Eating Disorders in Teens
Eating disorders are more well known than they used to be, but there are still many misconceptions surrounding them. There are several types of eating disorders that demonstrate symptoms in different ways, which we will discuss today.
It is important to remember that eating disorders are a treatable mental illness. They are not a result of stubbornness or defiance. They are not a choice that is made. They are not caused by parental behavior. They do not only occur in girls.
Types of eating disorders
Anorexia Nervosa: characterized by restrictive weight loss and difficulty in maintaining an appropriate body weight for height, age, and gender. It is often accompanied by a distorted body image – in other words, these individuals still perceive themselves as being overweight even when they are clearly underweight. They will often develop food rituals, deny feeling hungry, and will be preoccupied with food, calories, and dieting. They will consistently make excuses for missing mealtimes, and maintain an excessive or rigid exercise regimen.
Binge Eating Disorder: characterized by recurrent episodes of consuming large quantities of food, usually very quickly and to the point of physical discomfort. This is then followed by feeling of shame, loss of control, distress, and guilt. At times these individuals will compensate for these binging episodes by purging, but this is not always true. Individuals with Binge Eating Disorder are usually of normal or higher than average weight, and up to two-thirds are considered clinically obese (but it is important to note that most people who are obese do NOT have Binge Eating Disorder).
Bulimia Nervosa: characterized by a recurrent cycle of binge eating and compensatory behaviors meant to counteract the binging. These behaviors include self-induced vomiting, inappropriate use of laxatives or diuretics, medications, fasting, or excessive exercise. Individuals feel a loss of control while binge eating and seek to gain that control back with compensatory behaviors.
Avoidant/Restrictive Eating Disorder (ARFID): AFRID is a very different type of eating disorder, but dangerous nonetheless. Teens with ARFID do not restrict their eating due to self-esteem or body issues, or from the desire to be thin. Rather, the reason they do not eat is because they fear they will die. This causes an actual physical restriction of the throat and mouth tissues and causes an inability to eat certain foods, which leads to inadequate weight gain and growth over time.
Risk factors for developing an eating disorder
Eating disorders are a result of a complex mix of biological, physical, and social/cultural factors. While each individual with an eating disorder is different, researchers have been able to identify wide similarities of major risk factors to developing an eating disorder. These include:
Biological
- Having a close relative with an eating disorder or other mental health condition.
- History of dieting.
- Type 1 Diabetes
- History of deliberately restricting amounts or types of foods consumed.
Psychological
- Personal history of anxiety
- Personality traits of inflexibility and perfectionism
- Body image dissatisfaction
Social
- Thin stigma, or discrimination based on weight
- Bullying, particularly about weight
- “Ideal body” messages
- Limited social networks
Social media
Have you met Ana or Mia yet? If your teen has an eating disorder, there is a good chance he or she has.
Ana and Mia are the internet and social media personifications of Anorexia and Bulimia. “My friend Ana” or “My friend Mia,” and “Pro-Mia” or “Pro-Ana” provide easy ways to search out like-minded individuals, to connect and provide support for one another. Many parents are unaware of these terms as well, adding an element of secrecy and allowing teens to participate in these groups undetected.
These sites, whether intentional or not, are dangerous. They encourage unhealthy behaviors and make eating disorders harder to break away from. They often declare anorexia and bulimia a “lifestyle choice” and deny it is a mental disorder. They typically have “thinspiration” boards, with images of extremely thin individuals for motivation. Some Pro-Ana sites will promote the “Thin Commandments” which are ten statements of belief in promoting Anorexia. A few examples include:
“If you aren’t thin, you aren’t attractive”
“Being thin is more important that being healthy”
“Thou shall not eat without feeling guilty”
“You can never be too thin”
Studies have shown that teens who are exposed to websites that promote eating disorders have higher levels of body image dissatisfaction than adolescents who do not have such exposures. They also have decreased quality of life and longer duration of struggle with eating disorders.
Treatments
It is possible to fully recover from an eating disorder, even if it is a long-standing issue. The first step to treatment of an eating disorder is an actual diagnosis. Treatment usually requires a combination of nutritional counseling, psychological therapy, and medical management. Teens must be evaluated for electrolyte and metabolic disturbances that can be a result of long-term disruptions in nutrition. Treatment of eating disorders can be done through a variety of settings.
outpatient programs – medically stable and does not need constant monitoring.
partial hospitalization programs – medically stable but needs daily assessment of mental status and functioning.
residential programs – medically stable but needing more intensive psychiatric help.
inpatient programs – medically unstable and at a risk for severe complications or death.
Final thoughts
Eating disorders are incredibly sad. They are disruptive to every day life, activities, and can lead to health problems and even death. They are not the fault of the individual who is suffering, rather they are a mental health disorder much like anxiety or depression. They greatly impact the lives of the individual with the disorder as well as the family that surrounds them. Eating disorders can be difficult to overcome but it is possible to do so. Help your teen to develop a healthy body image. Be careful of negative associations, or of commenting on weight in a negative way. Monitor your teen closely for signs of an eating disorder – including body dissatisfaction and preoccupation with food, weight, or exercise.
Resources
https://www.nationaleatingdisorders.org/
https://www.healthychildren.org/English/news/Pages/Identifying-and-Treating-Eating-Disorders.aspx
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