CHLA Program Enhances Care for Adolescents With Eating Disorders

Nearly 5 million adolescents in the U.S. have an eating disorder such as anorexia nervosa, bulimia, or binge-eating disorder. Just as alarming, though, is the fact that only 1 in 5 of those young people receive appropriate treatment.

To bridge this gap and improve care for these young patients, Children’s Hospital Los Angeles transformed its treatment framework for eating disorders two years ago. In addition to enhancing its inpatient clinical pathway, CHLA launched a special outpatient eating disorders program.

The program is one of only two on the West Coast to provide comprehensive, multidisciplinary care under one roof—from assessment to treatment and beyond—for young patients with eating disorders.

“There’s a tremendous need for more centers to offer comprehensive, multidisciplinary care for adolescents with eating disorders,” says Ashish Buttan, BDS, MBA, Executive Director of the Behavioral Health Institute at Children’s Hospital Los Angeles. “We created a cohesive model that ensures that even those with severe conditions receive the continuum of care they need for long-term recovery.”

The gold standard of care

At CHLA, the outpatient program integrates with the inpatient clinical pathway and offers specialized, multidisciplinary care—including an adolescent medicine physician, child and adolescent psychologists, a registered dietitian, nurses, and social workers.

“Multidisciplinary care is the gold standard for eating disorder treatment,” says Celia Framson, MPH, RD, CSP, Clinical Dietitian IV in the Eating Disorders Program at CHLA. “Here, we work as a team in the same clinic, under one roof, which allows us to better collaborate on care for each patient.”

The program takes a family-based treatment approach, particularly for anorexia, but also for bulimia and avoidant/restrictive food intake disorder (ARFID). Often, the first goal is to empower families to take control of feeding their child.

“Refeeding the brain is the most important aspect of early treatment,” Framson notes. “You cannot do psychotherapy with a child who has a starved brain. But it can feel counterintuitive to parents because adolescence is a time of increasing autonomy. We have to tell families to temporarily take that autonomy away.”

Although nutrition is a key aspect of care, a multidisciplinary approach is critical. At CHLA, patients see an adolescent medicine physician, as well as a psychologist, at each clinic visit. Patients are screened for anxiety and depression each visit as well, and specialists across disciplines collaborate in real time on each child’s care.

“There’s an art and a science to treating eating disorders, and different practitioners will sometimes take different approaches,” Framson says. “Since we work so closely together, we are able to individualize care and ensure that we are all aligned on a consistent treatment plan.”

The program is one of only two on the West Coast to provide comprehensive, multidisciplinary care under one roof—from assessment to treatment and beyond—for young patients with eating disorders.

Expanding access

The team has also made several enhancements to its inpatient clinical pathway. For example, patients with eating disorders are now strategically grouped within a dedicated hospital area.

“This optimizes the delivery of specialized care, but it also streamlines training for frontline staff and multidisciplinary teams,” Buttan explains. “By ensuring that nurses, care partners, and physicians are well-versed in the complexities of eating disorders, we enhance care delivery and improve patient outcomes.”

About half of patients come to the outpatient program after completing the inpatient pathway. The synergy between both helps set patients up for success after being discharged from the hospital, he notes.

Today, one of the biggest challenges for the team is trying to meet the growing need for eating disorder care. Although the team has plans to expand in the coming years, it currently has a long wait list for patients.

Improving access to care will require a multipronged approach, Buttan says. That includes leveraging technology, such as AI-driven early diagnosis apps and online therapy. He also urges businesses in the health care sector to invest in eating disorder treatment facilities and outreach services.

CHLA’s program is continuing to evolve, with ongoing recruitment of providers trained in eating disorders.

“This expansion is allowing us to serve a larger client base with this high standard of care,” Buttan says. “We are committed to improving outcomes and access to ensure that youth and families get the patient-centered care they need.”