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When caring for an adolescent suffering with an eating disorder for any length of time, you soon realize how invaluable earlier diagnosis and treatment become in making purposeful and healthy strides forward, as well as any necessary changes and re-strategizing needed to better support a loved ones recovery process.
And while there is a better knowledge base available regarding eating disorders today, studies and research of “what works” and “what doesn’t” in the real day to day of those living with this illness, and how to better train, educate and provide for those treatment services are still slowly surfacing.
Dr James Lock, whom many a parent are familiar with from his work and book: Help Your Teenager Beat an Eating Disorder is spearheading one of the Largest-Ever Bulimia Study involving adolescents suffering from bulimia through Stanford University:
…psychiatrists at the Stanford University School of Medicine and the University of Chicago are seeking volunteers for the largest-ever randomized controlled trial of bulimia treatments for adolescents.
Only two small randomized trials have previously been done in this age group. “We desperately need more information,” said James Lock, MD, PhD, professor of psychiatry and behavioral sciences at Stanford and the study’s senior investigator. Lock is also director of psychiatric services at the Comprehensive Eating Disorders Program at Lucile Packard Children’s Hospital.
Prior bulimia-treatment trials focused on adult patients, Lock said, which is why the National Institute of Mental Health awarded his team a five-year, $2 million grant to compare bulimia treatments for young people. Full-blown bulimia affects 1 to 2 percent of adolescents, and another 2 to 3 percent display significant bulimic behaviors, Lock noted. Female patients outnumber males by five to one, he said.
The team will study three treatments that may help adolescent bulimics. Study subjects will be randomly assigned to receive 20 outpatient consultations using cognitive behavioral therapy, family therapy or individual psychotherapy. Cognitive behavioral therapy is widely recognized as the preferred bulimia treatment for adults, whereas family therapy is used in teens with anorexia nervosa. Individual psychotherapy has succeeded as an alternate treatment for bulimic adults and adolescents.
Interested individuals should contact research assistant Brittany Alvy at (650) 723-9182.
The pathology Lock hopes to heal stems from poor body image and an unhealthy focus on rigid dieting. Strict dieting sets up patients for lapses of control—binge-eating episodes. After binge eating on thousands of calories, patients purge with vomiting, laxatives or excessive exercise. They then feel guilty over their loss of control, fueling further negative thoughts and deepening the downward spiral.
Cognitive behavioral therapy works on changing patients’ behaviors and thinking patterns related to food and to body image. The therapist aims to help the patient stop thoughts that overemphasize the importance of weight and shape and end severe, destructive dieting. Family therapy focuses solely on eating behaviors.
The patient’s parents are involved in every therapy session, and the underlying goal is to change the home environment so that it reinforces healthy eating and discourages dieting. “In this treatment, we see parents as a resource to facilitate behavioral change,” Lock said. Individualized psychotherapy, rather than targeting eating, examines underlying life problems that contribute to negative self-image.
“We hope early intervention will become a chronic, long-lasting strategy,” Lock said. Instead of treating bulimia in adulthood, “after the horse is out of the barn,” early treatment has a better shot at causing a lasting cure, he added.
About Stanford University Medical Center Stanford University Medical Center integrates research, medical education and patient care at its three institutions — Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children’s Hospital at Stanford. For more information, please visit the Web site of the medical center’s Office of Communication & Public Affairs at http://mednews.stanford.edu/.
About Lucile Packard Children’s Hospital Ranked as one of the best pediatric hospitals in the nation by U.S.News & World Report and Child magazine, Lucile Packard Children’s Hospital at Stanford is a 272-bed hospital devoted to the care of children and expectant mothers. Providing pediatric and obstetric medical and surgical services and associated with the Stanford University School of Medicine, Packard Children’s offers patients locally, regionally and nationally the full range of health care programs and services — from preventive and routine care to the diagnosis and treatment of serious illness and injury. For more information, visit http://www.lpch.org/.
Anyone involved with eating disorders knows all too well the commitment, expense, and time that treatment and recovery encompass. There are no quick fixes on this journey towards reclaiming ones’ Life back from a devastating illness that can lead to chronic health debility and even death if left untreated.
Just mention the word “insurance” to anyone acquainted with eating disorders and you will undoubtedly get a credible grunt of frustration or despair when it comes to what insurance companies “allow” for treatment and follow up care. And for those of us who have loved ones requiring the most intense level of care in either residential ED programs and/or partial-day programs for any length of time, insurance becomes yet another demon to lock horns with; and certainly not what caregivers, families and sufferers need tacked onto an already onerous battle to save someones Life.
We have had many a battle with insurance to get our daughter the care she deserves, and to push beyond the bullying that desperate parents face when told your child cannot get the medical services s/he needs until you’ve taken out a second mortgage, gone bankrupt, taken out exorbitant loans because extended coverage was denied, but by all Dr recommendations is absolutely necessary in continuing care and treatment.
The manner at which eating disorders are covered by insurance (and obtaining equal access to quality care is another needle-in-the-haystack!) is still quite crude that my blood boils when listening to parent after parent exhaustively stating the same heartrending scenario over and over. And speaking with parents and sufferers outside the US, you find some of the same- sometimes even worse.
Well, after stating all this rather negative reality, there is some hopeful news to share with the now infamous New Jersey Blue Cross/Blue Shield class action federal court case which restores my belief, coupled with the progression of Mental Health Parity, that 2009 will continue to move forward and keep chipping away towards change in improved coverage and treatment of eating disorders that is well overdue:
January 10, 2009 Horizon Blue Cross/Blue Shield of New Jersey has tentatively settled a class action pending in federal court in Newark, New Jersey involving reimbursements for medical expenses relating to the treatment of eating disorders. The terms of the settlement must still be approved by the court.
Although Horizon covered treatments related to eating disorders (primarily anorexia and bulimia), including hospitalization, outpatient treatment, psychotherapy and nutritional counseling, there were benefit limits on such treatments.
So many celebrations lately- my blog-baby has turned “1”!
Happy Blog Anniversary to You….