Eating disorders clinic

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What are eating disorders?

Eating disorders are severe disturbances in attitudes and behaviors around eating, weight, shape, and body image. These disorders are often accompanied by emotional difficulties (e.g., depression, anxiety), as well as medical complications, which can lead to hospitalization.

Eating disorders can be life-threatening and often require professional treatment. They are the leading causes of chronic illness in adolescents, with symptoms often lasting many years. That being said, adolescents can recover from this illness. Long term outcomes of adolescent patients treated for eating disorders are much better compared to adults, in particular when interventions are started early in the course of illness. 

Who we are

The Montreal Children’s Hospital adolescent eating disorder program has been providing medical care and psychological services to individuals with eating disorders and their families for well over 25 years. Our program has an interdisciplinary approach to treatment, meaning care is provided by a wide variety of health care specialists who are trained in eating disorder management. Families are encouraged to participate as part of the care team, as we believe their involvement is crucial for recovery from an eating disorder.

Our services

Our program treats any patient aged 10 to 18 (new referrals accepted up to 17 years, 6 months) who is struggling to eat enough to stay healthy, with concerns about their body weight or shape, severe anxiety around food or with unhealthy behaviors related to weight control.

Our clinic follows adolescents with anorexia nervosa (AN), bulimia nervosa (BN), avoidant/restrictive food intake disorder (ARFID) and other specified feeding or eating disorder (OSFED), a category that includes subclinical eating disorders and atypical eating disorders. Each patient receives a comprehensive evaluation that determines their individualized treatment plan.

We unfortunately are unable to offer services to those under 10 years of age at this time.

Please note that family involvement (parent or guardian with whom the young person lives) is required for any psychological treatment program offered at our clinic.

Our approach

As a university-based program, we are committed to providing state-of-the-art treatments based on research and new understandings of eating disorders. Our treatment approach is designed to both aid in recovery, as well as prevent future relapses. At the Children’s, we take pride in our ability to provide both inpatient and outpatient services, depending on medical and/or psychological need. Our multidisciplinary treatment team includes physicians, psychologists, psychiatrists, social workers, dieticians, and nurses who are all eating disorder specialists.

Our program’s foundation is Family Based Treatment (FBT); also known as the Maudsley approach. FBT focuses on supporting parents to take the lead in helping restore their child’s weight to a healthy level.  The FBT approach stresses that eating disorder behaviors are outside of the adolescent’s control.
FBT requires parents to temporarily take over the youth’s nutrition in order to defeat the eating disorder. Currently, FBT is the most effective treatment for restrictive eating disorders in youth. The Montreal Children’s Hospital was the first eating disorder program in Quebec to offer FBT by accredited therapists.

To learn more about FBT, please see our clinic’s information pamphlet.

For certain families enrolled in FBT, our program utilizes complimentary, evidence based treatments to help our patients cope with their emotions, particularly anxiety, that often accompany eating and social situations. Cognitive Behavior Therapy (CBT) is utilized as an adjunct to FBT for all of our patients receiving a diagnosis of avoidant restrictive food intake disorder (ARFID).

In addition, we offer a step up intensive outpatient program (IOP) several times a year for those struggling despite weekly FBT sessions. This 6-week program runs 2 afternoons a week and incorporates elements of dialectical behavioral therapy (DBT), mindfulness, nutritional support, creative arts therapy and CBT to help families further build on the FBT principles.

Assessment clinics

All new eating disorder patients enter our program through an assessment clinic in order to ensure proper diagnosis and to make recommendations for treatment that fit the patient’s needs.

During an assessment, families will meet with both a registered nutritionist and an adolescent medicine specialist. These assessments take a full afternoon.

Following the clinic, we will offer the best treatment option – either through our program or suggested community interventions.  

Hospitalization

Although most families are followed as outpatients at the adolescent clinic, a patient at serious medial risk due to malnutrition (e.g., unsafe heart rate) may be transferred to the Montreal Children’s Hospital’s pediatric inpatient ward for monitoring and treatment.

While in hospital, your child will continue to be followed by the eating disorder team. Treatment includes medical monitoring, nutritional rehabilitation (initially with nasogastric feeds i.e. tube feeding from the nose to the stomach) and psychiatric consultation as needed. The focus of the inpatient stay is on restoring health to the point that treatment can begin or continue in the outpatient setting allowing families to resume an FBT approach.

Family education and support

For families participating in our treatment programs, we offer a 5-week family education series that runs several times per year.  This program takes place at the adolescent medicine clinic Wednesday afternoons from 4:00-5:30 pm and is led by an adolescent medicine specialist, a nutritionist and an FBT therapist.  A complimentary yoga/mindfulness class is offered simultaneously for the adolescent of parents participating in these groups.

These sessions provide education around the medical and nutritional complications of eating disorders as well as strategies to empower parents to assist in the nutritional and psychological recovery of their child. The open forum allows parents the opportunity to reflect on difficulties they are encountering and to troubleshoot with other families experiencing similar issues.

Families will receive information about these education sessions at their assessment or in an initial meeting with their care providers. 

Research

Many of our specialists are often pursuing research projects.  Families may be approached about participation in research aimed at improving our knowledge and treatment of pediatric eating disorders.  Participation in research is not required and refusal to be part of a study will not affect treatment in any way.

Referring a patient

In order to be booked for an assessment clinic, a referral must be made by a medical provider by completing the following intake form. Along with the required medical information, the referral should include any pertinent blood work and past growth curves when available.  It is the responsibility of the referring provider to send us this information.

All information can be faxed to our program coordinator:

Alexandra Itzkovitz

  • Phone: (514) 412-4400 ext. 23662
  • Fax: (514) 412-4319

Once the necessary documentation has been received, our intake coordinator will contact the family to triage them to the next available assessment clinic.

Our team

The Montreal Children’s hospital eating disorder program team includes professional from a variety of disciplines and departments.

Department Head:  Dr. Julius Erdstein, Director of the Division of Adolescent Medicine and of the Pediatric and Adolescent Gynecology Program

Program Head: Dr. Holly Agostino – Adolescent Medicine Specialist

Staff members

  • Peggy Alcindor, Nutritionist
  • Dr. Franziska Baltzer, Adolescent Medicine Specialist
  • Nancy Berney, Creative Arts Therapist, MBSR/mindfulness Practitioner
  • Dr. Jason Bond, Psychiatrist
  • Dr. Giuseppina Di Meglio, Adolescent Medicine Specialist
  • Dr. Suzanne MacDonald, Adolescent Medicine Specialist
  • Dr. David Martens, Adolescent Medicine Specialist
  • Anne-Marie Martinez, Clinical Nurse Specialist and Accredited FBT Therapist
  • Sue Mylonopoulos, Social Worker and Accredited FBT Therapist
  • Dr. Danit Nitka, Psychologist
  • Dr. Catherine Serra Poirier, Psychologist and Accredited FBT Therapist
  • Cindy Vielleuse, Creative Arts Therapist

Program Coordinator:  Alexandra Itzkovitz

Refer a patient 

1040 Atwater, suite W-105

For any information regarding our services or the referral process please contact our program coordinator:

Alexandra Itzkovitz

  • Phone: (514) 412-4400 ext. 23662
  • Fax: (514) 412-4319

To change or cancel an appointment or to leave a message for a team member: (514)-412-4481