Teenage Eating Disorders

Eating disorders affect people of all ages, but are especially prominent among teenagers.

Teen Eating Disorders
The Massachusetts Eating Disorders Association cites the following statistics on teen eating disorders:
  • 15% of women 17 to 24 have eating disorders
  • 40% of teenage females have eating disorders
  • 91% of female teenagers have attempted to control their weight through dieting

While recent information is not available, experts say the incidence of teen agers with eating disorders among males is also increasing. According to one study on teen age eating disorders, 5% to 20% of college females and 1% to 7% of college males have eating disorders (Johnson & Connors, The Etiology and Treatment of Bulimia Nervosa, 1987).

Diagnosing Teen Age Eating Disorders

The earlier eating disorders are diagnosed in the teen age years and treated, the more likely it will be that they will recover completely. And yet many teenagers do not receive treatment for their eating disorders until their illness is at an advanced stage.

At that point, teenagers, like other patients, may already have, or may be at risk of having, a serious medical condition. Teen age eating disorders can damage almost every organ system or body part, including the brain, liver, kidneys, heart, GI tract, bones, teeth, skin and hair. If left untreated, teen eating disorders can result in osteoporosis, retarded growth, kidney problems, ulcers and heart failure. Teen age eating disorders can also lead to death.

So why aren’t teen age eating disorders diagnosed earlier? One reason is that teenagers with eating disorders often try to hide them. Teenagers with eating disorders – and their family and friends – may be in denial about their eating disorders, or may simply be unaware of the signs of eating disorders.

Another reason is that many teenagers who have eating disorders are not people we would think of as having eating disorders. We’ve come to think of eating disorders as affecting young women, yet they are increasingly common in males as well as females, and in people of all ages, from pre-teens to seniors. While teenagers are especially at risk, eating disorders are increasingly common even in pre-teens.

The more a teen knows about eating disorders, the better they will be able to determine whether they, family members or friends have eating disorders.

Types of Teen Age Eating Disorders

The most common teen age eating disorders are anorexia, bulimia and binge-eating disorder. Most patients do not meet all of the clinical criteria for their eating disorders.

Even if they have some of the symptoms or come close to meeting the criteria, they should seek medical treatment.

Anorexia Among Teenagers

The clinical definition says teenagers suffering from anorexia are at 85% or less of their ideal body weight.

Teenagers with anorexia may take extreme measures to avoid eating. Teenagers often become abnormally thin – and still talk about feeling fat or bloated. Because they have a distorted image of their body, they typically continue to diet even when they are severely underweight. Signs of anorexia include:
  • An intense drive for thinness
  • Refusal to maintain a minimal normal weight
  • Fear of becoming fat
  • Distorted body image
  • Denying feelings of hunger
  • Avoiding situations where food in involved
  • Developing rituals around preparing food and eating
  • Obsession with dieting
  • Social withdrawal
  • Pronounced emotional changes, such as irritability, depression and anxiety
  • Thinning hair; dry, flaky skin, and cracked or broken nails.
  • Woman with anorexia often stop menstruating

In spite of dieting, people with anorexia are typically preoccupied with food, cooking, nutrition and the number of calories in each meal.

A teenager with anorexia nervosa is often a perfectionist or high achiever in school. Despite his or her high performance, a teenager with eating disorders suffers from low self-esteem, irrationally believing she or he is fat regardless of how thin she becomes.

Desperately needing a feeling of mastery over her or his life, the teenager with anorexia nervosa experiences a sense of control only when she or he says “no” to the normal food demands of her or his body. In a relentless pursuit to be thin, the teen starves – often reaching the point of serious damage to the body, and in a small number of cases leading to death.

Bulimia Among Teenagers

The clinical diagnosis defines a person as having bulimia if she or he binges and purges several times a week for at least three consecutive months.

A binge is the consumption of a large amount of food within a short period of time. Purging is forced vomiting. Teenagers with bulimia may use other methods to compensate for their binging and control their weight, such as excessive exercise, or use of laxatives or diet pills.

Teenagers with binge eating disorder often consume huge quantities of high-caloric food and/or purges her or her body of calories by self-induced vomiting and often by using laxatives. These binges may alternate with severe diets, resulting in dramatic weight fluctuations.

Teenagers with bulimia can frequently hide the signs of throwing up by running water while spending long periods of time in the bathroom.

Physical signs may include swollen glands, discolored teeth and calluses on the hands caused by self-inducing vomiting, staining or deterioration of tooth enamel; broken blood vessels around the eyes; stomach pain, and weakness or fatigue. Woman with bulimia often stop menstruating.

Teenagers with bulimia are always extremely concerned with their body weight and shape, and they may have a distorted image of their body. Teenagers may create complex schedules to make time for binging and purging. Teenagers are often socially withdrawn, depressed, severely self-critical and obsessed with weight loss and controlling what they eat. Other signs may include:
  • Hiding of food
  • The frequent presence of a large number of food containers and wrappers
  • The frequent smell of vomit
  • Frequent trips to the bathroom after meals
  • Excessive use of diuretics
  • Going to the kitchen frequently when everyone is sleeping
  • Excessive, rigid exercise

The purging of bulimia presents a serious threat to the patient’s physical health, including dehydration, hormonal imbalance, the depletion of important minerals, and damage to vital organs.

Binge-Eating Disorders Among Teenagers

Binge eating disorder, as the name implies, is characterized by uncontrollable, excessive eating, followed by feelings of shame and guilt. Unlike those with bulimia, teenagers with binge-eating disorder typically do not purge their food. However, many teenagers who have bulimia also have binge-eating disorder.

Teenagers with binge-eating disorder typically are overweight or obese. Teenagers feel like they have no control over their behavior, and eat in secret and when they are not hungry. Teenagers also feel shame and remorse over their behavior. Teenagers may hide food. Excessive amounts of food containers and wrappers are also evidence of binging. Other signs include:
  • Eating in secret
  • “Grazing” continuously without feeling satiated
  • Eating when stressed or when feeling uncertain how to cope
  • Feeling unable to control how much they eat
  • Experimenting with different diets

Helping Teenagers With Eating Disorders

Teenagers with eating disorders often have other psychiatric disorders; most commonly, mood and anxiety disorders. Teenagers may have obsessive-compulsive disorder or tendencies, and may also suffer from trauma or substance abuse, or engage in self-harming behavior, such as cutting or burning themselves. It is important to recognize and get appropriate treatment for these co-occurring problems as well.

Remember, that the longer an eating disorder goes untreated, the more advanced it is likely to become – and the more difficult it will be to achieve full recovery. Parents who notice symptoms of anorexia or bulimia in their teenagers should ask their family physician or pediatrician for a referral to a child and adolescent psychiatrist.

With comprehensive treatment, most teenagers can be relieved of the symptoms or helped to control eating disorders. Treatment for eating disorders usually requires a team approach; including individual therapy, family therapy, working with a primary care physician, working with a nutritionist, and medication.

If you know a teenager with an eating disorder, or believe that you or a loved one have an eating disorder, do something about it. Seek professional counseling immediately. Call your primary care physician or an eating disorders treatment program in your area.