What to do if you think your child has an eating disorder

What to Do If You Think Your Child Has an Eating Disorder

Co-Written By: Ava Elliott, Marketing Intern & Danielle Marzella MS, RDN, LDN

Reviewed by: Devon Kroesché MS, RDN, LDN & Danielle Marzella MS, RDN, LDN

The prevalence of eating disorders (ED) and disordered eating is still being studied and results vary based on specific types and subtypes of EDs. However, the nationwide prevalence for children with EDs is increasing and can continue into adulthood. It is vital to prevent disordered eating from developing into a clinically diagnosed ED. After speaking with Danielle, who specializes in counseling clients with eating disorders (ED) and disordered eating, we compiled a list of “do’s” and “don’ts” if you suspect your child may have disordered behaviors. Additionally, some general tips on how to proceed with getting professional help.


Tips To Do

Make an appointment with a professional. There is no point that is too soon to schedule an appointment with a Registered Dietitian (RD), counselor, or doctor. It is important to get help and establish a path towards recovery. As a parent, be aware of the conversations your children are having with their friends and conversations that occur around your children. Is anything triggering? Is there a lot of diet talk?

Step 1: Express concerns to a doctor and see their opinion.

  • Danielle recommends speaking with a pediatrician or RD who has background knowledge in working with EDs and disordered eating. Look for the Certified Eating Disorders Specialist (CEDS) credentials or a provider with a specialty in EDs. It is vital to work with a professional who is trained and can help your child on the path to recovery. Some RDs and doctors have experience with appetite stimulants, how to manage medications, and can also refer you to another qualified provider.

Step 2: Be an advocate for your child.

  • If you start working with a health-care professional that you do not feel comfortable with, switch to another provider. Children are easily imprinted upon, and you want them to get the best help possible. Speak up to help your child maximize their experience.

Step 3: Support your child.

  • Encourage your child and always support them, but do not force any diet talk. Forcing certain food patterns will create a negative environment around food and you want to create a welcoming environment in your home. All foods fit.
  • Your tone of voice as a parent is vital to support your child. For example, you might say to your child in private, “I’m noticing (behavior) and wondering if you are feeling some type of way? Why don’t we find someone that can help us explain this behavior. We can both learn more together.” Sharing the burden with your child will help them feel loved and supported in this complex environment.

Step 4: Be aware of your tone of voice.

  • Remain inquisitive and supportive.
  • If you are struggling to get your child to attend a meeting, spin it in way that your child needs to hear it. This conversation might look like:
    • “Okay, detective. If you’re concerned, let’s seek help.”
    • “You want to maximize your nutrition and a dietitian can help us with our bodies and nutrition.”
    • “You think nothing is wrong with your habits. Let’s go prove your point and see a professional to provide proof you are right.”
  • Your child may know something is wrong deep down and not want to do anything about their disordered behaviors. Meet them where they are. Remain supportive and you can say, “I want to feel my body too. Let’s go find a dietitian that understands us.”


Please, Do Not:

  • Minimize a person’s experience.
  • Say, “just eat it” or “it doesn’t matter.”
  • Do not comment on your child’s food choices, body shape, or size.
  • Do not say foods are “good” or “bad” for you.
  • Do not align morality with food.
  • Do not talk about dieting and expect your children not to diet.


Once you and your child are ready to seek help, you want to feel comfortable with your RD and trust them to help your child through this tough time. RDs will work with you and your child to develop a level of care that is most comfortable for both of you. Keep in mind, throughout the process you can evaluate YOU. Are you contributing to triggering thoughts and talking about how foods are good and bad for you? Or are you supporting your child on the journey to create a positive relationship with food and their bodies?

You can be an advocate for your child even outside of counseling sessions. Normalize shutting down body talk and food talk. During the holidays, you can tell your family members, “do not say comments about food in front of my child.” You are their biggest support system. What is your child comfortable with? Make sure you are on the same page with how to handle things in public. If you think your child may have disordered eating and you want to minimize further disordered thoughts, you can schedule an appointment to speak with a dietitian by emailing scheduling@casespecificnutrition.com.


Protein-Rich Tomato Soup

Written by: Ava Elliott, Marketing Intern and Future Dietitian

Reviewed by: Devon Kroesché, MS, RDN, LDN

I took a functional nutrition class last year and learned all about how food functions in the body. For example, food can provide anti-inflammatory properties, help prevent chronic diseases, balance hormones, and so many other functions! It is so interesting to think about using food as medicine. When learning about carotenoidsa phytonutrient that promotes eye health, cellular communication, etc. we made a delicious soup recipe during lab hours that was rich in carotenoids.

Carotenoids are phytonutrients like lycopene, lutein, and beta-carotene, to name a few. These nutrients are found in yellow to red fruits and vegetables and dark leafy greens. Picture fruits like cantaloupe, grapefruit, guava, watermelon; and vegetables like carrots, kale, pumpkin, red pepper, and peas. This carotenoid-rich soup is also packed with protein from beans that make the soup creamier. Blending beans into a soup or sauce is a great tip to add extra protein. Below is the tomato soup recipe adapted from Cookie and Kate!

What You’ll Need: 

  • 3 tablespoons extra-virgin olive oil 
  • 1 medium yellow onion, chopped 
  • 1/2 teaspoon fine sea salt 
  • 2 tablespoons tomato paste 
  • 1 large can (28 ounces) whole tomatoes, with liquid 
  • 2 cups vegetable broth 
  • 1/2 cup Cannellini beans, rinsed and drained 
  • 1 teaspoon coconut sugar or brown sugar, to taste 
  • Freshly ground black pepper, to taste 
  • For the tomato-basil variation (optional): 10 to 15 fresh basil leaves, to taste 

What To Do: 

  1.  In a Dutch oven/soup pot, warm 2 tbsp olive oil over medium heat. Add in the onion
    and salt and cook for 7-10 mins, stir occasionally until onions are translucent.
  2.  Add in the tomato paste, stir constantly, until fragrant (for about 30 seconds).
  3.  Add the tomatoes and vegetable broth and stir to combine. Bring to medium-high, and
    bring the mixture to a simmer. Cook for 30 minutes, reduce the heat as necessary to maintain a
    gentle simmer, stir occasionally. 
  4.  Next, remove the pot from the heat and let it cool for a few minutes. Carefully transfer the soup to a
    blender and add the beans, 1 tbsp olive oil, sugar, and several twists of black pepper. Blend the soup until smooth.  
  5.  Once blended, taste and add a little more sugar, pepper, and salt, as needed. 
  6.  Add in basil and blend into soup. Serve hot and enjoy!

You can keep the soup well for about four days in the fridge. Freeze leftovers for up to 3 months. Share your soup on social media and tag us @casespecificnutrition. If you’d like to speak with a dietitian about more nutritious recipes, email scheduling@casespecificnutrition.com! 

Anti-inflammatory foods

Anti-Inflammatory Foods & Reducing Stress

Written by: Ava Elliott, Marketing Intern and Future Dietitian

Reviewed by: Devon Kroesché, MS, RDN, LDN

I often hear others around me express stress whether involving schoolwork, a job, or personal matters. I get it. I get stressed out too, but how can we reduce daily stressors to prevent our bodies from initiating an innate inflammatory response? I will highlight examples of anti-inflammatory foods and lifestyle changes that can help you reduce stress and inflammation in your life.

First, let’s discuss the inflammatory process that occurs in our bodies. When there is an inflammatory response caused by cell injury, the body sends immune cells to the site of infection/trauma to clear it. The immune cells help return the affected site back to normal and reduce local inflammation. Anti-inflammatory substances released are part of a healthy immune response.

Do you know the difference between acute vs chronic inflammation? Acute inflammation occurs for minutes to hours and is involved with things like wound healing. Chronic inflammation occurs for weeks to months, and sometimes years. It can occur in diseases like rheumatic disorders, autoimmune diseases, and other chronic illnesses. Our bodies are not built to deal with chronic inflammation. Long term, chronic stress can suppress the immune system and lead to complications. By adding anti-inflammatory foods into your diet, you can counteract inflammation.

Nutrition and lifestyle can help reduce inflammation and lessen symptoms. Many phytonutrients and other micronutrients have anti-inflammatory properties. Phytonutrients also have antioxidant properties that help reduce oxidative stress. This reaction is important because damage from oxidative stress can lead to chronic diseases and cause damage to cells. Antioxidants act as a safety net from this damage.

  • Examples of anti-inflammatory nutrients include:
    • Curcumin (in turmeric) and black pepper combined
    • Polyphenols in green tea, blueberries, and capsicum peppers
    • Carotenoids:
      • Lycopene in tomatoes, peaches, watermelon
      • Beta-carotene in carrots, sweet potatoes, spinach, broccoli
      • Astaxanthin in salmon, algae, shrimp
    • Omega 3 fatty acids in foods like olive oil, canola oil, fatty fish (like salmon and tuna), flax seeds, chia seeds, walnuts, fortified foods
    • Some herbs and spices like garlic, cinnamon, rosemary, sage, thyme

As you can see, there are many plant foods that contain phytonutrients that can be beneficial for our bodies and help reduce inflammation. Following a dietary pattern high in fruits and vegetables, eating legumes, sources of omega-3s, low-fat dairy products, lean meats, whole grains, and minimal alcohol consumption can provide our bodies with the essential nutrients it needs. The Institue of Functional Medicine has a great resource of foods rich in phytonutrients displayed by eating a “rainbow.”

As far as lifestyle habits to reduce stress and inflammation, it is important to practice mindfulness, exercise, spend time outdoors, avoid processed foods, drink water, and eat a variety of nutrients (especially fruits and veggies). Other important factors include getting adequate sleep, avoiding foods if you have an allergy/intolerance, and reducing oxidative stress (limit toxins, smoking, and eat your anti-inflammatory foods). If you want to speak with a registered dietitian about incorporating more anti-inflammatory foods and practices into your lifestyle, please email scheduling@casespecificnutrition.com.

Sweet Potato Veggie Chili (2)

Sweet Potato Veggie Chili

Written by: Ava Elliott, Marketing Intern & Future Dietitian

Reviewed by: Devon Kroesché, MS, RDN, LDN

October has been beautiful in Pittsburgh so far with all the leaves changing and cool weather. It is a perfect time to make your favorite chili and soup recipes. Personally, I love making vegetable chili with sweet potatoes for me and my boyfriend; it has quickly become our favorite. We add different beans for protein, but you can also add lean ground beef or ground turkey for extra flavor. All the spices remind me of fall/winter and will create a delightful aroma in your kitchen.


What You’ll Need:

  • 1 medium onion, diced
  • 1-2 medium sweet potatoes, chopped
  • 1 can diced tomatoes, low sodium, 14 oz
  • 1 can crushed tomatoes, low sodium, 28 oz
  • 1 can black beans, rinsed, 15 oz
  • 1 can kidney beans, rinsed, 15 oz
  • 1 can corn, rinsed, 15 oz
  • 2 tbsp olive oil
  • 2 tbsp chili powder
  • 1 tbsp garlic powder
  • 2 tbsp ground cumin
  • ½ teaspoon cayenne pepper
  • ½ tsp salt
  • ½ tsp black pepper


What To Do:

  1. Add olive oil and onion to a large pot and heat for 2-3 minutes on medium-high heat. Cook until onions are translucent, stirring occasionally.
  2. Add the sweet potatoes to the pot and cook for 45 minutes, until softened. (Or microwave sweet potatoes for 15 minutes, then simmer in pot for 10-15 mins)
  3. Add in the spices: chili powder, garlic powder, cumin, cayenne, salt, and pepper. Stir into onion and sweet potatoes.
  4. Add diced and crushed tomatoes, beans, and corn. Stir and add in ½ cup water if mixture is very thick.
  5. Bring chili to a slight boil, then cook on medium-low for 25 minutes, uncovered. Stir occasionally.
  6. Once softened and flavors are combined, remove from heat and cool for about 5 minutes.
  7. Serve with fresh cilantro and sprinkle cheese, or any of your favorite chili toppings. Enjoy!


This meal is great on a cool, fall day. It provides many nutrients from vegetables and beans, and you can alter it with your other favorite chili ingredients, if desired. Sweet potatoes are a great source of fiber, potassium, and vitamin A. Try it out and let us know how it tastes! If you have questions or want to speak with a dietitian about more nutritious recipes, email scheduling@casespecificnutrition.com.

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Functional Movement Screen

Posted by: Ava Elliott, Marketing Intern and Future Dietitian

Hess Physical Therapy provides rehabilitation services in the west side of Pittsburgh. Their team of physical therapists uses a science-based approach to provide the utmost care for their patients. The following post is written by Jessica Homer, the Director of Operations, and her colleague about functional movement screening. Their services are similar to what Alex at Case Specific Athletics provides to the east side of Pittsburgh.



Functional Movement Screen

Written By: Jessica Homer, PT, DPT, COMT, HMS, OCS


Alex Kalmar, CSCS


What is the FMS?

The Functional Movement Screen (FMS) is a screening tool used to evaluate fundamental movement patterns that are necessary for an individual’s optimal performance. The FMS is designed to provide an individual with opportunities to improve movement and maximize their training results.  The screen is a series of movements that highlight dysfunction where stability and mobility deficits exist. Many individuals who perform weightlifting, sports, and other activities at high levels are limited in fundamental movement, thus increasing their risk for injury. The desire to perform quantity over quality results in compensatory movements to achieve or maintain the level of performance required for that activity. The use of compensation during movement will lead to poor biomechanics. This limits gains in performance and reduces the body’s ability to remain adaptable against the risks involved in that activity or sport.


Why FMS?

FMS screening will provide an individual with a personalized report on areas of weakness, asymmetries, and movement dysfunction that correlates with their activity of interest. These results will highlight ways to optimize and improve performance, maximize results, and ultimately decrease risk of injury! If you want to learn how to improve your performance, maximize your results and decrease risk of injury, you will want to get an individual FMS score!



FMS is a great tool to observe someone’s movement quality and highlight any asymmetries they may have. A key focus to proper training is to balance out any asymmetries. This helps mitigate compensatory movements due to strength or mobility imbalances, which will hopefully improve biomechanics and limit risk of injury in all populations.


So, before you begin developing your workout program, think about FMS! 

For functional movement screening in the North and West Sides of Pittsburgh, check out Hess Physical Therapy and their team at hesspt.com

For FMS on the East Side, reach out to Alex Kalmar of Case Specific Athletics at alex@casespecificathletics.com



Back to School 5-min Breakfasts

Written by: Ava Elliott, Marketing Intern and Future Dietitian

Reviewed by: Devon Kroesche, MS, RDN, LDN

The back-to-school rush is here. Whether you are getting ready for school, work, or getting your kids to school, the morning can be hectic. Often, we hear about meal prepping and meal planning, but what about a quick 5-minute breakfast? Count me in. Below are several options:

  1. Jimmy Dean’s Delights – breakfast sandwich or bowl
  1. Protein shake – enjoy your favorite protein powder in a shake with a banana and milk of your choice
  1. Overnight oats – This recipe is super easy because you combine all the ingredients in a mason jar and leave in the fridge overnight. In the morning, grab and go.

Make it unique! Here is my fav:

    • 1 cup rolled oats
    • ½ cup milk (I use oat milk)
    • ½ cup Greek yogurt
    • 1 banana, mashed
    • 2 tbsp peanut butter
    • ½ tsp cinnamon
    • 2 tbsp chocolate chips

You can also add honey, hemp seeds, chia seeds, or ground flax seeds for extra nutrients.

After discussing these quick recipes, can you think of any others? If you would like to schedule an appointment to speak with one of our dietitians about more quick recipes, email scheduling@casespecificnutrition.com


Does Cooking Food Make It Lose Its Nutrients?

Written by: Ava Elliott, Marketing Intern & Future Dietitian

Reviewed by: Devon Kroesche, MS, RDN, LDN


A common question registered dietitians receive is: does how we cook food alter its nutrient content and absorption? The short answer is, yes – the way food is prepared can maintain or decrease nutrient absorption, and in this article, I’ll explain why. 

The six main nutrient groups consist of carbohydrates, lipids/fats, proteins, vitamins, minerals, and water. All of these nutrients are essential to our bodies, and it is vital to maintain the highest nutrient content during the cooking process.  

Vitamins and minerals function as antioxidants and provide many essential nutrients. Foods with a high vitamin and mineral content include meat, dairy products, egg yolk, fermented foods, and plants. There are certainly many others, so it is important to eat a variety of foods during the day.  

Cooking methods and preparation time are priorities you may have while cooking. Nutrient-breakdown is another important factor to consider during cooking because not all cooking methods are created equal. The goal is to maintain the most nutrients. For a lot of vegetables, it is necessary to cook them to improve digestibility; the softening of cellulose structure increases nutrient absorption (like calcium, magnesium, and potassium.) Boiling and cooking reduces the nutrient content, but about 75% is retained. As you know, cook the veggies until they are softened and have a bright color.  

Keep in mind, the nutrients most susceptible to nutrient loss are water-soluble vitamins. Instead of cooking, you can buy/prepare frozen, canned, and dried fruits and vegetables that retain water-soluble vitamins. If you are trying to shop on a budget, frozen or canned produce are budget-friendly and still provide many nutrients. Frozen fruits and veggies undergo blanching (boiling and steaming for a short period of time) prior to freezing, which helps maintain the vitamin and mineral content. The USDA has a table of Nutrient Retention Factors if you are interested in the exact amount of 16 vitamins and 8 minerals maintained for around 300 foods.  

Other foods like meat and eggs are cooked to eliminate bacteria. Make sure you follow proper food safety methods and cook food to the correct temperature. For example, chicken and poultry should be cooked until they reach an internal temperature of at least 165 degrees Fahrenheit. When frying, roasting, or boiling chicken, 40% of folate is lost. Many other nutrients are retained, so it is not a concern. On the other hand, eggs on the stove (fried or scrambled) lose folate the most from the heat process as well as a few other vitamins like vitamin C and vitamin B12. About 75-85% of these nutrients are retained, however.  

Overall, the cooking process does alter nutrients because of the heat. But, as long as you prepare food safely and for the correct time, you can maintain the most nutrients. If you’d like to speak to a dietitian about the way you prepare your food, schedule an appointment by emailing scheduling@casespecificnutrition.com. 

Food and Wine:40 Recipes From 40 Years: Kimchi Collard Greens Photography: Greg Dupree, Food Styling: Maggie Ruggiero, Prop Styling: Thom Driver

Healthful Crab Cake

By: Ava Elliott, Marketing Intern & Future Dietitian

Reviewed by: Devon Kroesché, MS, RDN, LDN

As we near the beginning of fall, we are making our last-minute favorite summer recipes. This week, I want to highlight a healthful crab cake recipe courtesy of Andrew Wade, CEO of Case Specific Nutrition. Crab cakes remind me of sitting in a restaurant near the ocean with my family, enjoying the summer breeze, and eating fresh fish caught that day.


Crab cakes can be a great addition to your plate and a great source of protein: which is great for building and maintaining muscle, curbing your hunger, and is good for your bones, to name a few benefits. Crab cakes can provide high levels of omega-3 fatty acids, selenium, and vitamin B12 and this recipe can help you reach your nutrient needs. These nutrients help keep your heart and brain healthy, while providing energy. Here is what you’ll need and how to make these delicious crab cakes:


What You’ll Need:

    • 2 16oz containers lump crab
    • 1 cup egg beaters
    • 2 large whole eggs
    • ½ cup light mayo
    • 12 saltine crackers
    • 1 tbsp old bay


What to Do:

    1.   In a small bowl, combine egg beaters, eggs, mayo, and old bay seasoning into a bowl and whisk together.
    2.   In another bowl, stir crab and saltines. Fold mixture from step one into the bowl.
    3.   Roll into 4oz balls (size of applesauce cup).
    4.   Bake at 350 for 20-28 mins (depending on oven) until solidified.
    5.   Turn on broil for 3-5 min.
    6.   Let sit for 5-10 mins to cool.
    7.   Enjoy!


For more recipes, check out our blog or schedule an appointment to speak with a dietitian at scheduling@casespecificnutrition.com!



Upcoming at CSN…

Andrew Wade, MS, RDN, LDN, CSSD is hosting a talk on Thursday, August 25th at 7 pm free on Zoom! He will be discussing how to untrained your brain from the GRRRRR Cycle (Click the link to learn more!)

3 Things Your RD Wants You to Know Before Your First Appointment

3 Things Your RD Wants You to Know Before Your First Appointment

Written by: Ava Elliott, Marketing Intern

Reviewed by: Devon Kroesché, MS, RDN, LDN

It can be intimidating to schedule an appointment with your new healthcare provider. You are wondering what a registered dietitian (RD) can do. Rest assured that the RDs at Case Specific Nutrition (CSN) are here to help. To prepare for your first visit, here are a few things your RD wants you to know:

    1. You are courageous. I’m proud of you for realizing that you can’t do this alone and seeking out an expert health professional, rather than trying the trendy diet you saw on TikTok. It takes bravery to reach out, schedule an appointment, show up and be vulnerable because, let’s face it, food is personal.
    2. You won’t be judged. Dietitians are not the food police. I won’t judge you if you eat fast food every day or even if you want to KEEP eating fast food every day. If you’re not sure if you want to give up your current diet like keto or beach body, I will meet you where you are to help you achieve YOUR goals. I will give you my honest opinion, but you decide where we go from there.
    3. Your life is about to change forever. Once you start working with a dietitian, you’ll relate to food in a whole new way and finally understand the root of your eating behaviors. You’ll have an arsenal of knowledge and tools that you will be able to use to make informed food decisions for the rest of your life!

Working with an RD can be very impactful and bring peace to your body and mind. Whether you are struggling with food intolerances/allergies, disordered eating, or wanting peace with food, CSN has a dietitian that is right for you. If you are interested in scheduling an appointment, email scheduling@casespecificnutrition.com.

Upcoming at CSN…

RDN Devon Kroesché and Dr. Sobel are hosting A Midsummer Night’s Dream on August 11th at 7pm on Zoom! They will be discussing seasonal plant-based meal prep that is both affordable and easy for a busy household. Click the button to join the Zoom.

Picture from https://www.simplyhappyfoodie.com

Summer Protein Pasta Salad

Summer Protein Pasta Salad

Written by: Ava Elliott, Marketing Intern

Reviewed by: Devon Kroesche, MS, RDN, LDN

Picture from https://www.simplyhappyfoodie.com

We must challenge the perception that pasta is unhealthy or heavy. It can be very nutritious and a great option for meal prep or an easy-to-pack lunch. This simple yet nutritious recipe is perfect as a side dish or the star of a meal with family and friends. Using fresh vegetables that are in-season will pack the pasta salad with more flavor and brighter colors. Add more protein by using Banza chickpea pasta or Barilla protein pasta.

Growing up, I always craved pasta salad in the summer. I have a core memory of getting dropped off at a friend’s house in the summer after fourth grade and enjoying her mom’s “famous” pasta salad. Since then, I have asked my mom to create a version of it and now that I am older and cook for myself, I try to perfect the flavors. This recipe is very delicious, and you should add it into your summer rotation like I did.


What You’ll Need:

1 lb barilla protein pasta or Banza chickpea

lite or fat free Italian dressing, to taste (~1 cup)

¾ cup turkey pepperoni

1 cup mozzarella balls

1 cup each celery, cucumbers, peppers, onions, chopped


What to Do:

  1. Boil a pot of water and cook pasta as instructed from the package. Drain paste and rinse under cold water.
  2. Chop the vegetables and cheese. Also, chop the turkey pepperoni if desired.
  3. Add the dressing and turkey pepperoni, mozzarella, and vegetables to the pasta. Mix and add additional seasoning if necessary.
  4. Refrigerate for at least 30-60 minutes then serve.


Adding extra protein to your day can be helpful to meet your daily protein requirements. This recipe is protein-packed and will help you keep your muscles healthy, recover after exercising, and satisfy your hunger.

Please share with us your Summer Protein Pasta Salad on Instagram or Facebook and tag us @casespecificnutrition! As always, if you’d like to schedule an appointment to speak with one of our dietitians, email scheduling@casespecificnutrition.com.