I’ve seen a number of kids come to TBITC in the last few years who keep getting diagnosed with everything under the sun other than an eating disorder. It’s frustrating. Not only do these kids and their families start to think everyone in the medical and therapy community are a bunch of quacks, but the treatment is critically delayed and outcomes much worse as a result.
An example that gets missed often: a young woman is called depressed over and over by therapists and doctors, while nobody does a formal eating disorder assessment. She is losing weight steadily, but nobody is paying attention to that. Her mood, her negative behaviors, her isolation – that’s what they see. Until the eating disorder is really bad.
Another example: a teenage boy who doesn’t seem to be really concerned about body weight but has become very thin. He says he’s not hungry and doesn’t really like food anyway. He seems kind of checked out emotionally, not making eye contact, doesn’t have any real social outlets and would rather be on the computer or iPad for hours on end. One doctor thinks it’s depression. Another says the kid is on the autism spectrum. But what about lack of nutrition? The same presentation comes from this. And just putting them on a medication and telling the parents to check back in a month is flat out negligence! This is a classic case of anorexia in a male in fact; the presentation of thoughts is focused on a lack of control in his home, so he’s taking control where he can. He doesn’t care about being thin, just proving his point that nobody but him has any authority in this part of his world.
While we may not catch all cases of eating disorders as early as we would like, there are ways to help doctors identify patients who need help. It’s called the SCOFF Questionnaire.
1. Do you make yourself Sickbecause you feel uncomfortably full?
2. Do you worry you have lost Controlover how much you eat?
3. Have you recently lost > Onestone(6.3 kg or 14 lb) in a 3 month period?
4. Do you believe yourself to be Fatwhen others say you are too thin?
5. Would you say that Fooddominates your life?
One point should be given for every “yes” answer; a score of 2 or more indicates a likelihood of an eating disorder.
If you suspect your child or loved one may have an eating disorder, don’t settle for the less scary answer like depression or anxiety or it’s “just part of growing up.” Get them the right diagnosis from a specialist and get them the help they need.
By Andrew Walen, LCSW-C - Founder, Executive Director, Psychotherapist at The Body Image Therapy Center. If you would like to get in touch with Andrew please call 443-602-6515 or email firstname.lastname@example.org.