🎧 Episode 12: Spotting the Signs – A Pediatrician’s Frontline Role in Eating Disorders

Guest: Dr. Gretchen Hoyle, MD, Pediatrician
Host: Matt Butterman
Duration: 30–40 minutes

Eating disorders often begin quietly—but their impact is serious and, in some cases, life-threatening. In this episode, host Matt Butterman speaks with returning guest Dr. Gretchen Hoyle about how pediatricians play a critical role in identifying eating disorders early and helping families take action before things become more severe.

While Dr. Hoyle is not an eating disorder specialist, her position on the front lines of pediatric care means she’s often the first professional to spot concerning patterns and refer families to appropriate treatment.

In this episode, we cover:

• 🚩 How eating disorders present in a primary care setting

  
  

• 🧠 The importance of early detection and trust in the pediatrician-family relationship

  
  

• ⚠️ Medical red flags that may signal the need for hospitalization (low heart rate, blood pressure, body temp, weight %iles, lab values, etc.)

  
  

• 🏥 What “refeeding syndrome” is and why it can be life-threatening

  
  

• 🏡 The difference between residential and outpatient care—and how treatment decisions are made

  
  

• 👨‍👩‍👧‍👦 The role of the care team: doctor, therapist, and nutritionist

  
  

• 💊 Medications sometimes used in treatment (SSRIs, hydroxyzine)

  
  

• 📈 What recovery looks like—and why early action matters

  
  

• 💬 Advice for parents who are worried about their child’s eating or behavior around food

Dr. Hoyle reminds us that families don’t need to have all the answers to take the first step. If you're concerned, bring it up with your pediatrician—it’s never too early to start asking questions.

Key Quotes:

“Most of the time, it starts when a parent says, ‘Something’s not right.’ They may not be able to name it—but they know.” — Dr. Gretchen Hoyle

“Recovery isn’t just about weight—it’s about mindset, function, and emotional health.” — Dr. Hoyle

Resources & Links:

• National Eating Disorders Association (NEDA)
  
  
• Veritas Collaborative – Residential and outpatient treatment programs

  
  

• The JAMA Pediatrics Study on ED Hospitalizations Post-COVID

  
  

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🎧 Nimble Youth – Episode 11

“The Absenteeism Spiral: Understanding and Addressing Chronic Absenteeism”
Guest: Dr. Gretchen Hoyle, Pediatrician

Chronic school absenteeism is surging—and it’s not just about skipping class. In this episode, pediatrician Dr. Gretchen Hoyle joins us to unpack the many factors driving today’s absenteeism crisis. From the long shadow of the pandemic to rising anxiety, screen-time habits, and shifting cultural norms, Dr. Hoyle shares practical insights for families navigating this complex issue.

Whether your child has begun missing days here and there or is already caught in a cycle of extended absences, this episode offers concrete strategies to help you intervene early, set clear expectations, and get back on track—without shame or panic.

🧠 What We Cover:

• What defines chronic absenteeism and why the numbers have spiked
• How post-pandemic routines and mental health struggles contribute
• Why keeping your child home “just in case” can backfire
• When a child is truly sick: the importance of limiting screen time during school hours
• How technology—especially phones—is affecting school engagement
• Why schools need support from parents on phone-free classroom policies
• What to do if physical symptoms mask deeper emotional or developmental concerns
• The role of pediatricians and therapists in breaking the cycle
• Encouraging embodied, in-person experiences that rewire motivation
• How schools are beginning to respond with community-focused solutions

🛠️ Takeaway Tips for Parents:

• Catch it early – Missing a few days can spiral into weeks. Treat even small patterns seriously.
• Stick to routines – Structure, morning rituals, and expectations help children feel safe and ready.
• Limit tech use at home – Especially during school hours, even when your child is sick.
• Support school phone policies – Unified messaging from parents and schools matters.
• Don’t wait for a diagnosis – Continue school attendance during medical evaluations when possible.
• Get help early – Therapists and pediatricians can uncover underlying issues and guide the next steps.
• Know you're not alone – Up to 1 in 4 kids may now meet the criteria for chronic absenteeism.

Chronic absenteeism isn’t a moral failing—it’s a warning sign. With empathy, clarity, and the right supports, families can help kids return to the classroom and thrive again.

🔗 Resources Mentioned:
Visit www.nimbleyouthpodcast.com for transcripts, past episodes, and links to related tools and references.

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Leave us a review, subscribe, and share this episode with a fellow parent, educator, or caregiver. Your support helps us reach more families with practical guidance and hope.

Episode 10: A Gut Feeling—Constipation, Anxiety, and ADHD in Children
Guest: Dr. Gretchen Hoyle

In this enlightening episode of Nimble Youth, pediatrician Dr. Gretchen Hoyle returns to tackle a topic that’s both common and frequently misunderstood: chronic constipation and stool withholding in children. What may seem like a simple digestive issue is often a complex interplay between physical discomfort, behavioral habits, and underlying mental health challenges such as anxiety and ADHD.

Dr. Hoyle unpacks how children can fall into a cycle of withholding stool—often due to discomfort, embarrassment, or fear—which leads to abdominal pain, functional constipation, and in some cases, encopresis (involuntary stool leakage). She explains how these physical symptoms are not always isolated but can be part of a broader mind-body connection, especially in children with diagnosed or emerging anxiety or ADHD.

Key Topics Covered:

• Why children may begin withholding stool and how it becomes a chronic issue

  
  

• The connection between constipation and mental health conditions like ADHD and anxiety

  
  

• Understanding the feedback loop between physical symptoms and emotional distress

  
  

• Dr. Hoyle’s step-by-step approach to treatment, including clean-outs, maintenance with MiraLAX, and behavioral retraining

  
  

• Practical toileting routines and environmental supports to prevent recurrence

  
  

• How parents, schools, and pediatricians can work as a team to support a child

  
  

• Screening for anxiety and ADHD when GI symptoms don’t resolve

  
  

• Why summer is the perfect time to build healthy bathroom habits before school resumes

  
  

Resources:

• Mind-Body Cycle of Constipation (Downloadable Graphic)

  
  

• SCAS (Spence Children’s Anxiety Scale) and other screening tools

  
  

• Sample letter for school to support flexible bathroom access

  
  

Quote of the Episode:
"For kids with anxiety or ADHD, constipation is rarely just about the gut—it’s about how the brain processes pain, embarrassment, urgency, and control. The good news? It’s highly treatable with a team approach." —Dr. Gretchen Hoyle

Next Episode Teaser:
Join us next time as we explore eating disorders in adolescents, debunking myths and examining the serious impact these conditions can have—regardless of gender.

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If this episode resonated with you or you know a family facing these challenges, please share it. You can find all past episodes, full transcripts, and helpful resources at www.nimbleyouthpodcast.com.