Holistic Pediatric Eating Disorder Treatment at Sheba

The clinic brings together five distinct arms of care: an outpatient clinic, day hospitalization, an inpatient ward, community-based care, and a dedicated consultation service embedded within Sheba’s pediatric wards, allowing patients and families to transition between care intensities as needs change rather than starting the process over repeatedly.

This integrated, family-centered model, characteristic of all areas of practice overseen by Dr. Adi Enoch-Levy, Director of the Department for Eating Disorders in Children and Adolescents, has helped strengthen Sheba’s reputation for translating medical advances into better outcomes, contributing to its recognition as one of the world’s best hospitals for eight consecutive years by Newsweek.

One Roof, No Gaps

A young patient’s path through eating disorder treatment can present considerable challenges. A stay in the inpatient ward might give way to day hospitalization, then outpatient follow-up, or a patient might need psychiatric input before they ever reach a specialized clinic. The framework of care is structured around that reality: all arms of care sit under one clinical roof, so a change in what a patient needs doesn’t mean a new waiting list or a new team learning their case from scratch.

That is critical at the exact moments when continuity is easiest to lose. Progress made during a higher level of care, like an inpatient stay, can unravel during the gap before day treatment or outpatient follow-up begins, a risk the program’s structure is built to close. A rapid-intervention team extends that same logic into the Edmond and Lily Safra Children’s Hospital’s general pediatric wards, bringing together a physician specializing in adolescent medicine, a youth psychiatrist, and a dietitian to assess and treat eating disorder complications dynamically as soon as they surface in a clinical setting and route each case to whichever setting fits it best.

Behind every arm of this structure sits an interdepartmental team made up of clinicians spanning pediatricians to psychiatrists and educators, all working from a shared understanding of each patient rather than separate ones.

Matching the Treatment to the Child

Every child with an eating disorder comes to the clinic with a unique story, so experts at the Edmond and Lily Safra Children’s Hospital draw from a wide array of evidence-based protocols when designing pediatric care pathways. These can range from family-based treatment, mentalization based therapy, eating disorder-focused cognitive-behavioral therapy (ED-CBT) and eating disorder-focused dialectical behavior therapy (ED-DBT), radically open dialectical behavior therapy (RO-DBT), and supportive parenting for anxious childhood emotions (SPACE); methods are chosen and combined based on what each patient actually needs rather than defaulting to a single protocol across the board.

That flexibility carries particular weight when it comes to ARFID (avoidant/restrictive food intake disorder), a diagnosis the clinic has built specific expertise around. Unlike more commonly recognized eating disorders such as anorexia or bulimia, ARFID is not rooted in body image concerns and can affect children at a much younger age—sometimes as early as infancy. Treatment is grouped by age, with psychoeducation for parents, joint parent-child sessions for younger children, and peer groups for older children and teens available.

This integrated spectrum of care changes what ARFID recovery can look like; as Senior Physician Dr. Dan Farbstein explains, “By integrating cognitive-behavioral approaches with art and movement therapies, children learn to recognize hunger and satiety cues, understand their diagnosis, and overcome fears associated with eating. Learning alongside peers with similar challenges creates a therapeutic environment where children encourage one another to try new foods and build healthier eating behaviors.”

For families of children with more severe ARFID, the clinic has also introduced SPACE-ARFID, a newer approach that works through the parents rather than the child directly. Rather than asking parents to enforce new eating behaviors, it teaches them to respond to their child’s difficulties with support instead of accommodation, addressing the patterns at home that can unintentionally keep a restrictive eating pattern in place.

Going Toward Behavior’s Roots

Alongside its clinical programs, the eating disorders array functions as a research hub, running studies in partnership with universities in Israel and abroad. One line of inquiry is currently studying the microbiome, tracking how its makeup shifts over the course of treatment and what that might reveal about recovery itself. 

A parallel study examines how personality disorders co-occur with eating disorders within the inpatient population, work aimed at understanding why some cases resist treatment more than others. On the outpatient side, researchers are also testing how well SPACE performs specifically for children with severe ARFID, building an evidence base for a treatment approach still relatively new to the field.

None of this sits apart from day-to-day care. Findings move directly into how the clinic treats patients, refining which approaches get used, and for whom, as the underlying science develops.

Recovery Beyond the Chart

Medical stabilization is a milestone in eating disorder treatment and not the finish line. The Pediatric Eating Disorders Clinic treats the whole family as part of the recovery process, using parent guidance and family therapy to work through the relational and emotional pressures that often surround, and sometimes feed, a child’s eating disorder. Strengthening that parent-child relationship is treated as part of the treatment itself, not a separate support offered alongside it.

Recovery is also measured by how much of a child’s everyday life stays intact. A dedicated school framework keeps patients connected to their education throughout treatment, so a hospitalization or day program doesn’t mean falling behind or losing touch with their classmates. Group therapy, movement therapy, and peer support round out that picture, giving children space to rebuild confidence and connection alongside the more clinical work of recovery.

The goal, ultimately, isn’t just a child who eats safely again. It’s a child who returns to growing, learning, relating to the people around them, and the parts of childhood an eating disorder tends to interrupt first.

Care Built to Last

What defines the Edmond and Lily Safra Children’s Hospital’s approach to eating disorders within Sheba Psychiatry isn’t any single program or protocol, but the refusal to treat them as separate. Full-spectrum care, tailored innovation, active research, and a the family’s own involvement all feed into the same outcome rather than running as parallel efforts. That integration helps sustain a child’s recovery after leaving the clinic, rather than supporting them only for the duration of treatment.