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Psychiatry Newsletter - When Obesity and Mental Health Issues Fuel Each Other
Hopkins BrainWise Spring 2014
When Obesity and Mental Health Issues Fuel Each Other
Date: May 1, 2014
As medical director of the Child Psychiatry Overeating Clinic, Shauna P. Reinblatt understands that successful treatment is about more than simply dieting.
Psychiatrist Shauna P. Reinblatt was busy in clinic seeing children and adolescents with conditions like anxiety and attention deficit hyperactivity disorder when she started noticing that a fair number of her patients were obese.
“You might imagine that hyperactive children would have trouble gaining weight given their increased activity, but instead they were putting on weight,” she says. After studying the medical literature, Reinblatt found that there is an overlap, more documented in adults than children, between obesity and mental health issues such as depression, anxiety and ADHD. As a result, the department recently opened the Child Psychiatry Overeating Clinic to treat children and teens ages 6 to 18 who are overweight or obese and struggling with mental health conditions or binge eating disorder.
“This is not a typical weight loss clinic,” Reinblatt explains. “Binge eating, or loss of control eating, is a problem of having trouble stopping eating and stopping the amounts you’re eating. Treating it takes a bit of a different approach than just going on a diet.”
Often, she says, adolescents can get into cycles in which they feel guilty after binging, which actually can then increase the number of binges. They also can eat in response to negative emotions or to help soothe themselves. Understanding that children who binge eat early in life tend to remain overweight as they age, Reinblatt wants to help break the cycle.
“Basically the approach is, how do we get the family healthier? How do we get the child healthier and increase healthier eating?” says Reinblatt, who along with counselors and nutritionists, and the children’s pediatricians, devise individual treatment plans for patients. These include cognitive behavioral strategies to resist cues or urges to eat, help managing interpersonal issues to improve peer relationships, and counseling for body image issues, in addition to family therapy and nutrition consultations.
Reinblatt also is starting to analyze data from her study funded by the National Institute of Mental Health to explore whether children who binge eat are more impulsive and have poorer response inhibition than peers who don’t binge eat. In addition, she’s investigating whether childhood binge eating is comorbid with other mental health disorders presenting with impulsivity, like ADHD.
“I hope,” she says, “that exploring various underlying mechanisms of disinhibited eating will eventually lead to more targeted binge-eating interventions.”
For information: 410-550-0104