Teens with eating disorder behaviors or symptoms may be referred to an eating disorder program by their pediatrician, family doctor, or nurse practitioner. While no two programs are exactly the same, outpatient programs usually perform a complete assessment to provide appropriate treatment for teens with eating disorders and support for family members. The approach is usually multidisciplinary, which means that more than one specially trained health care provider will be involved in the evaluation and treatment plan. All of these team members will likely involve the family as well, to plan the guidance and support needed at home. College students and young adults often see the team alone, but may still work with parents or other family members.

The first visit typically includes:

Medical Evaluation by a health care provider (HCP) who is specialized in caring for teens.

Your HCP will:

• Check your blood pressure, pulse, temperature, and weight
• Ask you and your family about your medical history
• Ask you questions about your eating habits and menstrual periods
• Order tests such as labs (blood tests), urinalysis (to see if you are drinking the right amount of fluids), EKG (a test which looks at the activity of your heart if your heart rate is low), and/or bone density test (DXA scan), if needed

Mental Health Evaluation by a psychologist or social worker experienced in eating disorder treatment.

You and the mental health provider may talk about:

• How you feel about the way your body looks
• Your food related behaviors
• Your family’s concerns about your health
• Your thoughts and feelings about being evaluated for an eating disorder
• Your treatment goals
• Anything else you feel is important for the counselor to know

Nutrition Evaluation by a registered dietitian experienced in eating disorder treatment.

You and your dietitian will:

• Talk about your food likes and dislikes
• Talk about any behaviors you have related to food
• Discuss common myths about food and eating disorders
• Talk about your health goals and concerns about changing your behaviors
• Work with you and your family on creating a healthy eating plan for you

After the evaluation:

Your HCP will talk to you about a personal treatment plan that will likely include:

• Individual and family therapy
• Medical monitoring by your primary care provider
• Nutritional counseling and support from your dietitian

The Treatment Team: Eating disorders are both medical and psychological conditions. Therefore, treatment usually includes working with a team of specialists including: a doctor or nurse practitioner, therapist or counselor, a dietitian, and sometimes a psychiatrist or family therapist.

The Health Care Provider’s (HCP) role is to:

• Keep track of a person’s medical health by checking height, weight, blood pressure, pulse, and temperature.
• Draw blood or take urine samples, if necessary, to make sure the chemicals in the body called electrolytes are balanced.
• Order special tests such as an EKG to monitor heart rhythm, or a bone density test (DEXA) to see if osteoporosis (thinning of the bones) is present or developing.
• Offer suggestions on achieving weight goals, calcium and vitamin supplements, exercise, hormone replacement, and possibly medication for anxiety or depression.
• Determine the best treatment option for you. The HCP may suggest meeting with a therapist and nutritionist, going into residential treatment, having a family-based therapist, or being hospitalized until medically stable.

The Therapist/Counselor’s role is to:

• Help improve self-esteem, body image, and confidence.
• Involve parents and other family members in providing support, guidance, and supervision of meals.
• Teach healthy ways to manage emotions and stressful situations.
• Address other emotional problems that may be related to the eating disorder, such as depression, obsessive-compulsive disorder, or substance abuse.
• Create a place where someone can (privately) discuss her/his needs and goals.
• Provide a safe place to experience feelings of sadness, anxiety, anger, etc.
• Discuss disordered eating thinking and behaviors, and teach strategies to become mentally healthy.

The Family-based Therapist’s role is to:

• Provide parents guidance and support around refeeding their child.
• Teach parents how to manage mealtime conflict.

The Registered Dietitian’s role is to:

• Help create a safe and healthy eating plan that is balanced in all the food groups.
• Answer questions about food.
• Teach why our bodies need specific nutrients and which foods provide them.
• Offer suggestions on healthy eating, how to achieve weight goals, vitamin and mineral supplements, and exercise.
• Discuss the harmful myths and confusing messages about food and diets.