I should have known. Right after I wrote my most recent blog on two essential updates in adolescent health – HealthEd released a podcast on Spotting Eating Disorder Red Flags in Children that lit my brain up like a pinball machine! Because I know for many it’s hard to access things on HealthEd given you do need to register and registration is somewhat restricted, I was trying so hard to sit on my hands BUT this 45min discussion with Michelle Boyd, a general paediatrician but specialist in this area, was sooooooo overflowing with really nuanced practice-changing information (potentially equalling life changing info for those individuals affected)…well, I just could not stay quiet 🤐 So while only listening to the whole episode yourself will do it justice…here are some critical concepts in the interim.
The number of children admitted to Australian children’s hospitals for eating disorders doubled in one year (2020-2021)
We all meticulously measure growth in young children – Why stop during such a critical growth stage such as adolescence & what do we miss if we do?
Any weight loss during this period is a red flag – and should be approached with a non-judgemental open curiosity
What’s new? What’s changed? How does this feel?
Many screening tools for eating disorders used in adults are too blunt for this age-group and will undo your open & curious approach – use the Children’s Eating Attitude Test (ChEAT) instead & only administer the EDEQ to better understand the severity, if an eating disorder is confirmed.
Don’t leave this differential til last – thinking you’ll investigate every other possible explanation first, e.g. functional or organic GIT dx etc – this is a dangerous practice.
Dr. Boyd’s approach and advice to other health practitioners about how to keep EDs high up in your differentials while continuing to practice due diligence in your work up, is to flag it directly with the individual and their family, something along the lines of: “I am worried there’s an element of an eating disorder that underpins this, that’s really important for us to better understand and address for us to make the fastest improvements on how you feel”
What we all can access, regardless of being registered with HealthEd or otherwise, is this: A Practical Guide to prevention, identification & response to eating disorders for GPs which looks like a ripper but I haven’t had a chance to read in its entirety yet!