According to the National Eating Disorders Association (NEDA), as many as 10 million females and one million males in the United States are struggling with eating disorders.
It may begin subtly enough. Your teenage daughter starts concealing her body beneath several layers of clothes. Your teenage son becomes obsessed with exercise and weight lifting. Perhaps you find packages of laxatives in your teen’s room. Or maybe your daughter no longer wants to eat with the family when you order pizza—a weekly ritual that she used to love. You may think that your son or daughter is just “going through a phase.” After all, the teenage years are a turbulent time, and teens seem to change their moods and behaviors from day to day. But don’t be so quick to dismiss any unusual occurrences as passing phases. All of these behaviors are red flags and may be signs that your teen is struggling with an eating disorder.
Many people believe that eating disorders are not “real” illnesses or that they are just fads. Others acknowledge that the illnesses are serious, but they believe that such conditions only affect females.
“There are many misconceptions regarding eating disorders,” says Dr. Ovidio Bermudez, Medical Director of Child and Adolescent Services for Eating Recovery Center in Denver, Colo. “Researchers are still learning and accumulating information. We know more now than we did 10 years ago, but there is still much we don’t know, still much more we need to learn. However, we do know that everyone is at risk. Eating disorders affect people of all races and ethnicities. And they don’t just affect girls and young women. They also affect children, older women and men.”
According to the National Eating Disorders Association (NEDA), as many as 10 million females and one million males in the United States are struggling with eating disorders, such as anorexia, a condition involving self-starvation and dramatic weight loss, and bulimia, a condition involving binge eating followed by purging (vomiting, abusing laxatives or exercising excessively) to eliminate the calories consumed. Data provided by NEDA indicates that the peak onset for eating disorders occurs during puberty and the late teen/early adult years, but symptoms can appear as early as age five. Although anorexia and bulimia are the most well-known eating disorders, disordered eating encompasses a large spectrum, and there are other types of eating disorders.
Eating disorders are serious, life-threatening illnesses that cause physical and emotional problems and require treatment by a team of professionals, including physicians, nutritionists and therapists. So if you notice that your teen is engaging in unusual or suspicious behaviors or acting secretively, you must reach out to him or her immediately. If detected early, the illness responds better to treatment, potentially resulting in a quicker recovery.
Some signs that your teen may be anorexic include dramatic weight loss (and attempts to hide his or her body under layers of clothes), preoccupation with weight, food and calories, obsession with gaining weight, anxiety about being “fat,” excessive exercise, refusal to eat certain foods (that perhaps used to be favorite foods), denial of hunger and withdrawal from friends or social activities, such as eating at restaurants.
Signs of bulimia include secrecy and frequent episodes of bingeing and purging. You might notice your teen making frequent trips to the bathroom, smell vomit in the bathroom or find laxatives hidden in his or her room. Other signs to look for include obsession or anxiety about being “fat,” excessive exercise, swelling around the jaw line (from purging) or calluses on the hands and knuckles (from vomiting).
Although the warning signs are generally the same for females and males, teenage boys who have a distorted body image may become preoccupied with exercise, including body building and weight lifting. They might also use muscle-building drinks and supplements—or even resort to steroids—in an attempt to achieve what they perceive to be the “perfect” body. Such behavior is especially common in young male athletes.
“As a parent, you really have to look critically for the signs,” says Ann Caldwell, R.D., L.D.N., nutrition services coordinator at Anne Arundel Medical Center. “Be vigilant. Since bulimia involves secrecy, you’ll have to look harder for the signs. Anorexia is a little easier to detect. If you suspect something is going on, trust your instincts. Trust your ‘parental’ gut.”
Factors That Can Contribute to Eating Disorders
Although eating disorders may begin with a preoccupation with food or weight, they often occur as a result of issues much more serious than food. Many teens use food in an attempt to gain control over life circumstances that are difficult or seem overwhelming. Eating disorders are extremely complex and involve a combination of psychological, emotional, social, biological, familial and societal factors. In some cases, another underlying mental illness can lead to an eating disorder. Children with certain personality traits, such as hypersensitivity, perfectionism or resistance to change, might be more likely to develop eating disorders. The illness may also result from feelings of low self-esteem, anxiety or depression or in response to problems at home or school.
Social networking sites and the media might also play a role. Teens can use Facebook to post photos or negative messages about their peers, causing feelings of low self-worth. And the media often portrays unrealistic images of beauty and promotes specific body types as “ideal,” furthering the notion that being thin is beautiful and putting pressure on teens to attain impossible standards.
“Society praises ‘thinness,’ so children with eating disorders think they’re successful,” says Sharon R. Peterson, LCSW-C, founding director of the Eating Disorder Network of Maryland in Towson and a therapist in private practice who specializes in treating eating disorders. “They are manipulating their eating habits in an attempt to be thin and have the ‘ideal’ body. But genetics dictate size, and not everyone can be a size zero. Children with eating disorders think they’re coping well, but they aren’t. Their behaviors are self-destructive, and they’re using the eating disorder to feel in control.”
Clearly, eating disorders are not black-and-white issues, and they are caused by a myriad of factors. Your teen’s genetic makeup may even predispose him or her to an eating disorder. According to NEDA, researchers are investigating possible biochemical causes that involve chemical imbalances in the brain. In addition, eating disorders may run in families; research indicates that genetics play a role.
“The old philosophy regarding eating disorders was that they were caused by emotional or social factors,” says Bermudez. “But when it comes down to the age-old question of nature versus nurture, the answer for eating disorders is actually ‘both.’”
Health Issues and Complications
Since eating disorders are so detrimental to the body, they can cause a variety of medical problems. Complications of anorexia include slow heart rate, dehydration, fainting, fatigue, weakness and the growth of a downy layer of hair on the body (called lanugo) to keep the body warm. Medical consequences of bulimia include electrolyte imbalances (from purging), dental problems and chronic constipation. If you suspect your child has an eating disorder, you must address the issue immediately. Don’t ignore the signs and hope the problem will resolve itself; it won’t.
“Choose a time when you can talk openly with your child,” says Caldwell. “Tell him or her why you’re worried, share your concerns and mention the warning signs you’ve noticed. Stress the fact that you feel that something is just not right, and you want to help. Offer unconditional love and support. If your child refuses to listen or talk to you, keep trying. This is an issue you can’t ignore, so stay on top of the situation and maintain a continuous dialogue.”
If your teen has any symptoms of an eating disorder or develops medical conditions associated with anorexia or bulimia, Caldwell suggests taking him or her to a physician for a complete physical. Consulting a physician is critical because you need to know how sick your child is—medically, nutritionally and emotionally.
Treatment for eating disorders depends on the severity of the illness and may involve inpatient or outpatient care. In addition, therapy is essential. Patients might also benefit greatly from support groups. Knowing that they are not alone and that others understand how they feel can be extremely comforting to teens suffering from an eating disorder.
“Without a doubt, the most important aspect of therapy for children with eating disorders is family support,” says Peterson. “You can’t just drop your child off at therapy. The process has to involve the entire family. Eating disorders must be aggressively addressed, and the earlier they are diagnosed and treated, the better. You really have to monitor the situation and hopefully ‘nip it in the bud’ early, or it becomes a lifelong process because people tend to fall back on old habits. But I really want to stress to parents that there is hope. There are so many great resources in Maryland for help and support. Your child can recover. It’s never hopeless.”
Lisa A. Lewis is a freelance writer who lives in Annapolis.