Eating Disorders

Services

Eating disorders are severe disturbances in attitudes and behaviours involving eating, weight, shape and body image. They are often accompanied by mental health issues such as depression and anxiety, as well as medical complications which can lead to hospitalization. Eating disorders:

• can be life-threatening
• often require professional treatment
• are the leading cause of chronic illness in adolescents
• have symptoms that often last many years

Adolescents can recover from these types of illness. The long-term outcomes of adolescent patients treated for eating disorders are much better than those of adults, especially when interventions start early. 

We treat patients aged 10 to 18 (new referrals accepted up to 17 years, 6 months) who struggle with eating enough to stay healthy, concerns about their body weight or shape, severe anxiety around food or unhealthy behaviours related to weight control.

We also treat patients who don’t eat enough because of the appearance, smell, taste or texture of food or past negative experiences. In these cases, the patient’s decreased intake must have resulted in weight loss, stagnated growth or severe anxiety and distress around specific foods and eating.

Each patient receives a comprehensive evaluation to determine an individualized treatment plan. Family involvement is required for any psychological treatment program offered at our clinic.

Our clinic follows adolescents with:

• anorexia nervosa (AN)
• bulimia nervosa (BN)
• avoidant/restrictive food intake disorder (ARFID)
• other specified feeding or eating disorder (OSFED) 

Referrals

For an appointment at our assessment clinic, you need a referral from a medical provider. Please have the medical provider complete this form and send it to us along with any pertinent patient blood work and past growth curves. The information can be faxed to our program coordinator Shari Segal at 514-412-4319. Our intake coordinator will contact you with a date for an appointment at an assessment clinic. 

To change or cancel an appointment or to leave a message for a team member: 514-412-4481.

Assessment clinics

All new patients enter our program through an assessment clinic. During an assessment, families will meet with a registered nutritionist and an Adolescent Medicine specialist. These assessments take a full afternoon. After the clinic, we will recommend the best treatment option, which will be through our program or community interventions. 

Team

Our team includes professionals from a variety of disciplines and departments.

Doctors

Specialist

Approach

As a university-based program, we are committed to providing state-of-the-art treatments based on research and new understandings of eating disorders. Our treatment approach is designed to help with recovery and prevent future relapses. Our treatment team includes physicians, psychologists, psychiatrists, social workers, dieticians, and nurses who are all eating disorder specialists.

Our program’s foundation is Family Based Treatment (FBT), also known as the Maudsley approach. It stresses that eating disorder behaviours are out of the adolescent’s control and requires parents to temporarily take over nutrition to defeat the eating disorder.

For certain families enrolled in FBT, our program also uses other treatments:  

• Cognitive Behaviour Therapy (CBT) is used with patients receiving a diagnosis of avoidant restrictive food intake disorder (ARFID).
• Linked Intensive Family Treatment (LIFT) is a 12-week program and works with emotions that often come up around eating and other social situations. combining dialectical behavioral therapy (DBT), mindfulness, and CBT.

Hospitalization

Most families are followed as outpatients at the Adolescent Clinic, but a patient at serious medical risk due to malnutrition may be transferred to the MCH’s pediatric inpatient ward. Treatment includes:

• medical monitoring
• nutritional rehabilitation
• psychiatric consultation 

The goal is to restore health enough so that treatment can begin or continue as an outpatient.

Family education and support

For families participating in our treatment programs, we offer a 5-week family education series that runs several times per year.  

The sessions explain the medical and nutritional complications of eating disorders and offer strategies that empower parents to help with the nutritional and psychological recovery of their child. The open forum is also a chance for parents to share their experiences with others facing similar issues.

Research

Families may be approached about participating in research on pediatric eating disorders.  Participation is not required and refusal to be part of a study will not affect treatment.

Resources

Books

• Skills-based Learning for Caring for a Loved One with an Eating Disorder: The New Maudsley Method
  (by Janet Treasure, Gráinne Smith, Anna Crane)
• Help Your Teenager Beat an Eating Disorder
  (by James Lock, MD, PhD and Daniel Le Grange, PhD)
• Survive FBT: Skills Manual for Parents Undertaking Family Based Treatment (FBT) for Child and Adolescent Anorexia Nervosa
  (by Maria Ganci)

Websites

• Academy of Eating Disorders – Educational Videos
• ANEB – Anorexie et Boulimie Quebec (French)
• Anorexia – Support for Families (some parts in French)
• BC Children’s Kelty Eating Disorders – Meal Support Videos
• Canped – Online Educational Tool for Parents/Caregivers of a Youth with an Eating Disorder
• Duke Center for Eating Disorders – Educational section
• FEAST – Families Empowered and Supporting Treatment of Eating Disorders
• Maudsley Parents
• National ED Information Center
• Parents to Parents

For physicians