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Obese Kids, Weight Loss, and Eating Disorders

Problems like anorexia may go undiagnosed or be disregarded, case studies show

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

MONDAY, Sept. 9 (HealthDay News) -- Obese children and teens who lose weight are in danger of developing eating disorders -- including anorexia and bulimia -- and a new study highlights how this can happen.

These problems may not be diagnosed quickly, because parents and doctors "think it's a good thing that these teens have lost so much weight," said lead researcher Leslie Sim, an assistant professor of psychology and an eating disorders expert at the Mayo Clinic Children's Center in Rochester, Minn.

"We started to see kids coming into our clinic with severe eating disorders such as anorexia nervosa, where you lose a lot of weight and restrict your eating, and these kids actually started out as obese," she said.

"They lost way too much weight and became preoccupied with their eating," Sim said. "Every thought and behavior really surrounded eating."

The new report, published online Sept. 9 and in the October print issue of the journal Pediatrics, focuses on two cases of obese teens who'd lost a great deal of weight.

In the first case, a 14-year-old boy lost 87 pounds over two years. Although the plan had been to get him to eat healthy and exercise, he developed a severe eating disorder involving a drastically low calorie intake and rigid food restrictions.

Despite losing more than half his body weight, among other symptoms, doctors initially ruled out eating disorders as a diagnosis, according to the study. Finally, his mother insisted on an eating disorders evaluation.

In the second case, an 18-year-old girl lost 83 pounds over three years. After seeing a doctor, the girl's mother said she was concerned because her daughter wasn't eating any fat and had restricted eating in general.

Although these were clear signs of an eating disorder, the doctor attributed the girl's dizziness and not having menstrual periods as symptoms of dehydration or possible polycystic ovary syndrome -- a hormone imbalance that causes menstrual cycle changes.

Both teens had embarked on running regimens as part of their weight-loss efforts.

In both cases, despite regular check-ups and clear signs of undernourishment, their eating disorders were not recognized and only got worse, Sim said.

Kids she's seen with these problems were constantly worried about what and how much they were eating, Sim said, and were socially withdrawn and depressed.

"We think obese kids are at risk for eating disorders because they are getting a lot of media messages that they are not healthy and that there is something wrong with them and they need to change their ways," Sim said. "And because they are teens, they do extreme things."

Weight loss is not that typical for adolescents, Sim said. "I think parents should be concerned with any weight loss," she said.

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