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November 24, 2008

Behavior, Meal Planning, Food and Diet

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Question from Louisville, Colorado, USA:

My 16-year-old daughter was diagnosed with type 1 diabetes 12 years ago. She has had body image problems for as long as I can remember and has been on a yo-yo of unsuccessful dieting and unhappiness for years. I have brought this to the attention of her endocrinologist, physician’s assistant, social worker and nutritionist with very unsuccessful results (“she’s just big boned” or “make sure she knows the importance of a good diet.”) Over the summer, she began running and lost some weight. I guess the excitement of losing weight got out of hand because she has now developed bulimia. She admits she has a problem but would rather “self medicate” (in her words). But, I know I need to help her. My problem is, where do I start – a therapist, dietitian, new endocrinologist? And, at 16, does she go to a pediatric endocrinologist or not? I have spent hours looking online and can’t seem to figure it out. Do you have any ideas?

Answer:

From: DTeam Staff

It can be so frightening to watch your child suffer from the ups and downs of weight management. Adding diabetes to the mix can make it even more frightening. Eating disorders can be dangerous and your daughter needs help from experts in eating disorders. I would encourage you to contact your pediatrician, your local children’s hospital, your local American Diabetes Association office, and your insurance company to learn about the experts in eating disorders in your community. Many mental health specialists with expertise in eating disorders work closely with dietitians with similar areas of expertise. That type of multidisciplinary team is often the most effective.

JWB

[Editor’s comment: A pediatric endocrinologist should be able to help you. If not, ask if your current one would recommend an adult endocrinologist.

BH]