Anorexia nervosa is a common eating disorder that usually begins at the age of fourteen or fifteen, with another peak in incidence in eighteen year olds. It is more common in adolescent girls (affecting almost 1% of adolescent females), but it is also found in boys and its incidence has been increasing. Anorexia causes an overwhelming
fear of being overweight and a drive to be thin, leading to a restriction of calories that can lead to being
underweight. Teens with anorexia may also have
bulimia nervosa, with a loss of control and binge eating, followed by purging behaviors.
It is not known what causes eating disorders, but it does seem to be associated with certain genetic attributes and it is more common in children who have a first-degree relative with an eating disorder. Other factors that put you at risk for an eating disorders is participating in certain competitive activities (especially ballet, skating, athletics, and fashion modeling,), having a perfectionist or obsessive personality, and having a parent with an eating disorder or weight problem (obesity, frequent dieting). Eating disorders are probably also more common in children with a past history of physical or sexual abuse.
Early risk factors for eating disorders include having low self esteem and being dissatisfied with their body. Some other factors that you should look for if you suspect that your child has an eating disorders include:
- recent weight loss
- a fear of gaining weight or of being overweight
- purging behaviors (vomiting or using diuretics (water pills) or laxatives to lose weight)
- having a distorted image of their body's size or shape (for example, believing that she is overweight even though she is at a healthy weight)
- a preoccupation with thoughts of food, calories and their weight
- restrictive eating patterns, which can lead to a failure to gain weight or to being underweight and can include skipping meals, fasting, or eliminating entire food groups
- preference for eating alone
- amenorrhea (absence of menstrual cycles) or delayed onset of puberty and menarche
- being underweight, with a body mass index that is below normal. Use the body mass index calculator to see if your child is underweight.
- exercising compulsively
- an extreme denial that there she may have an eating disorder
- withdrawal from friends and family
- wearing bulky clothing to hide weight loss
- has had a recent or past event in their life that was very stressful
Questions you or a physician may ask if they suspect someone has an eating disorder include:
- How do you feel about your weight?
- When you look in the mirror, which parts of your body look best and worst and why?
- How often do you weigh yourself?
- Have you ever used diet pills, laxatives, diuretics (water pills) or vomiting to lose weight?
- Do you ever feel that your eating is out of control?
- And get a detailed history of what they eat each day at each meal and their daily exercise routine.
You should have your child seen by a physician as soon as possible if you think she might have an eating disorder. At this visit, your doctor will probably perform a nutritional assessment, including taking a look at her eating patterns, daily caloric intake, measuring her height, weight and body mass index, and evaluating her for depression.
Your doctor will also try and rule out other causes of weight loss and decreased appetite, including other psychiatric disorders (depression, obsessive compulsive disorder), drug abuse, inflammatory bowel disease (which is usually accompanied by vomiting, diarrhea and abdominal pain), hyperthyroidism, diabetes (usually accompanied by frequent urination (polyuria) and excessive drinking (polydipsia)), and other medical problems. However, children with most of these medical problems don't have a preoccupation with food or a distorted body image.
There are many serious complications of anorexia, including fainting from low blood pressure, electrolyte disorders, being intolerant to cold, constipation, decreased energy, changes in mood, anemia, kidney failure, osteoporosis (brittle bones), suicide, heart rhythm abnormalities, heart failure, sleep problems, confusion, irritability, and dizziness and even death.
Some physical signs that are found in patients with bulimia include an enlargement of the parotid glands (causing chubby cheeks), dental erosions (especially on the back surfaces), and having calluses on their knuckles. Other signs found in teens with eating disorders include having dry and brittle hair, losing hair, and having muscle wasting.
The treatment of eating disorders is slow and difficult (and sometimes requires hospitalization) and should be overseen by a mental health professional that is familiar with treating patients with this disorder to begin psychotherapy and behavior modification. Patients with anorexia also require nutritional and medical intervention to make dietary recommendations, ensure a slow and steady weight gain and correct the medical complications.
