Eating Disorders Program

Untreated eating disorders may lead to significant medical complications and can also be extremely difficult on teens and their families. At CHOC, we offer both inpatient and outpatient treatment as a part of our comprehensive eating disorder program that includes adolescent medicine doctors, mental health professionals and specialized nutritionists to care for our patients.

If you are experiencing a life-threatening emergency, call 911.
To reach the Crisis Text Line, text HOME to 741-741 or visit crisistextline.org.
To reach the National Suicide Prevention Lifeline, call 9-8-8 or visit suicidepreventionlifeline.org.

The CHOC Difference

Treating eating disorders in adolescents and young adults can be complex and often requires a team of caregivers. We work with patients who have serious medical complications and/or are severely underweight and require medical and nutrition intervention and monitoring under expert care.

• We treat all eating disorders, including anorexia nervosa, bulimia nervosa and binge-eating disorder.
• Our specialists address the unique physical, emotional and social needs of eating disorder patients.
• We address the special nutritional needs of adolescents and teens.
• Your child will have access to a program case manager who arranges all appointments in the program.
• We coordinate any required inpatient care through the outpatient program to ensure continued treatment and recovery.

A Team Approach: Determining Inpatient vs. Outpatient Care

At CHOC, our board-certified pediatricians and psychiatrists understand the specialized expertise and multidisciplinary approach needed to care for eating disorders. Depending on your child’s condition, your appointment may include CHOC experts from our many specialties, such as adolescent medicine, psychology, psychiatry and nutrition. For both inpatient and outpatient services, we offer a wide range of services, including:

• Individualized treatment plan including vitamin and mineral supplements
• Cardiac and respiratory monitoring
• Nutritional assessment and management by a registered dietitian
• Psychological assessment and individual/family therapy
• Behavioral interventions, including supervised meals and personalized motivation plan
• Parent education classes on topics such as nutrition, meal support, behavior management and understanding eating disorders
• Access to a program case manager who arranges all appointments

What is an eating disorder?

An eating disorder is an unhealthy obsession with food and weight. People with eating disorders eat – or avoid eating – in extreme ways. These are the 4 main types of eating disorders:

• Anorexia nervosa. People with anorexia severely restrict calories to the point of starvation. They are obsessed with being thin and have an unhealthy and distorted body image. They may refuse to eat at all or only eat tiny amounts of food that has few calories. Anorexics are extremely thin, yet constantly think of themselves as overweight.
• Bulimia nervosa. Bulimics binge on huge quantities of food, then force themselves to vomit. They may also exercise compulsively and take laxatives to help rid their body of the calories they’ve eaten. Bulimics continue this cycle of binging and purging and may also excessively restrict calories in between binges. Bulimics aren’t necessarily extremely thin and may often seem to be of normal weight.
• Avoidant Restrictive Food Intake Disorder (ARFID). Some people are not overly concerned with their weight or body image, but nonetheless refuse to consume enough calories to stay healthy. These are not simply picky eaters; their restrictive eating can lead to serious medical consequences in ways that are very similar to anorexia and bulimia.
• Binge-eating disorder. This is also known as compulsive overeating. Binge eaters consume excessive amounts of food without purging. They often eat uncontrollably despite feeling full. Binge eaters may feel guilty or ashamed after a binge and go on an extreme diet as a result. Binge eaters may be of normal weight, overweight, or obese. Although anorexia and bulimia aren’t common in men, binge eating disorder affects about as many males as it does females. At this time, the CHOC Eating Disorders Program does not treat patients with binge-eating disorder; please talk to your child’s pediatrician about a referral to a psychologist, psychiatrist or weight management program.

How can I identify an eating disorder in my child?

There are several behaviors or key indicators you can observe in your child to evaluate whether or not they have an eating disorder or are showing signs of disordered eating. Common symptoms include:

• Preoccupation with weight, food, calories, body image, and/or dieting.
• Fluctuations in weight (both up and down).
• Refusing to eat certain foods or whole food categories (e.g., no carbohydrates, no dairy).
• Development of abnormal, secretive, extreme, or ritualized food or eating habits.
• Eating beyond the point of comfortable fullness.
• The disappearance of a large amount of food.
• Intense fear of weight gain.
• Loss of menstrual period in women.
• Extreme mood swings.
• Skipping meals or eating small portions.
• Frequent trips to the bathroom after meals.
• Abuse of laxatives, diet pills, or diuretics.
• Dizziness or fainting.
• Fear of eating after a scary experience with food (e.g., choking, vomiting).
• Excessive exercise.

Inpatient vs. Outpatient Treatments

Inpatient Care

When your child has medical issues due to an eating disorder, it is important to stabilize them as quickly and safely as possible. The Eating Disorder Medical Stabilization Program at CHOC at Mission Hospital provides inpatient care for children and adolescents with eating disorders such as anorexia nervosa, bulimia nervosa and avoidant restrictive food intake disorder (AFRID).

Our team will coordinate any required inpatient care through the outpatient program to ensure continued treatment and recovery.

Outpatient Care

The Eating Disorder Clinic at CHOC is a multidisciplinary outpatient program designed to help families identify and manage a variety of concerns related to nutrition and eating behaviors.

Eating disorders can be treated successfully, but the answer isn’t as simple as changing eating habits because eating disorders are about much more than food. No one-size-fits-all treatment is available for eating disorders. Rather, treatment is specifically tailored to each individual.

Treatment through the outpatient or inpatient program will be determined by the provider.