How The Healthy Teen Project are Combatting Eating Disorders in the USA

Eating disorders among young people possess an obstacle not only for themselves, but for their families as well. While, among professionals, there is a general agreement that there is no single cause for eating disorders. We spoke to Katie Bell, ANP/PMHNP, Co-Founder of the Healthy Teen Project, in an exclusive interview with Youth Time, to find out how they address physical, emotional, and nutritional health when supporting people with this illness.

Katie Bell Photo Veronica Riedel
Katie Bell / Photo: Veronica Riedel

Young people suffering from eating disorders are disrupted in various serious ways. This also affects their family’s wellbeing in all aspects of lives. Such challenges seek professional treatment and help. We will highlight the contribution of the Healthy Teen Project, which today is able to serve the majority of the San Francisco Bay Area, California, creating a welcoming and recovery-oriented milieu that accepts individuals from all diverse backgrounds, who are challenged with eating disorders.

Katie Bell explains the impact of group therapy and support from their peers for young people suffering from eating disorders, and why a teenager-only therapeutic environment is important when treating teens with eating disorders, acknowledging that they have specific needs that are different from adults.


Eating disorders disrupting family life

In the beginning of her discussion with Youth Time, Bell briefs our readers on why eating disorders are a challenge for youth and their surroundings.

Families need to be supportive
Families need to be supportive

“In general, eating disorders for teens and families create a significant disruption in a family system.  Like any severe illness, a teen’s eating disorder requires the family’s 100% commitment and focus to ensure that the teen receives comprehensive and effective treatment.” she says.

Bell continued: “Given the nature of an eating disorder, treatment generally involves intensive meal support as well as psychological support daily, and in this context, becomes a central focus of the family system.”

Per her conversations with the youth in their program, there are numerous challenging aspects that affect their lives including:

  • losing privileges.
  • losing autonomy.
  • noticing it’s hard for parents, family and friends to really understand what it’s like to have an eating disorder.
  • finding that the family is often arguing and have lost the family’s ‘happy vibe’.
  • that the eating disorder leads to the creation of a whole different part of you, and a part of you that your parents cannot trust.
  • Experiencing their parent’s fear and that they are “always worried about something”.


Best ways to treat eating disorders

Bell contributed by sharing her say on how common are eating disorders among young people and what’s the proper way to treat them?

Therapy is an important aspect of treating eating disorders
Therapy is an important aspect of treating eating disorders

She states that in the United States, it is estimated that eating disorders (anorexia nervosa, bulimia nervosa and binge eating disorder) affect 2.7% of adolescents between the age of 13-18.  Note: this does not include the ARFID eating disorder diagnosis.  This prevalence is based on diagnostic interview data from the National Comorbidity Survey Adolescent Supplement (NCS-A).

Regarding treatment, the American Psychiatric Association guidelines recommends that eating disorders are treated by a multi-disciplinary team specialized in eating disorder treatment.

Bell added: “This team typically includes a therapist, dietitian, medical provider and psychiatric provider to target all the different health challenges faced by an individual suffering from an eating disorder. For teens specifically, Family Based Treatment (FBT), is a therapeutic modality that has demonstrated the greatest evidence of treating a teen with an eating disorder effectively.”

The Healthy Teen Project addresses physical, emotional, and nutritional health, academic functioning, and family and peer relationships. She elaborates for Youth Time how this is possible and measurable.

She remarked: “A medical provider will address the physiological health, the dietitian will address the nutrition, and the therapist and psychiatric providers will address the emotional, family/peer relationships and academic functioning of the teen.”

She explains that the elements are measurable via psychological inventories as well as nutritional and medical metrics which they are assessing daily, several times per week and weekly.

The Healthy Project co-founder said:“We also follow a teen’s and family progress via our outcomes study (started in 2016 and have 214 people surveyed) in which we have the teens and parents’ complete inventories and questionnaires within one week of admitting to the program and then within one week of discharging from the program.”


The crucial role of group therapies and support from their peers


Youth Time looked at what their programme offers for young people with eating disorders, and what are some of the common challenges they face during their work.

Bell reported: “The Healthy Teen Project (HTP) believes a teenager-only therapeutic environment is important when treating teens with eating disorders as teens have specific needs that are different than those of adults like family support.

With teens, family support and therapy is an integral component, both for nutritional rehabilitation and to explore other challenges of adolescence and mental health.

“Group therapy and support from their peers: group therapy allows teenagers to find a place where they can open up and be honest and real about their struggles, relate to others, and receive much needed support. Teenagers are at very different places in life than adults and it is other teenagers that provide the validation and support they require.

“Greater focus on behavioural and experiential opportunities versus cognitive/verbal skills. Teenagers get more out of doing rather than talking about doing. At HTP, teenagers are actively engaged in experiential opportunities and behavioural approaches, such as art therapy, yoga therapy, meal preparation and restaurant exposures.”

Additionally, HTP provides a teen-oriented environment where teens can feel safe, nurtured and hopeful. By not treating adolescents alongside adult peers, the project is able to provide the interventions specific to teens with eating disorders.


Common challenges faced at work

When asked about the challenges they face at work, Bells recalls that every teen and every family is different.

“Speaking for myself as a medical and psychiatric eating disorder specialist, I find that supporting teens to shift psychologically from wanting to be in their eating disorder to wanting to be in a healthy mind-set (or recovery oriented), to be the most challenging aspect of my job.”

She adds: “Not surprising, this also becomes the most rewarding aspect of my job: when a teen share what a welcome change it is to have more mind space to think about things outside of their eating disorder thoughts.”


The causes of eating disorders

If we can know the causes of eating disorders among young people, we can better-help them, or in best cases even prevent this situation. Bell shares her say on this, and moreover talks about what society and institutions do toward helping the youth in this issue.

Young woman with anxiety and fears
Young woman with anxiety and fears

“While there is no single cause for an eating disorder, eating disorder professionals understand in their work with teens that an eating disorder may result from what may be referred to as the “perfect storm.”

To her opinion, this storm may be the culmination of biological, psychological and social stressors.

“This is to say that someone may be predisposed to eating disorders genetically, while simultaneously managing psychological stressors such as anxiety, depression, and/or body dissatisfaction.  Additionally, social stressors such as cultural norms that perpetuate an unrealistic body idea, bullying, family conflicts, and differences in family values/beliefs can all come together in a manner (perfect storm) to trigger an eating disorder.”


What can society do for young people with eating disorders?

The celebration of individuality
The celebration of individuality

When discussing how society and institutions can help teens with this issue, she shared with us some of their teen’s responses which are similar to the requests she has heard teens share in her work:

  • In the family system, to be more accepting of individual differences
  • For all media to provide greater representation of individuals and to elevate individuality (rather than shame it)
  • For the media and our culture to celebrate individual differences
  • Helping and supporting teens to learn how to love our bodies and not comparing to others
  • Valuing a teen’s character and not their appearance

The National Eating Disorder Association (NEDA) has information regarding eating disorders among young people. You can check it out by clicking here.

Photos: Veronica Riedel, Shutterstock / Edited by: Martina Advaney

Read more about food and nourishment from another one of our experts here:

Food And Nourishment For All – An Interview With Professor Matin Qaim

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