What should pediatricians know?
After publication of our book, "Hungry: A Mother and Daughter Fight Anorexia" http://tinyurl.com/y9cgz9a Lisa and I have spoken to high school students, college students, medical students, book groups, public libraries and community organizations. It's always rewarding. People often say, "I had no idea anyone else felt like this."
The pediatricians at Palo Alto Medical Foundation www.pamf.org would be different. For one thing, Lisa was unable to attend. But that was good news. After dropping out of college three years ago, in the depths of anorexia and depression, Lisa is back in school. She had a final exam the morning of our talk. Also, she has a good job, enjoys the work and the collegiality. She's busy, engaged, moving forward.
The other difference in talking with these physicians was that our usual roles were reversed. I was the thoughtful expert, they the anxious questioners. They had patients, some as young as eight, with serious eating disorders that could become life-threatening.
Some of their questions:
How come families don't go to the doctor sooner when intervention is easier and more successful?
Since any given therapy may or may not work for a particular ED patient how can the doctor help prevent the "yet another doctor/therapist/drug" rollercoaster?
Are there any preventive strategies to defuse buying into the culture's thinness obsession?
Pediatricians often are the first responders to budding ED. What should the first doctor know, ask about or do?
Dr. Frederick Lloyd http://tinyurl.com/y9bm3ja told me, "I've never had to hospitalize on that first visit. My usual strategy is to listen to the family and the child's concerns, which is most often weight loss. The child almost always feels there is not a problem and they are in control. Since they are usually medically stable, I suggest the parents step aside and we will see where we are in a couple of weeks. Sure enough they come back with further weight loss, and then I describe what needs to be done to be sure this is not an occult medical condition [such as celiac disease]. I describe how we will follow this, and then, depending on how they do, discuss other resources."
I gave the physicians my thoughts, and will elaborate in future posts, but I'd love to hear from you. Pediatricians have the opportunity to help nip eating disorders in the bud. How can they do it better?