Children’s Nebraska Behavioral Health Director talks eating disorder awareness


OMAHA, Neb. (WOWT) – Sunday wraps up Eating Disorder Awareness Week. It’s a time to bring attention to the different behaviors and the signs to look for in friends, family, or even young children.

Eating disorders can often be mislabeled, according to Dr. Mike Vance, director of behavioral health at Children’s Nebraska.

“We see a lot of kids who are under the umbrella of ‘oh they’re just a healthy eater… a lot of times those kids then go under the radar in terms of identified,” says Dr. Vance.

The Behavioral Health Program at Children’s Nebraska sees around 3% of the population between the ages of 13 and 18; a group that’s mostly female.

Anorexia is the most common condition they treat at Children’s. Vance explains there’s a lot more commonality with binge eating disorders in adults, but they’ve seen a significant uptick in ARFID, which deals with food refusals and avoidances.

“When we look at the statistics nationally, only about 20% of adolescents that are diagnosed with an eating disorder, or that have the diagnosable characteristics, actually receive treatment,” says Dr. Vance.

In addition, there’s many kids who have eating disorders but are never diagnosed.

“As we see there’s an increase in kids even ages 6 to 10, in particular in females, where they start to become more aware of their body, and their body weight and then when you look at that by age 13 and 14, some studies show as much as 50 to 70% of females are dieting or trying to lose weight,” says Dr. Vance.

Just like many things, the COVID-19 pandemic only made behavioral health concerns worse.

“We saw an uptick in almost all mental health concerns, in particular with children,”… We screen for depression across all of our primary care offices. We saw those numbers almost double throughout COVID for positive screens for depression,” says Dr. Vance.

The silver lining is there has been a decrease in the stigma. Dr. Vance says it’s important to know what signs to look for.

“Obviously significant weight loss, increased fatigue, changes in appearance. If a person was having binge eating or bulimia, they might immediately disappear after the meal, or with anorexia they might avoid the meal situation,” says Dr. Vance. “When you see something that’s out of the ordinary for your child. Just like when we talk about all mental health presentations, if you’ve got a very outgoing child and their super social, and then all of a sudden they’re like ‘no, I’m not going to do that anymore,’… or ‘no it’s not that important anymore’. Ask questions, and listen to their answers,”

Dr. Vance advises it’s best to not shame your child and to be positive when speaking about body image.

“Whether that is someone who appears more thin, or someone who appears more larger-boned or a description, what sort of adjectives do you attach to that, rather than letting people be people and focusing on people’s skills and energies. And, what do you say about yourself?” says Dr. Vance.

If you’re noticing signs and symptoms in your child that you think might be linked to an eating disorder, Dr. Vance says it’s best to reach out to your child’s doctor first.


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