Eating Disorders & Overweight/Obesity

EATING DISORDERS & OVERWEIGHT/OBESITY – (click  to jump to specific module section)
Updated March 2020

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EATING DISORDERS

Learning Objectives:

  1. Recognize and define DSM-5 eating disorders including anorexia nervosa, atypical anorexia nervosa, bulimia nervosa, avoidant/restrictive food intake disorder, binge eating disorder
  2. Describe risk factors (including genetic and neurobiological vulnerabilities) that may predispose youth to develop eating disorders
  3. Recognize that eating disorders can develop in all populations (ie: males, normal /overweight adolescents, adolescents with chronic disease, refugees), and that certain populations are at higher risk
  4. Identify medical complications of eating disorders and reasons for medical hospitalization
  5. Recognize long-term health risks associated with eating disorders and that they are more likely if youth with eating disorders are not identified early, followed closely, and treated using a multidisciliplanry approach

Readings and Videos:

Readings:

  1. Campbell K, Peebles R.  Eating disorders in children and adolescents: state of the art review, Pediatrics 2014;134(3):582-92.
  2. Golden NH, Katzman DK, Sawyer SM, Ornstein RM, Rome ES, Garber AK, et al. Update on the medical management of eating disorders in adolescents. J Adolesc Health 2015;56(4):370-5. 
  3. Katzman DK, Peebles R, Sawyer SM, Lock J, Le Grange D: The Role of the Pediatrician in Family-Based Treatment for Adolescent Eating Disorders: Opportunities and Challenges  Journal of Adolescent Health Oct 2013
  4. Lock J, LaVia MC, American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with eating disorders. J Am Acad Child Adolesc Psychiatry 2015;54(5):412–425. 

Book

  1. Lock J, Le Grange D.  Help Your Teenager Beat an Eating Disorder, Second edition. New York: The Guildford Press, 2015.  

Videos

  1. ​Handbook of Assessment and Treatment of Eating Disorders. Edited by B. Timothy Walsh, M.D., Evelyn Attia, M.D., Deborah R. Glasofer, Ph.D., and Robyn Sysko, Ph.D.(Videos accompanying text.)  American Psychiatric Association 2016.
  2. Kreipe RE, and Peebles R. “Model Eating Disorder Interview,” “A Comprehensive Approach to Serving Youth with Eating Disorders” and “Working with Families of Adolescents with Eating Disorders,” in “Reaching Teens: Strength-Based Communication Strategies to Build Resilience and Support Healthy Adolescent Development” Elks Grove Village IL; American Academy of Pediatrics; 2013. (A Textbook and Video Product). January 2014.
Interactive Learning Opportunities:
Materials to Develop Educational Sessions:


Online Resources:

  1. National Eating Disorders Association – for Medical Professionals. 
  2. The eating attitudes test (EAT – 26) 

Pedicases:

  1. Anorexia Nervosa: Stephanie’s Long Walk 

MedEd Portal resources:

  1. Sonneville K, Freizinger M, Forman S, Burke P, Goncalves A, Pitts S, Gooding H. Treating Taylor: Multidisciplinary Management of Eating Disorders. MedEdPORTAL Publication; 2014. 
  2. Douziech I, Miller A, Student J. Child and Adolescent Eating Disorders. MedEdPORTAL Publication; 2014. 
Clinical and Community Settings:
  • Adolescent rotation
  • Experience at eating disorder treatment center
  • Inpatient hospital rotations
  • College health experience
  • Emergency department

DISORDERED EATING

Learning Objectives:

  1. Recognize that disordered eating including dieting is common during adolescence
  2. List indications to refer adolescents with disordered eating to eating disorder specialists (e.g. medical, mental health, nutrition)
  3. Recognize that unhealthy weight control behaviors can occur at any weight, may be present in youth with overweight, or may initiate after a provider raises concerns about weight or rate of gain
Readings and Videos:
 

Readings:

  1. Yoon C, Mason SM, Hooper L, Eisenberg ME3 Neumark-Sztainer D. Disordered Eating Behaviors and 15-year Trajectories in Body Mass Index: Findings From Project Eating and Activity in Teens and Young Adults (EAT).  Journal of Adolescent Health. 2020 Feb;66(2):181-188. doi: 10.1016/j.jadohealth.2019.08.012. Epub 2019 Oct 18.
  2. Golden NH, Schneider M, Wood C, Committee On Nutrition, Committee On Adolescence, Section On Obesity. Preventing Obesity and Eating Disorders in Adolescents. Pediatrics 2016;138(3).
  3. Sim LA, Lebow J, Billings M. Eating disorders in adolescents with a history of obesity. Pediatrics 2013;132(4):e1026-30.

Book:

  1. ​​​”I’m, Like, SO Fat!” Helping Your Teen Make Healthy Choices about Eating and Exercise in a Weight-Obsessed World. Dianne Neumark-Sztainer.  New York: Guildford Press, 2005.
Materials to Develop Educational Sessions:


Online Resources:

  1. Disordered eating and dieting. National Eating Disorders Collaboration 
Clinical and Community Settings:
  • Adolescent rotation
  • Experience at eating disorder treatment center
  • College health experience
  • Outpatient primary care

OVERWEIGHT/OBESITY

Learning Objectives:

  1. Recognize risk factors for, public health impact of, and medical complications of obesity
  2. Discuss appropriate screening labs for obese individuals
  3. As sensitivity is required in addressing overweight with young people to avoid development of unhealthy weight control practices, demonstrate techniques, effective language, and strategies to work with adolescents around weight loss
  4. List indications for pharmacotherapy and bariatric surgery in adolescents 
Readings and Videos:
 

Readings:

  1. ​Inge TH, et al. The effect of obesity in adolescence on adult health status. Pediatrics 2013;132(6):1098-104.
  2. Apovian CM, Aronne LJ, Bessesen DH, McDonnell ME, Murad MH, Pagotto U, et al. Pharmacological management of obesity: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2015;100(2):342-62.

Videos:

  1. ​Videos on Motivational Interviewing around weight. Abbot Nutrition Health Institute
Websites and Online Resources:
  1. “Take Charge of Your Health” (NIH 2012) – teen handout, information for teaching patients the basics of health energy balance. 
  2. Body Basics: An Adolescent Provider Toolkit, Section on Overweight: Further Evaluation.  J. Shalwitz, D. Bushman, K. Davis, S. Williams (2005). San Francisco, CA: Adolescent Health Working Group, San Francisco. 
  3. Bariatric Surgery Procedures. American Society of Metabolic and Bariatric Surgery 
Interactive Learning Opportunities:
Materials to Develop Educational Sessions:

Online Resources:
  1. Office of Adolescent Health – Adolescent Health Topics – Physical Health and Nutrition. 
  2. The Obesity Society – Resources for Childhood Overweight 
  3. Centers for Disease Control and Prevention. Obesity and Overweight – Prevention Strategies and Guidelines 
Clinical and Community Settings:
  • Outpatient (adolescent clinic, primary care clinic, endocrinology, weight management programs)
  • Inpatient (wards)
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