Eating Disorders

Eating disorders affect millions of teens and young women worldwide and are more common in cultures that focus on weight loss and body image. Intense focus on thinness can lead to negative body image and unhealthy eating behaviors in teens and young women. Sometimes, these unhealthy eating behaviors lead to eating disorders such as anorexia nervosa, bulimia, binge eating disorder or eating disorders not otherwise specified (ED-NOS).

What are eating disorders?

According to the 2006 Metrowest Adolescent Health Survey, 36% of youth reported that they had dieted in the past 30 days to lose weight.

Teens and young women with eating disorders often have a negative and distorted body image, and intense emotions and behaviors surrounding food. They may start to eat less because they are afraid of gaining weight. Sometimes they binge (overeat or consume very large quantities of food) and sometimes purge (by making themselves vomit, by over-exercising, or using laxatives). Eating disorders affect a person’s physical and emotional health. They are very dangerous illnesses and can be fatal if they are not treated.
The four types of eating disorders are:

  • Anorexia Nervosa is an illness that involves having an extreme desire to be thin. The key elements of anorexia nervosa are: a refusal to keep body weight at a healthy level, an intense fear of being fat, a distorted body image. Many teens who have anorexia stop having their periods or don’t get it on a regular schedule.
  • Bulimia Nervosa is an eating disorder that involves frequent binging and purging, as well as a distorted body image. Binging means eating a lot of food at one time even when you’re not hungry. Following a binge, young women with bulimia will try to get rid of food by vomiting, taking laxatives or by excessively exercising. People with bulimia may hide what they eat from others and feel afraid or ashamed of their behavior.
  • Binge Eating Disorder, or compulsive eating disorder, involves eating large amounts of food in short periods of time without purging. Often, people with binge eating disorder will skip meals or eat small portions when they are around others and then eat large amounts when they are alone. Young women with binge eating disorder often suffer from anxiety, depression, loneliness, shame, and/or self-hatred. Their body weight can vary from normal to obese.
  • EDNOS (Eating Disorders Not Otherwise Specified). People with EDNOS have some, but not all, of the symptoms of anorexia, bulimia, or binge eating disorder. For example, young women struggling with EDNOS may have periods of restrictive eating (days or months) followed by periods of overeating or binge eating, or they may be at a very low weight, but not have anorexia because they still get their menstrual period. Young women with EDNOS may also maintain a stable weight that is within a medically safe range, but still have many of the other symptoms and continue to be at risk for medical complications of eating disorders.

What causes eating disorders?

  • There are many different theories regarding the causes of eating disorders. Eating disorders are likely caused by a combination of social, psychological, family, genetic, and environmental factors.
  • Society’s intense focus on thinness and appearance influences how young women view their bodies and their self-esteem. While this focus may not cause eating disorders, it can contribute to their development.
  • An individual may have a family history of emotional disorders such as depression or anxiety. Eating disorders are often associated with feelings of helplessness, sadness, anxiety, and the need to be perfect. This can cause a person to use dieting or weight loss to provide a sense of control.
  • Teens who participate in competitive sports that emphasize thinness or artistic activities, such as ballet, running, gymnastics, or skating, are more likely to develop an eating disorder.
  • Family stress of any kind can also contribute to the development of these illnesses. Dealing with difficult transitions, (grief or loss of family member or a relationship), or teasing about weight from friends or family may trigger eating disorders.
  • The stresses involved with transitioning into adolescence (i.e., independence and individualization) can themselves be risk factors for developing eating disorders.

How can I tell if my teen has an eating disorder?

Your teen may have an eating disorder if he or she:

  • Has an obsession with weight and food
  • Discusses exactly how many calories and fat grams are in everything that he or she eats
  • Exercises all the time, even when sick or exhausted
  • Has an aversion to hanging out with you and other friends during meals
  • Wears big or baggy clothes. Lots of people wear baggy clothes as a fashion statement, but someone who wears baggy clothes to hide their shape might have other issues
  • Goes on dramatic or very restrictive diets, cutting food into tiny pieces, moving food around on the plate instead of eating it, and/or being very precise about how food is arranged on the plate
  • Competes with others about how little they eat
  • Goes to the bathroom a lot, especially right after meals
  • Talks about how fat he/she is all the time
  • Appears to be gaining a lot of weight even though you don’t see him or her eating excessive or fatty foods
  • Appears defensive or sensitive about his or her weight loss or eating habits
  • Takes laxatives, diuretics, or diet pills
  • Has a tendency to faint, bruises easily, is very pale, or starts complaining of being cold more than usual (cold intolerance can be a symptom of being underweight)

For a full list of physical and emotional symptoms of eating disorders, click here.

What should my child eat?

According to the 2006 Metrowest Adolescent Health Survey, 90% of Metrowest youth do not eat the recommended 5 or more servings of fruits and vegetables per day.

Just like adults, kids need to eat a wide variety of foods for good health. In January 2005, the U.S. Department of Health and Human Services (DHHS) and the U.S. Department of Agriculture (USDA) jointly released the 2005 Dietary Guidelines for Americans. These new guidelines outline recommendations to promote health and reduce the risk of chronic disease through nutritious eating and physical activity. The new guidelines encourage Americans over 2 years of age to eat a variety of nutrient-dense foods. Recommended items include fruits, vegetables, fat-free or low-fat milk and milk products, lean meats, poultry, fish, beans, eggs, nuts, and whole grains. The guidelines also recommend a diet low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.

  • For advice on how your entire family can eat healthier, click here.

For an article written for parents on eating disorders including definitions, causes, effects, warning signs, and suggestions for intervening, click here.
For an article written for teens on eating disorders, click here.