Teens and Eating Disorders: How to Cope with Anorexia, Bulimia
Are you concerned that your preteen or teenager may have an eating disorder?
You aren’t alone.
Eating disorders among teenagers are rising in our country. One report from the U.S. Centers for Disease Control and Prevention showed that hospitalizations for eating disorders sharply increased during the COVID-19 pandemic, especially among adolescent girls. (Boys, too, can develop eating disorders.)
Parents across the country are finding that their children are struggling with issues about weight, image, and self-esteem and often ask pediatricians for help.
As a board-certified pediatrician, I am dedicated to raising awareness about the symptoms of eating disorders, especially during this Eating Disorders Awareness Week. If you are concerned about your child, reach out for help.
Untreated eating disorders can have devasting consequences: Every 52 minutes, one person dies as a direct consequence of an eating disorder.
Many Kids are Struggling with Eating Disorders
Parents, pediatricians and mental health professionals always have been concerned about eating disorders among adolescents, but the increased isolation and stress of the COVID-19 pandemic was so tough on many kids that more adolescents developed eating disorders.
Remote learning, loneliness and isolation, and spending more time on social media seem to have contributed to a spike in disordered eating. On social media, kids regularly see images of thin celebrities and supermodels – and want to look just like them.
Increased attention on weight-loss drugs has kids wondering about their own weight and what they can do to be thinner.
Anorexia Nervosa
People with anorexia nervosa limit what they eat to try to lose weight. There are two types of anorexia:
- Restrictive-type anorexia. People with restrictive anorexia severely limit what they eat. They may eliminate one food group at a time until they are eating very little, if anything. They may also diet, fast, or exercise excessively to try to lose weight.
- Binge eating and purging type anorexia. People with this type of anorexia eat a large amount of food and then have an uncontrollable urge to get rid of the food, either by self-induced vomiting, or use of laxatives or diuretics.
How would a parent know whether their adolescent has anorexia nervosa?
Here are signs to look for:
- Extreme weight loss. Kids might start wearing baggy clothes to hide how thin they are.
- Excessive focus on food or cutting food into small pieces at mealtime.
- Excessive focus on weight and negative talk about body image. We’ve seen kids weigh themselves several times a day. They are terrified of gaining weight.
- Callouses on knuckles from self-induced vomiting.
- Not eating meals with family or friends.
- Irregular menstrual cycles, particularly very light periods or missed periods.
- Excessive exercise. We’ve seen kids who used to run a mile a day start running seven miles a day.
- Tooth problems, such as yellowed teeth/ wearing away of enamel due to vomiting.
- Difficulty sleeping.
- Thinning hair.
- Fainting and dizziness.
- Feeling cold even when it’s warm.
- Dry skin.
- Constipation.
- Not meeting pubertal milestones.
Bulimia
Adolescents with bulimia eat an extremely large amount of food in a short period of time, and then induce vomiting or take diet or laxatives to rid the food from their bodies. This is similar to binge/ purge anorexia, but a key difference is that people with bulimia can be overweight or normal weight whereas those with anorexia are underweight.
Many people with bulimia don’t have obvious symptoms, but parents may notice that their child goes to the bathroom after meals or has calloused knuckles from forced vomiting.
What Should You Do If You Think Your Child Has an Eating Disorder
If you notice signs of anorexia or bulimia in your child, you should be concerned. Try to have an open and honest conversation with your child. Try not to judge them or accuse them. Avoid talking to them about dieting or specific numbers on a scale.
You might say: “Are you concerned about your weight?” or “I have noticed that you aren’t eating very much. Is there anything going on?”
Tell your child that you plan to reach out to their pediatrician so that together you can come up with a treatment plan.
Getting Help for Eating Disorders
Your child’s pediatrician plays an important role in making an eating disorder diagnosis and developing a treatment plan. Because eating disorders are mental health conditions, therapy is almost always an important part of treatment.
Some kids do well talking with a nutritionist and a therapist in an outpatient setting. Other kids many need hospitalization and/or the help of an inpatient residential treatment program. Ultimately, having the support of the family is vital to helping the child recover.
Recovery can take weeks to months to even years. Some teens will recover completely, and others may struggle with eating challenges as adults. Getting help at the earliest signs of an eating disorder can lead to better outcomes.
This blog was originally published by the Mid-Atlantic Permanente Medical Group
Featured Author
Dayna Ukwuoma, MD, is a board-certified pediatrician with the Mid-Atlantic Permanente Medical Group. She sees patients at the Kaiser Permanente South Baltimore County Medical Center. Her bio reads: I joined the Mid-Atlantic Permanente Medical group because Kaiser Permanente has always been familiar to me. I was once a patient at Kaiser Permanente and I am happy to be a part of the team as a physician!
It is important for my patients to know that I am devoted to providing the best level of care while building a safe and inclusive environment for everyone.
Read more at: https://mydoctor.kaiserpermanente.org/mas/providers/daynaukwuoma Disclaimer: If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.