Eating disorders are so common in America that 1 or 2 out of every 100 students will struggle with one. Each year, thousands of teens develop eating disorders, or problems with weight, eating or body image.
Eating disorders are more than just going on a diet to lose weight or trying to exercise every day. They represent extremes in eating behavior and ways of thinking about eating - the diet that never ends and gradually gets more restrictive, for example. Or the person who can't go out with friends because he or she thinks it's more important to go running to work off a snack eaten earlier.
Types of Eating Disorders
The three major types of eating disorders are:
1. Anorexia nervosa:
Commonly known as anorexia, this eating disorder is characterized by individuals restricting how much food they eat, which leads to alarmingly low body weight for the individual's age, gender and overall physical health. Anorexia is also accompanied by a fear of gaining weight or "getting fat." There's over-concern about body size, shape and weight and the teen is unable to recognize the seriousness of the low body weight.
2. Bulimia nervosa:
Commonly known as bulimia, this eating disorder is characterized by multiple episodes of binge eating - eating large quantities of food quickly - followed by purging behavior, which often takes the form of self-induced vomiting, laxative abuse and/or excessive exercise. The overeating or binge eating behaviors are typically accompanied by intense feelings of shame or guilt. This isn't just a one-time occurrence, it occurs at least once a week for three months. Like anorexia, this behavior is heavily influenced by body size, shape and weight concerns.
3. Binge eating disorder:
This eating disorder is characterized by multiple episodes of binge eating, however, it is not followed with purging behaviors. Similarly, this isn't just a one-time occurrence, it occurs at least once a week for three months.
Family, especially parents, along with friends, and primary care providers, have a key role in identifying when there may be an eating disorder. Common symptoms of eating disorders are:
- Limited food intake
- Anxiety about body size, shape and weight
- Unexplained weight loss or gain
- Throwing up after meals
- Excessive exercise
- Binge eating
- Laxative use
- Hiding food
- Loss of menstrual periods
If you see any of these symptoms, it's important to talk to the child and their primary care physician. The average onset for an eating disorder is just over 12 years old. Although girls outnumber boys overall, it's a serious concern for both. Another important element of eating disorders is that they're often accompanied by other mental health diagnoses such as depression and/or anxiety. Suicidality is also a concern for teens with eating disorders - nearly half of those with bulimia report thoughts of suicide. Individuals with eating disorders also tend to struggle in social and family relationships.
Early recognition and treatment of eating disorders is vital to producing positive outcomes. Positive outcomes are also aided when patients work with a dedicated team that includes a physician, mental health professional and registered dietitian.
Treatment focuses on helping the child understand how and why the eating disorder developed, how it can be resolved, and how to prevent it recurring later in life. Medications are sometimes used in the treatment of eating disorders, but more often they're used to address mood changes or eating disorder-related health consequences. A dietitian helps the teen develop healthy relationships with food, eating and body image. The therapist will address the underlying causes of the eating disorder and help the teen develop healthier coping skills.
Eating disorders can be treated and overcome. If you are worried about your child, reach out to your primary care physician for help.
Written by: Elizabeth Joy, MD, MPH
Intermountain Healthcare Medical Director, Community Health, Health Promotion and Wellness, Food and Nutrition; Family Medicine/Sports Medicine; Salt Lake Clinic LiVe Well Center