Roberta and her team work with girls and boys of all socioeconomic and ethnic backgrounds to help them sustain weight and deal with their fears and anxieties.
Roberta Freeman has worked at the Resnick Neuropsychiatric Hospital at UCLA in adolescent psychiatry for more than 30 years, and is a board-certified clinical nurse specialist in psychiatric and mental health nursing. As the clinical nurse specialist for UCLA's Adolescent Eating Disorders Program, she assesses prospective patients, facilitates the hospital admission process, and assists in treatment planning for children and adolescents with eating disorders. She runs group therapy sessions for adolescents suffering from eating disorders and supervises the nurses who work with them.
How has the treatment of eating disorders changed over the years?
In the past, teens would be hospitalized for anywhere from six months to one year. Now, they stay until they are stable, and then they step down to outpatient care - sometimes after only several days. Unfortunately, we know that without sufficient weight restoration, there is a much higher percentage of relapse. The closer these kids can get to a normalized weight, the sooner they can start dealing with the source of their fears and anxiety that lies beneath the eating disorder, and the better they will do.
Which children require hospitalization for eating disorders?
The children who come to us are very ill patients, up to age 17 and as young as 10. The predominant diagnosis is anorexia nervosa. These kids have very low heart rates, low blood pressure, feel cold all the time, and may be covered in lanugo (soft hair).
What is it like to work with children and teens with eating disorders?
This disorder is humbling. It is very powerful and robs the teenager of a self. The kid becomes entrenched in the disorder and believes she has found the answer to take away her unhappiness. It's heartbreaking to see such otherwise bright, sensitive, exceptionally high-achieving and likeable kids get hijacked that way.
What affect do you think popular culture has on eating disorders?
Our culture is about women being slender, if not skinny. Obviously, these cultural messages contribute to the problem, but there are many other factors that need to be in place. People who have eating disorders have symptoms that interfere with their lives, prevent them from functioning in a normal way and may be life threatening.
What are the most challenging and most rewarding parts of your job?
The most challenging and most rewarding part is probably the same. What I try to teach nurses who haven't been doing this as long as I have is that with this disorder, there is a time, a readiness for recovery, and we may not have the patient at that time of readiness. But the reward is finding out the relationship that didn't seem important at the time actually was very important to the child. I can't tell you how many kids have come back years later to say hello. They remember what you said. They quote you.
How else has your work affected your life?
I became acutely aware of how our culture portrays how women should look and the influence those expectations have on young girls. When my daughter was young, I used any opportunity to explain or point out other perspectives. For example, I allowed her to have Barbie dolls but I made sure she knew real women did not look like this, and she often repeated that to her friends.
What are your outside interests?
I enjoy movies and books - especially crime and detective stories - and going to Las Vegas with family and friends.