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Shelly Bar MD

Eating Disorder Specialist
Internal Medicine & Adolescent Medicine

Outpatient Treatment:
📍 Los Angeles & Newport
💻 Telehealth medicine

09/04/2026

Why does your eating disorder treatment team check your heart rate and blood pressure when you stand up?

That’s orthostatic monitoring and it can provide important information about how your body is responding to changes in nutrition, hydration, and overall medical status.

Checking orthostasis isn't about “looking for something wrong.” It’s about understanding what your body is communicating and helping keep you medically safe throughout recovery.

If you experience dizziness, fainting, chest pain, shortness of breath, or a racing heartbeat, let your healthcare team know.

Reference:
Tanner, A. B. (2023). Unique considerations for the medical care of restrictive eating disorders in children and young adolescents. Journal of Eating Disorders, 11(1), 33. https://doi.org/10.1186/s40337-023-00759-2

09/02/2026

When phosphorus levels are too low or too high, it’s worth taking a closer look at what may be happening in the bigger picture.

Phosphorus should be interpreted alongside other labs, symptoms, nutrition, medications, and other objective and clinical findings.

Check the number. Consider the context. Look at the whole person.

If you have questions about your lab results, talk with your healthcare provider for individualized guidance.

Reference:

Trapani, S., & Rubino, C. (2025). Medical complications of anorexia nervosa. Pediatrics, 156(2), e2024070304. https://doi.org/10.1542/peds.2024-070304

08/26/2026

𝗗𝗼 𝘆𝗼𝘂 𝗳𝗶𝗻𝗱 𝘆𝗼𝘂𝗿𝘀𝗲𝗹𝗳 𝗯𝗮𝗿𝗴𝗮𝗶𝗻𝗶𝗻𝗴 𝘄𝗶𝘁𝗵 𝘆𝗼𝘂𝗿 𝗰𝗵𝗶𝗹𝗱 𝗮𝗯𝗼𝘂𝘁 𝗳𝗼𝗼𝗱 𝗮𝘁 𝗺𝗲𝗮𝗹𝘁𝗶𝗺𝗲𝘀?

When the eating disorder speaks loudly at the table, parents don’t have to speak louder.

Sometimes, the most therapeutic response is calm, compassionate, and consistent.

Rather than negotiating every change, parents can acknowledge the emotion, stay connected, and remain grounded in the treatment plan.

Parents can understandably feel pulled toward fixing the distress immediately. But parental empowerment does not mean having the perfect response or eliminating every difficult moment.

Parents can acknowledge how difficult recovery feels without allowing the eating disorder to determine the next step. Connection and boundaries can coexist. ❤️👨‍👩‍👧

References:
Bédard, A., Côté, M., Meilleur, D., Di Meglio, G., Gingras, N., Pesant, C., Taddeo, D., Bélanger, R., Thibault, I., Nadeau, P.-O., Agostino, H., Stheneur, C., Frappier, J.-Y., & Bégin, C. (2025). Mother–Father distress, accommodation, and child eating disorder behaviors: A dyadic perspective. Family Process, 64(3), e70070. https://doi.org/10.1111/famp.70070

Kumar, A., Himmerich, H., Keeler, J. L., & Treasure, J. (2024). A systematic scoping review of carer accommodation in eating disorders. Journal of Eating Disorders, 12, 143. https://doi.org/10.1186/s40337-024-01100-1

08/21/2026

Are you functioning—or just pushing through?

With an eating disorder, showing up to school or work does not necessarily mean someone is doing well. Presenteeism can look like meeting deadlines, attending class, or getting through a shift while struggling with exhaustion, cognitive symptoms, emotional distress, or the constant effort of managing the illness.

You don’t have to “look sick” to be struggling. And you don’t have to stop functioning for your health to matter.

Recognizing the effort beneath the performance can be an important part of early intervention and compassionate care.

Reference:

Gallagher, L., Allen, K. L., & Schmidt, U. (2026). Evaluating the impact of eating disorder early intervention on young people's work, education and social functioning. European Eating Disorders Review, 34(1), 288–295. https://doi.org/10.1002/erv.70029

08/19/2026

An eating disorder diagnosis should never be dismissed—or assumed to be "just part of" a child's neurodevelopmental condition.

While neurodivergent individuals may experience unique feeding or eating challenges, clinically significant eating disorders can also occur and deserve timely recognition, compassionate assessment, and evidence-based treatment.

Not every eating disorder presents in the same way. Remaining open-minded and recognizing that every individual deserves to have their concerns understood helps ensure that no one is overlooked.

References:
Bertelli MO, Paletti F, Piva Merli M, Hassiotis A, Bianco A, Lassi S. Eating and feeding disorders in adults with intellectual developmental disorder with and without autism spectrum disorder. J Intellect Disabil Res. 2025 Feb;69(2):153-164. https://doi.org/10.1111/jir.13195

Sader, M., Weston, A., Buchan, K.,Sader, M., Weston, A., Buchan, K., Kerr-Gaffney, J., Gillespie-Smith, K., Sharpe, H., & Duffy, F. (2025). The co-occurrence of autism and avoidant/restrictive food intake disorder (ARFID): A prevalence-based meta-analysis. International Journal of Eating Disorders, 58(3), 473–488. https://doi.org/10.1002/eat.24369

08/13/2026

Could an eating disorder leave clues before anyone notices?

For many children and adolescents, the answer may be yes.

Routine growth monitoring is often viewed as part of preventive pediatric care—but it can also provide valuable clinical context when concerns arise. Research suggests that changes in a child's expected growth trajectory may precede the recognition of eating disorder symptoms by caregivers, highlighting the importance of looking at patterns over time, not just a single weight measurement.

Current clinical guidelines support incorporating longitudinal growth charts into a comprehensive eating disorder assessment. At the same time, they emphasize that growth charts are not diagnostic. Eating disorders occur across all body sizes, and no single measurement (including weight or BMI) can confirm or exclude an eating disorder.

Early recognition comes from putting the whole picture together: growth history, nutrition, eating behaviors, physical health, psychological symptoms, and developmental context.

The goal isn't to label children by a number; it's to recognize changes early, ask thoughtful questions, and ensure timely, compassionate care.

This post is for educational purposes only and is not intended to replace professional medical advice or evaluation.

References:

Marion, M., et al. (2020). Earlier diagnosis in anorexia nervosa: Better watch growth charts! Journal of Eating Disorders, 8, Article 44. https://doi.org/10.1186/s40337-020-00321-4

Hornberger, L. L., & Lane, M. A., on behalf of the American Academy of Pediatrics, Committee on Adolescence. (2021). Identification and management of eating disorders in children and adolescents. Pediatrics, 147(1), e2020040279. https://doi.org/10.1542/peds.2020-040279

Society for Adolescent Health and Medicine. (2022). Medical management of restrictive eating disorders in adolescents and young adults. Journal of Adolescent Health, 71(5), 648–654. https://doi.org/10.1016/j.jadohealth.2022.08.006

08/04/2026

Do you wake up tired no matter how much you rest?

Constant low energy isn't always explained by a busy schedule or poor sleep.

Feeling physically drained all the time can be a medical symptom, not a measure of determination or willpower. This can leave even simple daily tasks feeling overwhelming.

If this sounds familiar, a comprehensive evaluation by a healthcare professional experienced in eating disorders can help identify the underlying cause and guide appropriate treatment.

Reference:
Haines, M. S. (2023). Endocrine complications of anorexia nervosa. Journal of Eating Disorders, 11, Article 24. https://doi.org/10.1186/s40337-023-00744-9

08/03/2026

As we read studies like this, it's heartbreaking to reflect that these experiences are still happening today.

Friendship is often one of the quiet losses that isn't talked about enough in eating disorder recovery.

If you're feeling disconnected, we hope you remember this: friendship doesn't always look the way you imagined. Sometimes it's the cousin who checks in, your mom who cautiously asks, the healthcare provider who listens, the person you meet in recovery, or the once-stranger who becomes a safe place. The people meant to walk alongside you will meet you with compassion, not perfection.

And if you're a friend of someone living with an eating disorder, don't underestimate the value of your presence. You don't need to know exactly what to say or do. Simply checking in, staying curious, and reminding them they're not forgotten can offer comfort during a time when they may feel most alone.

Connection is a powerful part of recovery. Let’s build a culture of support. 🤍 🫂

Reference
Patel, K., Tchanturia, K., & Harrison, A. (2016). An exploration of social functioning in young people with eating disorders: A qualitative study. PLOS ONE, 11(7), e0159910. https://doi.org/10.1371/journal.pone.0159910

07/30/2026

DEXA scan is the most accurate way to check bone density.

But identifying low bone density is only one piece of the puzzle.

If a DEXA scan shows osteopenia or osteoporosis, it's equally important to understand why it developed in the first place. Simply treating the bone loss without addressing the underlying cause may allow it to continue progressing.

Early detection matters. If you or someone you know is living with an eating disorder, don't wait for symptoms. Bone loss can develop silently, making timely evaluation and treatment an important part of recovery.

References:

Misra, M., Golden, N. H., & Katzman, D. K. (2016). State of the art systematic review of bone disease in anorexia nervosa. International Journal of Eating Disorders, 49(3), 276–292. https://doi.org/10.1002/eat.22451

Misra, M., Aggarwal, A., Miller, K. K., Almazan, C., Worley, M., Soyka, L. A., Herzog, D. B., Klibanski, A., & Katzman, D. K. (2004). Effects of anorexia nervosa on clinical, hematologic, biochemical, and bone density parameters in community-dwelling adolescent girls. Pediatrics, 114(6), 1574–1583. https://doi.org/10.1542/peds.2004-0542

Misra, M., & Klibanski, A. (2011). Bone health in anorexia nervosa. Current Opinion in Endocrinology, Diabetes and Obesity, 18(6), 376–382. https://doi.org/10.1097/MED.0b013e32834b4bdc

Misra, M., & Klibanski, A. (2011). Bone metabolism in adolescents with anorexia nervosa. Journal of Endocrinological Investigation, 34(4), 324–332. https://doi.org/10.3275/7505

07/13/2026

There are countless reminders we could give you today, but more importantly, we hope you don't postpone your life while waiting for your body to feel "ready."

Go ahead—wear the swimsuit.

You deserve to experience summer—not someday, but today. 🌊🤍

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10309 Santa Monica Boulevard, Suite 300
Los Angeles, CA
90025

Opening Hours

Monday	9am - 5pm
Tuesday	9am - 5pm
Wednesday	9am - 5pm
Thursday	9am - 5pm
Friday	9am - 5pm

Telephone

+13104319208

Website

https://www.shellybarmd.com/

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