At Change Creates Change, we have created the Creating Change Pathway™ to navigate eating disorder recovery. We use this tool as a recovery roadmap to help our clients visualize what the road to recovery can look like. We’ve designed the Creating Change Pathway™ to have separate two stages. At the beginning and end of each stage, we have dedicated checkpoints where our clinicians meet with parents and clients to see where we are at.
Eating Disorder Recovery
At Change Creates Change, we often say that eating disorders begin as mental health concerns and quickly deteriorate into physical health concerns. When we talk about recovery, we need to treat the eating disorder the same way that it started. This means that first we must treat the malnutrition, but then we must also treat the mental health concerns.
In our practice, we use a combination of physical rehabilitation and improved mental health. For our best odds of success in recovery, we treat both the body and the brain.
Stage One
The pathway begins before we meet – when the eating disorder starts. We don’t know exactly what causes eating disorders, but we know it’s usually a combination of biological, social, and psychological factors.
In our practice, we follow the philosophy that eating disorders usually begin with our core values or beliefs. Often, these values sound like “I’m not good enough”, “I’m not worthy”, and “I will not be accepted”. These values are right at the core of individuals, and they influence our thoughts and behaviours as the eating disorder progresses.
The Start of The Eating Disorder
At the start of the eating disorder, eating disorder thoughts, emotions, and behaviours increase. As we restrict, binge, purge, or use other eating disorder behaviours – malnutrition increases.
This may or may not also occur alongside weight loss. However, weight loss is not necessary. We do not need to see weight loss to detect or diagnose an eating disorder. Folks of all bodies, weights, and shapes can be living with eating disorders that can have very serious health consequences.
Eating Disorder Detected
It is usually the signs of malnutrition that send off the red flags that an eating disorder is present. These include trouble concentrating, irritability, or feeling cold all the time.
Eating Disorder Treatment Begins
After the eating disorder is detected, treatment can begin. In our practice, we first focus on physical health repair. That is, treating the physical side effects of the eating disorder.
We ask the primary care provider, nurse practitioner, or GP to medically monitor your child. We also have them recommend or prescribe exercise cessation. This can include having them write a note to excuse the child from school gym class or any other physical activities. Further, we ask the physician or nurse practitioner to record blind weights. That is, they monitor and record the weight of the child without the child seeing the number. This weight may be taken weekly, biweekly, or monthly depending on the child.
Psychoeducation (Stage 1)
After the eating disorder is detected and treatment begins, we can start therapy and psychoeducation. This is a process we use for both the parent and the child affected by the eating disorder.
There are many things we try to go over with both the parent and the child. If we are able to understand the eating disorder better, we can have the best chances of success. At the same time, we want to offer a safe, non-judgmental space for both the families and child to express their feelings and thoughts throughout recovery.
The Refeeding Process
Once we have begun eating disorder treatment, we will start the refeeding process. This is a way in which we renourish the body and avoid refeeding syndrome. It is a way of slowly reintroducing calories to the body to treat malnutrition.
The Refeeding Hierarchy™
The Refeeding Hierarchy™ is the slow, controlled way that we reintroduce foods during eating disorder recovery. There are 5 stages to the hierarchy, and we take each stage one at a time.
Checkpoint
At this time, we have our clinicians meet with the parents and child to see if we are ready to move into Stage 2. If not, that is okay and we spend more time in stage one. If we are ready, we move into the next stage.
Stage Two
Stage Two of the Creating Change Pathway™ is where we start to interrupt the symptoms of the eating disorder. Our clinicians will work with your child to find the tools and resources that suit them best to do so.
We also encourage parents to take part in parent education to learn how to best support their child during recovery without burning out.
Symptom Interruption
Symptom interruption really depends on the unique person living with the eating disorder. We have lists of tools for folks affected by restriction, binge eating, purging, and other eating disorder behaviours that can be used for symptom interruption.
What works for one person may not work for the other – and that is okay. We work with the individual to find the right tools that work for them.
As we treat the eating disorder, malnutrition decreases. Once again, this may or may not be accompanied by weight gain. In our practice, we prioritize state, not weight.
Reintroducing Movement
Once we have treated any malnutrition, we encourage folks to reintroduce joyful movement. That is, moving our bodies for the positive effects rather than weight or shape control. We want to slowly reintroduce movement. Start with light walks, gentle yoga, and slowly add in more.
Improved Mental Health
Our focus during this second stage is on improving the mental health of the affected individual. We are really trying to challenge the distorted thoughts, feelings, and values that are at the core of the eating disorder.
Our expert team has qualified therapists that can help. For some folks, they may already be seeing an outside therapist. If not, we encourage folks to work with one of our psychotherapists to treat the mental health concerns.
The focus of the psychoeducation in this stage is on cognitive restructuring, exposure therapy, and learning positive coping skills.
Psychoeducation (Stage 2)
Similar to stage one, there is psychoeducation we bring to both the parent and affected child. Our team of therapists will work with the child and parents on topics to help in recovery.
We also increase activities to “crowd out” the eating disorder. These tools include mastery, distraction, and connection.
Body Image Work
Eating disorder recovery would not be complete without working on our body image. However, some folks may experience one without the other.
With body image work, psychoeducation, and improved mental health – we should see improvements in eating disorder thoughts, emotions, and behaviours.
How To Help Your Child With Their Eating Disorder
If you think your child is living with an eating disorder, we are here to help. Our practice believes in supporting both the child and the parent in recovery. To learn more, click below to book a free 15-minute consultation call.
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