What Are Eating Disorders?

Eating disorders, including anorexia nervosa, bulimia nervosa, and binge

eating disorder, are psychological disorders that involve extreme
disturbances in eating behavior. A teen with anorexia refuses to stay at a
normal body weight. Someone with bulimia has repeated episodes of binge
eating followed by compulsive behaviors such as vomiting or the use of
laxatives to rid the body of food. Binge eating is characterized by
uncontrolled overeating.
Anorexia nervosa affects as many as one in every 100 females. Teens with
anorexia fear gaining weight and are at least 15% below their ideal body
weights. They believe the main gauge of self-worth is their body image.
Experts believe many American girls are bulimic and have kept the
problem a secret. Bulimia often starts in the late teens and early adulthood.
People with bulimia go through cycles of eating enormous amounts of
foods followed by purging by vomiting, using laxatives, or diuretics or
hours of aerobic exercise.
“ Eating Disorders in Teenagers: Symptoms, Causes, Treatment (webmd.com) “

What Causes Eating Disorders in Teens?

There is no one cause of an eating disorder. Experts link eating disorders to
a combination of factors, such as family relationships, psychological
problems, and genetics. The teen may have low self-esteem and be
preoccupied with having a thin body.
Sometimes, being part of a sport such as ballet, gymnastics, or running,
where being lean is encouraged, is associated with eating disorders in
teens. In one study, researchers linked anorexia with an obsession with
perfectionism -- concern over mistakes, high personal standards, and
parental expectations and criticism.
 “ Eating Disorders in Teenagers: Symptoms, Causes, Treatment (webmd.com) “

What Are Symptoms of Eating Disorders in Teens?

Symptoms of eating disorders may include the following:

 A distorted body image

 Skipping most meals
 Unusual eating habits (such as eating thousands of calories at one
meal or skipping meals)
 Frequent weighing
 Extreme weight change
 Insomnia
 Constipation
 Skin rash or dry skin
 Dental cavities
 Erosion of tooth enamel
 Loss of hair or nail quality
 Hyperactivity and high interest in exercise

Teens with eating disorders are often in denial that anything is wrong.
They may be moody, anxious, depressed. They may withdraw from
friends, and become overly sensitive to criticism. The problem arises when
parents are not aware of these symptoms because the teen keeps them
hidden -- just like the trauma, insecurities, depression, or low self-esteem
that may help trigger the disorder.
“ Eating Disorders in Teenagers: Symptoms, Causes, Treatment (webmd.com) “

How Are Eating Disorders in Teens Treated?

Although there is no easy treatment for eating disorders, they are treatable.
A combination of treatments, including cognitive behavioral therapy
and antidepressant medication, can be used to help teens overcome
bulimia. Cognitive behavioral therapy helps by identifying and replacing
inaccurate thoughts to help change behavior and emotional state.
Anorexia treatment usually involves nutritional feeding, medical
monitoring, and psychological treatment.
“ Eating Disorders in Teenagers: Symptoms, Causes, Treatment (webmd.com) “

Can Eating Disorders Hurt my Health?

If left untreated, eating disorders can lead to serious illness and even death.
Along with the lower body weight, girls with anorexia nervosa can lose
their menstrual periods (amenorrhea). The loss of periods is associated
with osteopenia, early bone loss that can lead to painful fractures.
Eating disorders are also linked to other serious health problems, such
as kidney disease and heart disease. Each of these health problems requires
specific tests and treatment.
“ Eating Disorders in Teenagers: Symptoms, Causes, Treatment (webmd.com) “

When Should I Call a Doctor About Eating Disorders?

If you think you have an eating disorder, talk to your doctor. The sooner
you get medical and psychological treatment, the faster you will be on
your way to recovery.
If you suspect a family member or friend has an eating disorder, talk with
them about the problem.
“ Eating Disorders in Teenagers: Symptoms, Causes, Treatment (webmd.com) “
Eating Disorders (for Teens) - Nemours KidsHealth

What Are Eating Disorders?

Eating disorders are problems that affect a person’s eating behaviors as well as their attitudes and
feelings about food — and about their body.
Eating disorders affect a person’s mental health and can cause serious harm to a person’s physical
health.

There are several types of eating disorders. 

What Are the Different Types of Eating Disorders?

Common types of eating disorders are anorexia, bulimia, binge eating, and avoidant/restrictive food
intake disorder (ARFID).

Anorexia. People with anorexia:

 eat very little on purpose, leading to a very low body weight
 have an intense fear of weight gain and fear looking fat
 have a distorted body image and see themselves as fat even when they are very thin

People with anorexia are very strict about what and how much they will eat. They may think about
food or calories almost all the time.

To lose weight, some people with anorexia fast or exercise too much. Others may use laxatives,
diuretics (water pills), or enemas.

Bulimia. People with bulimia:

 overeat and feel out of control to stop, called binge eating
 do things to make up for overeating, such as:
o make themselves throw up on purpose after overeating, called purging
o use laxatives, diuretics, weight loss pills, fast, or exercise a lot to prevent weight gain
 judge themselves based on body shape and weight

People with bulimia eat much more (during a set period of time) than most people would. If a person
regularly binges and purges, it may be a sign of bulimia. Unlike people with anorexia who are very
low weight, people with bulimia may be thin, average weight, or overweight. People with bulimia
often hide their eating and purging from others.

Binge eating. People with binge eating disorder:

 overeat and feel out of control to stop
 eat large amounts even when they are not hungry
 may feel upset or guilty after binge eating
  often gain weight and may become very overweight

Many people with binge eating disorder eat faster than normal. They may eat alone so others don't
see how much they are eating. Unlike people with bulimia, those with binge eating disorder do not
make themselves throw up, use laxatives, or exercise a lot to make up for binge eating. If a person
binge eats at least once a week for 3 months, it may be a sign of binge eating disorder.

ARFID. People with avoidant/restrictive food intake disorder:

 are not interested in food or avoid foods
 lose weight, or don't gain expected amount of weight
 are not afraid of gaining weight
 don't have a poor body image

People with ARFID don't eat because they are turned off by the smell, taste, texture, or color of food.
They may be afraid that they will choke or vomit. They don't have anorexia, bulimia, or another
medical problem that would explain their eating behaviors.

How Do Eating Disorders Affect Health and Emotions?

Eating disorders can cause serious problems throughout the body.

Anorexia can lead to health problems caused by undernutrition and low body weight, such as:
 low blood pressure
 slow or irregular heartbeats
 feeling tired, weak, dizzy, or faint
 constipation and bloating
 irregular periods
 weak bones
 delayed puberty and slow growth

People with anorexia may find it hard to focus and have trouble remembering things. Mood changes
and emotional problems include:

 feeling alone, sad, or depressed

 anxiety and fears about gaining weight
 thoughts of hurting themselves
Bulimia can lead to health problems caused by vomiting, laxatives, and diuretics, such as:
  low blood pressure
 irregular heartbeats
 feeling tired, weak, dizzy, or faint
 blood in vomit or stool (poop)
 tooth erosion and cavities
 swollen cheeks (salivary glands)

People with bulimia may have these emotional problems:

 low self-esteem, anxiety, and depression

 alcohol or drug problems
 thoughts of hurting themselves
Binge eating can lead to weight-related health problems, such as:
 diabetes
 high blood pressure
 high cholesterol and triglycerides
 fatty liver
 sleep apnea

People with binge eating disorder may:

 have low self-esteem, anxiety, or depression

 feel alone, out of control, angry, or helpless
 have trouble coping with strong emotions or stressful events
ARFID may lead to health problems that stem from poor nutrition, similar to anorexia. People with
ARFID may:
 not get enough vitamins, minerals, and protein
 need tube feeding and nutrition supplements
 grow poorly

People with ARFID are more likely to have:

 anxiety or obsessive-compulsive disorder (OCD)

 autism spectrum disorder or attention deficit hyperactivity disorder (ADHD)
 problems at home and school because of eating behavior
What Causes Eating Disorders?

There's no one cause for eating disorders. Genes, environment, and stressful events all play a role.
Some things can increase a person's chance of having an eating disorder, such as:

 poor body image

 too much focus on weight or looks
 dieting at a young age
 playing sports that focus on weight (gymnastics, ballet, ice skating, and wrestling)
 having a family member with an eating disorder
 mental health problems such as anxiety, depression, or OCD

How Are Eating Disorders Diagnosed?

Health care providers and mental health professionals diagnose eating disorders based on history,
symptoms, thought patterns, eating behaviors, and an exam.

The doctor will check weight and height and compare these to previous measurements on growth
charts. The doctor may order tests to see if there is another reason for the eating problems and to
check for problems caused by the eating disorder.

How Are Eating Disorders Treated?

Eating disorders are best treated by a team that includes a doctor, dietitian, and therapist. Treatment
includes nutrition counseling, medical care, and talk therapy (individual, group, and family therapy).
The doctor might prescribe medicine to treat binge eating, anxiety, depression, or other mental
health concerns.

The details of the treatment depend on the type of eating disorder and how severe it is. Some
people are hospitalized because of extreme weight loss and medical complications. 

What if I Have an Eating Disorder?

If you think you may have an eating disorder:

Tell someone. Tell a parent, teacher, counselor, or an adult you trust. Let them know what you're
going through. Ask them to help.
Get help early. When an eating disorder is caught early, a person has a better chance of recovery.
Make an appointment with your doctor or an eating disorders specialist.
Go to all appointments. Treatment takes time and effort. Work hard to learn about yourself and
your emotions. Ask questions any time you have them.
Be patient with yourself. There's so much to learn, and change happens a little at a time. Take
care of yourself and be with people who support you.

Eating disorders spike among children and teens: What parents should know - Harvard Health

During the pandemic, we have seen many more children and teens go to the emergency room
with mental health problems. And there has been a notable rise in eating disorders, particularly
among adolescent girls. Eating disorders include a range of unhealthy relationships with food
and concerns about weight.
Unfortunately, eating disorders are common. In fact, one in seven men and one in five
women experiences an eating disorder by age 40, and in 95% of those cases, the disorder begins
by age 25. Many kinds of eating disorders may affect children and teens:

 Anorexia nervosa is an eating disorder characterized by an extreme fear of gaining weight.

People with anorexia nervosa often see themselves as overweight when they are at a healthy
weight, and even when they are greatly underweight. There are two forms of anorexia nervosa:
The restrictive form is when people greatly limit what and how much they eat in order to control
their weight. In the binge-purge type, people limit what and how much they eat, but also binge
and purge — that is, they will eat a large amount at once and try to get rid of the extra calories
through vomiting, laxatives, diuretics, or excessive exercise.
 Bulimia nervosa involves binging and purging but without limiting what and how much a person
eats.
 Binge eating disorder is when people binge eat but don’t purge or restrict. This is actually the
most common eating disorder in the United States.
 Avoidant restrictive food intake disorder is most common in childhood. The person limits the
amount or type of food they eat, but not because they are worried about their weight. For
example, someone with inflammatory bowel disease may associate eating with pain and
discomfort, and so may avoid eating. Children with sensory issues may find the smell, texture, or
taste of certain foods deeply unpleasant, and so will refuse to eat them. This is more than just
"picky eating" and can lead to malnutrition.
Misunderstandings about eating disorders
When most people think of eating disorders, they think of someone who is overly thin. However,
you can have an eating disorder and have a normal weight, or even be overweight. The most
important thing that many people don’t realize about eating disorders is that they are a serious
mental health issue and can be very dangerous. They can affect and damage many parts of the
body — and can even be lethal. Of all the kinds of eating disorders, anorexia nervosa is the one
that is most likely to lead to death.

What parents need to know: Signs of eating disorders

It’s not surprising that eating disorders have been on the rise in children and teens during the
pandemic, given the disruption, isolation, and stress — and excessive time on social media —
that it has brought. It’s important that parents watch for possible signs that their child or teen
could have an eating disorder, including:

 changes in what, when, and how much they eat

 being restrictive or regimented about their eating
 unusual weight fluctuations
 expressing unhappiness with their body or their weight
 exercising much more than usual
 spending a lot of time in the bathroom.

If it even crosses your mind that your child might have an eating disorder, remember that eating
disorders are not about choice. Mental health problems such as anxiety and depression play a big
role; emotional suffering often underlies eating disorders. And research shows that when you
undereat or overeat, it affects the brain processes that control hunger and food intake, reinforcing
the eating disorder.

Rescue Your Teen from an Eating Disorder | University of Utah Health

Talk to Your Teen

If you suspect your teen has an eating disorder, talk to them  in a loving and non-
confrontational way. Express your concern about changes in their food consumption,
including eating habits, variety and amount of food, energy levels, moods, or withdrawal
from social settings. Discuss media messages, promote a healthy body image, foster self-
esteem, and examine the dangers of dieting and emotional eating. Francis says, “Encourage
mindful eating of a variety of foods and avoid moralizing foods—no foods are ‘good’ or
‘bad.’”
Schedule a checkup  for your teen with their doctor. A physician can reinforce healthy
messages about eating habits, exercise routines, and body image and can refer your teen to
a mental health provider for extensive consultation, diagnosis, and treatment
recommendations.