Eating Disorders

Eating Disorders in Teenagers

Eating disorders are not just about food, weight, appearance, or willpower; they are serious and potentially life-threatening illnesses. Young people with eating disorders see their self-worth largely in terms of their body shape and weight and their ability to control them. Most people with eating disorders are very distressed about their appearance, body shape, and weight, and this distress causes significant disruption to their lives. A lot of these concerns stem from media portrayals of thin models. We often internalize these model photos as what "beautiful" is and strive to look similar to them. Please watch the video above which illustrates how society alters photos through use of photoshop in order to create a look that is unrealistic.

A young person with an eating disorder can be underweight or overweight or fall within the healthy weight range.

Eating disorders affect 10 percent of the U.S. population.

Signs and Symptoms of Eating Disorders

Here are some common warning signs of eating disorders in teenagers:

• Extreme dieting behaviors
• Evidence of binge eating (e.g., disappearance or hoarding of food)
• Evidence of vomiting or laxative use on purpose (e.g. taking trips to bathroom during or immediately after meals)
• Avoids eating meals with family by claiming to have already eaten
• Has rigid patterns around food selection, preparation, and eating
• Avoids eating meal, particularly in a social setting
• Lies about amount and types of food consumed
• Has body-image focused behaviors
• Social withdrawal
• Extreme weight loss or weight fluctuations
• Changes or loss in periods due to low body fat % (in females)
• Swelling around cheeks or jaw; calluses on knuckles; dental discoloration from vomiting
• Depression, anxiety, or irritability
• Heightened anxiety around meal times
• Expresses extreme body dissatisfaction
• Denies having a problem
• Does not usually ask for help
• Is increasingly preoccupied with exercise
• Talks about fat; focuses on specific body parts
• Changes their clothing style to conceal weight changes

Anorexia Nervosa

People with anorexia nervosa may see themselves as overweight, even when they are dangerously underweight. People with anorexia nervosa typically weigh themselves repeatedly, severely restrict the amount of food they eat, and eat very small quantities of only certain foods. Anorexia nervosa has the highest mortality rate of any mental disorder. While many young women and men with this disorder die from complications associated with starvation, others die of suicide. In women, suicide is much more common in those with anorexia than with most other mental disorders.

Symptoms include:

• Focuses on body shape and weight as the main measure of self-worth
• Maintains a very low body weight
• Has an intense fear of gaining weight or becoming fat
• Has altered pattern of menstrual periods
• Extremely restricted eating
• Extreme thinness (emaciation)
• A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
• Fear of gaining weight
• Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight

Other symptoms may include (but are not limited to):

• Thinning of the bones (osteopenia or osteoporosis)
• Brittle hair and nails
• Dry and yellowish skin
• Severe constipation
• Low blood pressure, slowed breathing and pulse
• Brain damage
• Organ failure
• Lethargy, sluggishness, or feeling tired all the time

Bulimia Nervosa

People with bulimia nervosa have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behavior that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. Unlike anorexia nervosa, people with bulimia nervosa usually maintain what is considered a healthy or relatively normal weight.

Symptoms include:

• Focuses on body shape and weight as the main measure of self-worth
• Has repeated episodes of uncontrolled overeating (binge eating) for at least twice a week for three months or more
• Has extreme weight control behavior; such as, extreme dieting, frequent use of vomiting or laxatives to control weight, diuretic and enema abuse, excessive exercise
• Does not meet characteristics of anorexia
• Chronically inflamed and sore throat
• Swollen salivary glands in the neck and jaw area
• Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
• Acid reflux disorder and other gastrointestinal problems
• Intestinal distress and irritation from laxative abuse
• Severe dehydration from purging of fluids
• Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium and other minerals) which can lead to stroke or heart attack

Binge Eating Disorder

Binge-eating disorder is the most common eating disorder in the U.S.

People with binge-eating disorder lose control over his or her eating. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese.

Symptoms include:

• Eating unusually large amounts of food in a specific amount of time
• Eating even when you're full or not hungry
• Eating fast during binge episodes
• Eating until you're uncomfortably full
• Eating alone or in secret to avoid embarrassment
• Feeling distressed, ashamed, or guilty about your eating
• Frequently dieting, possibly without weight loss

Body Dysmorphia

Body Dysmorphia is also a serious disorder associated with eating disorders as well. Oftentimes individual see one thing in the mirror, when in fact that may not be true. For example, someone may dislike something about his/her appearance and they obsess and think about that imperfection, causing much distress. People with body dysmorphia focus so much on their appearance that they often have difficulties with social situations, work, school, and tend to have low self-esteem. Below is a picture example of what someone with body dysmorphia may experience.

Risk Factors

Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life. These disorders affect both genders, although rates among women are 2½ times greater than among men. Like women who have eating disorders, men also have a distorted sense of body image. For example, men may have muscle dysmorphia, a type of disorder marked by an extreme concern with becoming more muscular.

Treatment and Therapy

Adequate nutrition, reducing excessive exercise, and stopping purging behaviors are the foundations of treatment. Treatment plans are tailored to individual needs and may include one or more of the following:

• Individual, group, and/or family psychotherapy
• Cognitive Behavioral Therapy (CBT)
• Medical care and monitoring
• Nutritional counseling
• Medications

Most of the information for this page was gathered from: The National Institute of Mental Health.

Other Resources

National Association of Anorexia Nervosa and Associated Disorders: www.anad.org

National Eating Disorders Association: www.nationaleatingdisorders.org