An eating disorder called anorexia nervosa

February 20, 2009

Drawing by Dayna Palmer made in art therapy in the eating disorders program.

Dayna Palmer is an artistic and creative 11-year-old who loves to draw, act, dance — especially to hip-hop — and listen to oldies. She also journals — "I like to express myself," she says — and shares her thoughts with her family.

But that wasn't always the case. Dayna is in recovery from an eating disorder called Anorexia Nervosa.

Dayna calls her eating disorder a "he." Personifying an illness is one step in separating oneself from the disease, said her therapist, Dana Labat, Ph.D., a psychology post-doctoral fellow at Children's Medical Center.

Dayna's "he" took many things away from her besides her will to eat. She stopped drawing, painting and dancing because of her eating disorder.

"I told myself I didn't like art," she said. "The eating disorder told me I couldn't do it anymore so I stopped."

Eating disorders treatment program

Before being admitted into the Center for Pediatric Eating Disorders at Children's, Dayna hadn't eaten or had anything to drink for days — despite having been through more than six months of eating disorder treatment at other facilities.

However, thanks to the long-term eating disorders treatment program — along with art and dance — Dayna was able to get herself back.

"The doctors teach you life skills and everyday skills like positive thinking, such as ‘I'm beautiful, I'm strong, I can do this,'" Dayna said. "It helped me to change back to Dayna instead of being lost in my eating disorder; it helped me be myself again."

Psychotherapy is an important part of the Children's eating disorder program because of the genetic and environmental components of the disease. Treatment includes individual and family therapy, multifamily groups, parent education groups and nutritional counseling as well as pet, recreational, play, art, and music therapy programs.

"The parental education is really wonderful and the support too," said Julie Palmer, Dayna's mother.

Medication support is also a component of treatment when needed. While the use of Prozac for Bulimia Nervosa is the only drug approved by the Food and Drug Administration specifically for eating disorders, medications can be used cautiously to treat targeted eating disorder symptoms in children and adolescents.

An array of eating disorder services

Children's has provided treatment for eating disorders for more than 20 years, and is the only hospital in the state that treats both girls and boys up to age 18 in an inpatient setting with a full continuum of care — including outpatient services.

Under the direction of Dr. Stephanie Setliff, the center's medical director and assistant professor in the Division of Child and Adolescent Psychiatry at UT Southwestern Medical Center, the program consists of four levels of care: inpatient hospitalization; partial hospitalization; intensive outpatient; and individualized outpatient. On any given day, there are 20 to 40 children and adolescents in the program.

Specialized treatment tracks also exist for boys and for children 6-12, like Dayna. Most stand-alone treatment centers will not admit males, leaving them with far fewer options for treatment, Dr. Setliff said.

Recovery continues

Today, Dayna's journey to recovery continues. She recently completed the last level of an extensive outpatient program and has returned to her home in Sugar Land, Texas, where she is a sixth-grader. She's continuing her treatment at home with an individual therapist, a child psychiatrist, a family therapist and a dietitian.

"When your child is treated for a mental illness it can be a scary experience at first, but the staff here is incredible and very responsive," Dayna's mother said. "You're part of the program so that you can take the ball when your child leaves."

"I learned a lot here," Dayna said. "Now I know that eating disorders are horrible, and God is much bigger and everybody's beautiful."

National Eating Disorders Awareness Week

National Eating Disorders Awareness Week is Feb. 22-28. Children's is sponsoring a special section on eating disorders in The Dallas Mornings News on Sunday, Feb. 22. A free documentary showing and a professional symposium also is associated with the week. For more information on eating disorders and National Eating Disorders Awareness week activities read Eating disorders affects many children.