The Future is Bright

An eating disorder took over April Lackpour’s life. Rady Children’s Medical Behavioral Unit helped her get it back.

By Lindsey Burke

Like many young women with their sights set on college, 15-year-old April Lackpour sought to be among the most appealing applicants. She was involved in sports and was thriving in academics. She took her studies seriously and was intensely focused on training for swim team and water polo. She was striving for fitness, yet paying extreme attention to maintaining a lean figure.

During the summer between her sophomore and junior years, April took part in an exchange program to Japan. There, she immersed herself in the Japanese language and culture while getting to know her host family. For the first time in her life, April was fully in control of her decisions.

“I was able to make choices for myself that I hadn’t made before,” she says. “I got to choose when to study and how much, but more important to me was what I could choose to eat and when. It was up to me, and the freedom felt powerful.”

April severely limited her food intake, partly to assert self-control and partly to fit in with the weight-obsessed culture of high school girls. Her food deprivation quickly reached dangerous levels—she was down to around 450 calories a day, and becoming increasingly obsessed with every bite.

With just one week left in the studyabroad program, April injured her hand. Her host family took her to a local doctor’s office, where she was asked to step on a scale. At 5-foot-3, she weighed barely 85 pounds. The physician, and her host family, were alarmed.

“We got the call that April was down to around 85 pounds and the family was concerned,” says Doug Lackpour, April’s father. “We talked with her and she admitted there was a problem with her food intake, but she wanted to stay in Japan to finish the program. Her mother and I were skeptical because it sounded like she was no longer capable of eating on her own. We were really worried.” Fearing that if they waited any longer she would be too frail to fly, April’s parents put her on the next flight home.

Back in San Diego, Doug and Melissa Lackpour were able to see just how serious their daughter’s eating disorder had become. “She would cry when food was put in front of her,” Doug says. “She knew she had to eat but couldn’t actually do it.” April was able to drink high-calorie nutritional beverages, but when faced with a slice of tomato, it took her an hour to finish.

“In my mind I was canceling out the medical side effects and havoc I was wreaking on my body and was celebrating being skinny,” April says. “I was fearful of macaroni and cheese. I couldn’t eat it. Even just looking at it gave me anxiety. I knew I needed help.”

Her parents agreed. They called a residential eating disorder clinic for women, but during her preadmission screening, nurses discovered April’s heart rate was perilously low and sent her to a local emergency room. April’s high-stakes dieting had taken a dangerous toll.

The hospital’s physicians weren’t equipped to treat an adolescent with an eating disorder. They stabilized April medically by placing a feeding tube to deliver essential nutrients, then recommended she be transferred to Rady Children’s Hospital-San Diego, where pediatric experts could care for her medically and emotionally. “I weighed so little and I was having a hard time coping with everything. I was knocking on death’s door,” April says. “Luckily, Rady Children’s took me in.”

April was admitted to Rady Children’s Medical Behavioral Unit, the only child and adolescent medical/behavioral in patient unit in San Diego. She spent two weeks undergoing intensive psychological and nutritional counseling, along with medical and psychiatric monitoring.

Elevating Care for Eating Disorders

There is a growing understanding of the way powerful brain processes contribute to behaviors that create and sustain eating disorders. Such knowledge has resulted in eating disorders being reclassified as biologically based brain disorders. However, relatively little has been done to apply new understanding of biology to develop more effective treatment—until now.

Experts at Rady Children’s Medical Behavioral Unit and the UC San Diego Eating Disorders Center for Treatment and Research use approaches based on this new knowledge—and are getting excellent results. This includes helping children and adolescents with eating disorders learn to be successful in a real-world environment by teaching them—and their families—effective support strategies.

Specialized, family-based treatment emphasizes an active and positive parental role to help restore the child’s weight, hand control over eating back to the child and encourage normal development through discussion of crucial issues. As a result, patients come to the program from across the country and around the world.

Another significant aspect of the Rady Children’s program is a daily meeting with the entire treatment team, which assesses the patient holistically. “Our multidisciplinary team includes medical doctors and nurses who specialize in eating disorders, as well as psychologists trained in family-based therapy treatment,” says Benjamin Maxwell, MD, medical director for Rady Children’s Inpatient Psychiatry. Close collaboration with the UC San Diego Eating Disorders Center allows a patient to receive inpatient care at Rady Children’s, in conjunction with partial hospital or outpatient care at UC San Diego. “This arrangement is purposeful,” Dr. Maxwell explains, “because there is no inpatient model that will solve all of the problems a patient will face when they leave the hospital.”

Her Journey Continues

Armed with techniques for managing her eating disorder and a dedication to always improving her mental health, April, now 21, still sees a therapist for a recent diagnosis of schizoaffective disorder, a chronic mental health condition that includes symptoms of schizophrenia, such as hallucinations or delusions, and symptoms of a mood disorder, such as mania and depression.

She was cared for at a local psychiatric hospital and then attended an outpatient treatment program for individual and group therapy. She shares her story broadly in hopes of reducing the stigma attached to mental and behavioral health treatment. “Sometimes people judge you for seeking mental healthcare, but even my therapist has a therapist,” she says. “I don’t go into every session with a big issue, but I find comfort in having someone who isn’t judging me in any way, and whom I can speak freely with. I am a work in progress and while a lot of my advocacy is for myself, if I can help just one person get the help they need, this intense journey will have been worth it.”

April’s parents are proud of her accomplishments; they watch as she continues therapy and learns to assert her independence while growing and defining herself. “This is my path now,” April says. “Mental healthcare will always be a part of me. My story doesn’t end where you think it ends. My story continues.”

Originally published in the Summer 2018 edition of Healthy Kids Magazine.