United Against Anorexia
A Providence specialist and unique new program in Spokane partner to help people fight eating disorders
Story by Kate Vanskike, with reporting by Staci Lehman | Photos by Gary Matoso
That’s when girls today start to express concerns about their weight or shape. According to the National Eating Disorders Association, roughly half of all elementary school girls ages 6 to 12 are concerned about becoming too fat.
If that fear were based on awareness of the growing obesity epidemic in our nation, that would be one thing. Instead, it’s more likely a result of the prevalence of kids on TV who are wearing skinny jeans and whose shape fits an overly thin “ideal.”
The pressure to be thin—or an uncontrollable fixation on food—can be insurmountable for many, and the resulting disorders have a devastating effect on a person’s physical and emotional well-being.
Disturbed by the Scale
When Ericka and Matt’s daughter Katie turned 13, they noticed a change in her—behavioral and physical shifts they assumed were just part of becoming a teenager, or maybe just a stage she was going through. It was the nurse practitioner at their doctor’s office who picked up on a key clue that something more was going on.
Every time Katie stepped onto the scale, she became upset.
Even then, Ericka says, they were reluctant to admit their daughter had an eating problem until the first time they saw Ponrat Pakpreo, MD, at Sacred Heart Children’s Hospital’s Adolescent Medicine Clinic, who pointed out that Katie was extremely underweight for her height.
It was hard for the family (pictured at the top of this page) to accept the diagnosis, until they discovered that Dr. Pakpreo was completely on their side in fighting the eating disorder.
“It became a working partnership because we were all on the same page,” says Ericka. “I feel like she had our best interest in mind because she was very honest and forthright.”
It Takes a Team
Dr. Pakpreo (pictured, right) treats many young people who come to her clinic with eating disorders. Early in her training, which included public health as well as pediatrics and adolescent medicine, Dr. Pakpreo learned about the need for a multidisciplinary approach in helping these young people. Because eating disorders are a form of mental illness, it’s important that the team include counselors or therapists as well as nutrition experts.
“There is no one person on the team who is any more important than the others,” she says.
Her team of specialists has now grown, and is closely connected, thanks to the arrival of The Emily Program to Spokane.
The Emily Program—a comprehensive approach to treating people of all ages who suffer from eating disorders—was created in 1993 by a Minnesota therapist whose own sister recovered from one such illness. Though he had initially started a hospital-based treatment, he discovered that the mental health aspects of eating disorders required different methods and settings. Today, there are four locations in the nation for The Emily Program, including the newest one in Spokane.
Dr. Pakpreo, who was already seeing a large number of affected youths in her clinic setting, now contracts to provide care at The Emily Program Spokane Clinic on the South Hill two days a week. The arrangement fosters close coordination with therapists, dietitians, a nurse practitioner and other support staff to anticipate and address patients’ needs more effectively.
“It’s a natural fit,” Dr. Pakpreo says. “Many of my patients needed more than the time I could provide. Now I am able to hook them up with higher levels of care in a more structured setting.”
A Family Affair
When Dr. Pakpreo diagnosed Katie with anorexia nervosa (see sidebar), she recommended family-based treatment (FBT) for Ericka, Matt, Katie and the rest of the family.
FBT is an intensive treatment where parents play an active role in helping their child restore normal weight levels, overcome the eating disorder and regain normal development.
While the approach can involve the entire family, parents are key players in the recovery.
Katie sees Dr. Pakpreo at least every other week and is making progress. She has put on weight, is back in school and is more involved in planning what she eats and her portion sizes. Even so, Ericka thinks Dr. Pakpreo will be in her family’s life for quite a while.
The moral support Dr. Pakpreo offers is important for parents who often suffer from guilt over their child’s disorder. “I feel like she’s concerned about me and my husband personally,” says Ericka. “She offers us encouragement and lets us know we’re doing the right thing.”
Treating an eating disorder is a tough road, and that’s why the family is sharing the story of the experience.
“It’s better to know about it and get help than to have your child affected their entire teen years or potentially into adulthood,” Ericka says. “If you suspect something is wrong and your health care provider isn’t educated on the topic, don’t be shy about finding your own Dr. Pakpreo.”