsessive compulsive disorder
Past medical history
Family history
Obesity
Eating Disorders
Depression
Substance Abuse
Social History
Home-relationships
Sexual History-sexual abuse
Substance abuse
3.What is the difference between Anorexia and
Bulimia?
Anorexia Nervosa
Eating Disorders- DSM V Criteria for Anorexia Nervosa
Anorexia Nervosa is characterized by self starvation and excessive weight
loss.
DSM V Criteria:
1. LOW WEIGHT--The refusal to maintain a minimally normal weightsignificantly low body weight in the context of age, sex, developmental
trajectory, and physical health.
2. FEAR OF WEIGHT GAIN/and or BEHAVIOR TO PREVENT
WEIGHT GAIN ---Intense fear of gaining weight or becoming fat, even
though underweight.
3. BODY IMAGE DISTURBANCE--Disturbance in the way in which one's
body weight or shape is experienced, undue influence of body weight or shape
on self-evaluation, or denial of the seriousness of the current low body weight.
Subtypes
Restricting
Binge eating/purging
Child and Adolescent Psychiatric Nursing
Epidemiology and Anorexia
Child and Adolescent Psychiatric Nursing
Eating Disorders -Epidemiology
It is estimated that 8 million Americans have an eating disorder—seven
million women and one million men
One in 200 American women suffers from anorexia
Two to three in 100 American women suffers from bulimia
Prevalence of age: 12-25 (NAMI)
Rates of diagnosed eating disorders has doubled since 1960’s
Eating disorders have the highest mortality rate of any mental illness.
The most common behavior that will lead to an eating disorder is dieting.
Natalia Zunino, Ph.D, of American Anorexia and Bulimia Association, Inc.
81% of 10 year olds are afraid of being fat.
51% of 9 and 10 year old girls feel better about themselves if they are on
a diet. Mellin LM, Irwin CE & Scully S: Journal of the American Dietetic
Association. 1992; 92:851-53.
The mortality rate among people with anorexia is 5-15%. Mortality is
from starvation, electrolyte imbalance, and suicide.
Child and Adolescent Psychiatric Nursing
Eating Disorders-Anorexia Nervosa
Common behaviors associated with Anorexia:
Eat only 'safe' foods, usually those low in calories and fat
Have odd rituals, such as cutting food into small pieces and excessive
chewing
Spend more time playing with food than eating it
Cook meals for others without eating · Engage in compulsive exercising
Dramatic weight loss
Dress in layers to hide weight loss
Denies that there is a problem
Anxiety about gaining weight or being fat
Consistent excuses to avoid mealtimes or situations involving food.
Preoccupation with weight, food, fat grams, and dieting
Denial of hunger
Spend less time with family and friends, become more isolated,
withdrawn, and secretive
Child andAdolescent Psychiatric Nursing
Complications due to Anorexia Nervosa
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Bradycardia, hypotension
Arrhythmias
Hypokalemia
Hypocalcemia
Dehydration
Amenorrhea
Lanugo,dry skin, hair loss
Hypoglycemia
Hypothermia
Edema
Constipation
Osteoporosis
Effects from Starvation
Minnesota Starvation Experiment
AIM: To Characterize the physical and Mental effects of starvation on healthy men
Study: Enrolled 36 males
Procedure:
For 3 months the men were put on observation and given 3200 kcal diet
For 6 months their caloric intake was reduced to semi starvation diet of 1500kcal
Exercise was increased to 22 miles of walking/week
For remaining 3 months they were place on refeeding plan
During the time researchers looked at labs, physical effects and psychological effects
Findings—very similar to what we see with Anorexia Nervosa
Psychological- apathy, mood swings, irritability, depression, anxiety, obsessions, delusions
Physical effects- anemia, cold intolerance, bradycardia, constipation and edema
Behavioral effects-perseveration with food, food rituals, hoarding food
Kalm, L. , Semba, R. (2005) They Starved So That Others Be Better: Remembering Ancel Keys and the
Minnesota Experiments Fed, Journal of Nutrition , 135 (6) : 1347-52
Child and Adolescent Psychiatric Nursing-Biology of Anorexia
GeneticsFamily studies have shown that first-degree relatives have a 6 -10 times greater lifetime risk of
developing AN than relatives of healthy controls. Bulik, C., Slof-Op’t Landt, M., van Furth, E., & Sullivan, P. (2007).
The Genetics of Anorexia Nervosa Annual Review of Nutrition, 27 (1), 263-275
Hypothalamus
Key center for regulating hunger. Dysregulation can cause hyposecretion of various hormones:
Low-Follicle stimulating hormone and luteinizing hormone are responsible for menstruation- low levels
result in amenorrhea.
Low-Growth hormone levels-result in stunted growth and osteoporosis.
Low –Thyroid stimulating hormone results in decreased energy and coldness.
Low- Cortical releasing hormone results in fatigue and depression.
Low-Leptin Levels. Leptin is a hormone that appears to trigger the hypothalamus to stimulate appetite,
and low levels have been observed in people with anorexia and bulimia.
Neurotransmitters
 Serotonin- Dysregulation of Serotonin (5-HT) pathways.
 Dopamine- “Increased dopamine activity has been implicated in food repulsion, hyperactivity,
weight loss, absence of menstrual cycles and obsessive-compulsive disorder, and is known mediate
reward states.” Bulik, C., Slof-Op’t Landt, M., van Furth, E., & Sullivan, P. (2007). The Genetics of Anorexia Nervosa
Annual Review of Nutrition, 27 (1), 263-275
The time course and phenomenology of Anorexia Nervosa
Walter, K., Fudge, J., and Paulus, M., (2009). The time course and phenomenology of Anorexia Nervosa,
Nature Review Neuroscience 10, 573-584
Child and Adolescent Psychiatric Nursing
Anorexia Nervosa
Psychological Vulnerabilities
Cognitive Features-personality traits
Misperception of body image
Rigid all-or-nothing thinking
Obsessive-compulsive thoughts and rituals
Perfectionism - Particularly concern for mistakes
Difficulty expressing emotions
Control Issues = Over Control
Puberty- Avoidance of maturity
Brain development
Child and Adolescent Psychiatric Nursing
Anorexia
Sociocultural Factors
3. What is the difference between Anorexia and
Bulimia?
Bulimia Nervosa
Eating Disorders- DSM V Criteria for Bulimia Nervosa
Bulimia Nervosa is characterized by binge eating WITH compensatory
behaviors.
DSM V Criteria:
Bulimia Nervosa
1. BINGE EATING-Recurrent episodes of binge eating characterized by BOTH
of the following:
Eating in a discrete amount of time (within a 2 hour period) large amounts of
food.
Sense of lack of control over eating during an episode.
2. COMPENSATORY BEHAVIOR--Recurrent inappropriate compensatory
behavior in order to prevent weight gain (purging, over exercising, abuse of
laxatives etc..).
3. BINGE PURGE CYCLE 1X WEEK FOR 3 MONTHS---The binge eating
and compensatory behaviors both occur, on average, at least once a week for
three months.
Self-evaluation is unduly influenced by body shape and weight.
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Child and Adolescent Psychiatric Nursing
Epidemiology and Bulimia Nervosa
Bulimia Nervosa
About 4-20% in Females and 0.1-0.2 % in males
Bulimia appears during late teens to mid 20’s
Some estimates of up to 40% college women have tried purging
Katie Couric
“I wrestled with bulimia all through college.”
Child and Adolescent Psychiatric Nursing
Bulimia Nervosa
Biological Factors
Serotonin- Binging behavior is consistent with reduced serotonin
function.
Psychological Factors
Control Issues = Out of control
Hiding
Self-esteem
Sexual Abuse
Family Factors
Parents described as neglectful and rejecting. Some research
has shown a higher than normal rate of substance abuse in families of
bulimics, especially alcohol abuse.
Learned response to stress. Some bulimics report that their
parents used "comfort food" to manage stress and negative emotions.
(See next Slide)
Child and Adolescent Psychiatric Nursing
Bulimia Nervosa
Person experiences stress and tension leads to loss of control
“Vicious Cycle of Bulimia”
Child and Adolescent Psychiatric Nursing
Eating Disorders-Bulimia Nervosa
Common Behaviors associated with Bulimia:
Recurrent episodes of uncontrollable binge eating
Become very secretive about food, spend a lot of time thinking about and
planning the next binge
Takes repeated trips to the bathroom, particularly after eating
Steal food or hoard it in strange places
Engage in compulsive exercising
Abuse Laxatives and diuretics
Anxiety escalates before eating
Child and Adolescent Psychiatric Nursing
Eating Disorders-Bulimia Nervosa
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Complications due to Bulimia Nervosa
Bradycardia
Arrythmias
Hypokalemia
Hypocalcemia
Dehydration
Irregular menses
Hoarseness
Dental caries
Enlarged parotid glands
Tears in esophagus
Hyponatremia
Constipation
Calluses on the back of hands and knuckles from self-induced vomiting
Adolescent Psychiatric Nursing
Eating Disorders-Recovery Rates
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Anorexia: among adolescents,
50–70% recover.
20% partially recover.
10–20% develop chronic anorexia (Steinhausen, 2002).
Bulimia: in a six-year treatment study,
60% had a good outcome.
29% had an intermediate outcome.
10% had a poor outcome (Fichter and Quadflieg 1997).
What is the treatment and criteria for hospitalization of an eating
disorder?
Treatment
Evidenced Based Treatment Modalities
Eating Disorders-Anorexia And Bulimia
Treatment for Eating Disorders-Outpatient, Day Treatment (Partial
Program), Inpatient Hospitalization
Nutrition therapy=Education
Cognitive Behavioral Therapy
Family TherapyMaudsley Family Based Treatment-Evidenced Based
Approach for adolescents living at home with parents
Three Stages: Stage I-Establish healthy eating patterns; Stage
II- Return control of eating and weight management
adolescent; Stage III -Address family and normal
developmental issues.
Pharmacologic
Treatment: What criteria are used for hospitalization of an
eating disorder?
The American Psychiatric Association (APA) Practice
Guidelines
According to the APA guidelines: “The decision about
whether a patient should be hospitalized on a psychiatric versus
a general medical or adolescent/pediatric unit should be made
based on the patient’s general medical and psychiatric status,
the skills and abilities of local psychiatric and general medical
staff, and the availability of suitable programs to care for the
patient’s general medical and psychiatric problems.”
Suggested Guidelines for Inpatient Treatment
Admission Criteria for Hospitalization-medical and psychiatric hospital
<75% Ideal Body Weight, Unstable Pulse<50, May be dehydrated
Hospitalize. Here it is essential for nursing staff to be included in the
plan of action, to take a supportive role and to not bargain with the
patient or keep information from the treatment team.
Restore nutrition through food trays planned by dietician with
expectation of completion. NG backup if patient unable or unwilling to
take in prescribed nutrition.
Provide calories through 3 meals and 3 snacks over the course of a day.
Calories will be determined by REGISTERED DIETICIAN.
MONITOR CLOSELY FOR REFEEDING SYNDROME
Supervision-the patient should be closely monitored during and for one
hour after eating to provide support and ensure compliance.
Educate-educate the patient about eating disorder and relaxation
techniques to use before and after eating. Educate the patient about
nutrition and provide support as needed.
ROME, E. S., S. AMMERMAN, D. S. ROSEN, R. J. KELLER, J. LOCK,K. A. MAMMEL, J. O’TOOLE, J.
M. REES, M. J. SANDERS, S. M.SAWYER, M. SCHNEIDER, E. SIGEL, and T. J. SILBER. Children and
adolescents with eating disorders: the state of the art. Pediatrics 111:e98–e108, 2003.
Suggested Guidelines by American Academy of Pediatrics
REMEMBER- “Hospitalization needs to be long
enough to enable the patient to stop losing weight,
establish a gaining weight trend, normalize vital signs
and laboratory studies, and be able to self select and eat
independently to continue to gain weight as and
outpatient.”
ROME, E. S., S. AMMERMAN, D. S. ROSEN, R. J. KELLER, J. LOCK,K. A. MAMMEL, J.
O’TOOLE, J. M. REES, M. J. SANDERS, S. M.SAWYER, M. SCHNEIDER, E. SIGEL, and
T. J. SILBER. Children and adolescents with eating disorders: the state of the art. Pediatrics
111:e98–e108, 2003.
Goals for Treatment of Eating Disorders
Goals of treatment:
Restore patients to a healthy weight-Clinical consensus suggests that
realistic targets are 2–3 lb/week for hospitalized patients.
Treat physical complications
Enhance patients’ motivation to cooperate in the restoration of healthy
eating patterns and participate in treatment
Provide education regarding healthy nutrition and eating patterns
Help patients reassess and change core dysfunctional cognitions, attitudes,
motives, conflicts, and feelings related to the eating disorder
Treat associated psychiatric conditions, including deficits in mood and
impulse regulation and self-esteem and behavioral problems
Enlist family support and provide family counseling and therapy where
appropriate
What is the role of the nurse when working with
patients suffering from an eating disorder?
1. Conduct a health history including screening questions.
2. IDENTIFY child or adolescent with risk factors or risky
behaviors
3. Based upon information gathered from assessment
Collaborate with the health care team—questions to ask?
Is this an Eating Disorder?
Is the patient medically and psychiatrically stable?
Does this patient meet criteria for inpatient admission?
4. Nursing Interventions –therapeutic communication-Do’s and don’ts when communicating with patients with
Eating Disorder
Providing support , empathy and education
Collaborate with health care team to provide resources
and link with health care professionals to monitor and
stop progression of eating disorder.
Nursing Assessment of Children and Adolescents with Eating
Disorders
Assessment focuses on the following Data:
Interview-from family and patient
Screening questions
Records from pediatrician
Developmental History
School functioning
Family relationships
Mental Status
Physical Exam
Nutritional intake—Breakfast-lunch-dinner
Labs-CBC, UA, Chem 7 with Mg and Phos etc..
EKG
Vital Signs
Eating Disorders- Nursing Interventions
Develop a therapeutic relationship- provide empathy and nonjudgmental
attitude
Try to gain insight into the patients strengths and weaknesses and how the
patient uses their disorder to communicate.
Monitor the patients physical and mental status
Observe vital signs, EKG and electrolytes, BUN, Creatinine, CBC TSH
Monitor activity level
Weigh daily with back to scale
Lock bathroom door 1 hour after eating
Do not allow patients to bargain with food; set limits
The dietician will determine number of calories required to provide
adequate nutrition and realistic weight gain.
Encourage verbalization of thoughts and feelings—Do not focus on food
and eating-The real issues have little to do with food or eating
pattern. Explore the correlation between use of food and dealing
with feelings.
Focus on CONTROL issues that have precipitated these behaviors
Explain benefits of compliance with routine and consequences for
noncompliance
Teach patient to recognize signs of increasing anxiety and ways to
intervene
Monitor for refeeding syndrome—see next slide
Eating Disorders- Nursing Interventions
Refeeding Syndrome occurs when the malnourished body has inadequate
nutrients for rebuilding. Typically, patients are at greatest risk from
3 days post initiation of refeeding and then for 2 weeks or until
stable. Deficiencies in potassium, magnesium, and phosphate can
cause death and need to be monitored and prevented.
Other symptoms of refeeding syndromeIncreased Pulse
Increased Respiratory Rate
Increased Peripheral Edema
Decreased gastric motility
Dyspnea
Delirium
Coma
Seizures
See handout treatment guidelines from Medical Management of Eating
Disorders by C. Laird Birmingham and Pierre Beumont (2004).
Approaching a patient you are concerned about and is suffering from
Eating Disorder
Shifting your attitude—a new approach
If you suspect ED is present or developing:
Approach the person with concerns using observations-Remember
the patient may not be in agreement and will try to persuade you to
think as they are. Their cognitive distortions may interfere with
reality. Don’t expect insight into illness.
Be prepared for denial and anger and don’t take it personally
Use “I” language vs. “You” language
Get family involved in the conversation—Maintain united front
with family and staff. Avoid “splitting”.
Provide support for meals
Encourage therapy to treat disordered eating and distorted thinking
Provide information—the National Eating Disorder Association
(NEDA) Parent tool kit
Adolescent Psychiatric Nursing
Eating Disorders- Nursing Interventions
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During meal times
Light hearted conversation
Provide distractions from the food
Avoid comments related to food, calories, body
Avoid being the food police
Discretely monitor for behaviors during mealtime
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Observe for signs of resistance
Talking about food/calories/body
Not eating in a timely manner, stalling
Cutting/shredding food into small pieces; Moving food around the plate
Hiding food in napkins, pockets or “Accidentally” dropping food on floor
Overconsumption of fluids >2 beverages
Bargaining for different foods
Slide adapted from ALLISON REED, RD-Forest View-Eating Disorder Program Coordinator
Therapeutic Communication
Eating Disorders- Nursing Interventions
Direct comments to avoid
“You look so much better”
“You are looking much healthier”
“I’m glad you’re starting to put on some weight”
“I can see your bones, eat a cheeseburger”
“I’m glad to see you eating again”
“We need to bulk you up”
“Have you lost more weight?”
“You don’t look like you have an eating disorder”
“You are so thin”
“You look good today”
“Just eat something”
Slide adapted from ALLISON REED, RD-Forest View-Eating Disorder Program
Coordinator
Therapeutic Communication
Eating Disorders- Nursing Interventions
Eating disorders tend to be made up of irrational thoughts, behaviors
and beliefs.
It’s challenging for support people to know what to say, and what not
to say. Many well intentioned comments can come across as very
triggering
Slide adapted from ALLISON REED, RD-Forest View-Eating Disorder Program Coordinator
Therapeutic Communication
Eating Disorders- Nursing Interventions
DO:
Do consider the person’s feelings/opinions and show that you value
his/her input
Do express love and support
Do try to understand
Do take time to listen
Do communicate honestly, with support and understanding
Do let the person have control over their own issues
Do accept your limitations
Do encourage the person to seek help
Do gently encourage proper eating
Do provide positive reinforcement
Slide adapted from ALLISON REED, RD-Forest View-Eating Disorder Program Coordinator
Therapeutic Communication
Eating Disorders- Nursing Interventions
Don’t:
Don’t try to force the person to eat
Don’t blame the individual or get angry
Don’t comment on weight or appearance
Don’t be afraid to talk about the problem
Don’t make the person feel bad or guilty
Don’t make threats or use punishment
Don’t be impatient and expect instant recovery
Don’t purchase food solely to accommodate the one struggling
with an ED.
Slide adapted from ALLISON REED, RD-Forest View-Eating Disorder Program Coordinator
Link to support groups
Eating Disorders-Anorexia And Bulimia
Support Groups
Forest View Hospital, 1055 Medical Park Drive SE.
Use the Partial Hospitalization Program entrance on the South side of the building.
Group meets in the community room 7-8:15pm
2nd and 4th Mondays of each month.
On the 4th Monday, Gail Hall, LMSW, owner and therapist at CTED
(Comprehensive Treatment for Eating Disorders) attends and leads a separate
forum for family members and support individuals.
Yellow House at Cavalry Church, 707 East Beltline NE
2nd Monday of the month, 7-8:30pm
This guided discussion group for women 18+ offers a spiritual perspective on
eating and body image issues as well as prayer and support utilizing the FINDING
balance curriculum. The group is led by Jennifer Lane, who is fully recovered and
free from an eating disorder.
Slide adapted from ALLISON REED, RD-Forest View-Eating Disorder Program Coordinator
Questions and Comments?