When to Worry About an Eating Disorder

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All teenagers worry about their appearance. Self-esteem can be precarious during adolescence, and body consciousness comes with the territory. But if you’ve noticed that your child is fixated on weight, you're probably worried. So what’s the difference between normal behavior and behavior that might indicate an eating disorder

Distorted body image

While other people see a normal (or painfully skinny) kid, teenagers with eating disorders look into the mirror and see a different person entirely. They have a distorted perception of their own appearance, and no amount of reassurance from family and friends—all of them saying, "You’re not fat"—will change that conviction. They may be very influenced by the ideal body perpetuated in media and popular culture, or the ultra-lean body type favored in sports like gymnastics or figure skating.

Fixated on appearance

Young women (and some young men) who develop eating disorders are extraordinarily focused on their appearance as a measure of self-worth. While other kids tend to stake their identities on their interests and accomplishments, these teenagers have their emotions, and their lives, wrapped up in thoughts of food and appearance.  

Excessive dieting

Dieting is fairly common in teenagers, but young women who have anorexia nervosa have such an intense fear of gaining weight that they maintain a dangerously low body weight through what is essentially self-imposed starvation. Personality types more likely to develop the disorder include athletes, perfectionists and over-achievers.

Out of control eating

People with binge eating disorder regularly consume unusually large amounts of food in relatively short periods of time, with the feeling that their overeating is out of their control. They often overeat in secret, and with great embarrassment or guilt. Binge eaters can be of normal weight, overweight or obese.

Bingeing and purging

Kids with bulimia nervosa indulge in periodic and usually secretive binges. Many kids with bulimia say they feel out of control during their binges and describe them as “out of body experiences.” To compensate, many will purge afterward by self-induced vomiting, the use of laxatives or strenuous exercise. It can be difficult to diagnose the disorder because it's done in secret, and people with bulimia can have a normal body weight or may even be overweight.

What to look for

Kids with eating disorders often try to keep their unhealthy eating habits and behaviors a secret, but there are still some signs that parents might notice. 

Signs of anorexia:

  • Losing weight unexpectedly and/or being dangerously thin
  • Obsessing over calorie counts and nutritional facts
  • Spending many hours exercising to burn off calories
  • Skipping meals
  • Avoiding eating socially 
  • Irregular periods, thinning hair and constant exhaustion

Signs of bulimia:

  • Going to the bathroom immediately after meals
  • Spending a lot of time in the bathroom
  • Exercising excessively or using diet pills or laxatives
  • A sore throat, sore knuckles, discolored teeth and poor enamel 
  • Hoarding food
  • Large amounts of food going missing at home

Signs of binge eating disorder:

  • Eating unusually large quantities of food
  • Eating when not hungry
  • Eating rapidly
  • Eating to the point of uncomfortable fullness
  • Eating in shame or in secret
  • Feeling depressed, anxious or ashamed about eating habits
  • Gaining and losing weight repeatedly ("yo-yo dieting")

What can parents do?

  • Try to establish healthy eating habits. Make a routine of eating healthy, balanced meals as a family.
  • Don’t criticize your child’s weight or appearance. Adolescence is a difficult time for most kids, and it’s essential to provide them with a nurturing and supportive environment.
  • Some kids are more likely than others to develop eating disorders. Be extra vigilant if you have a family history of eating disorders or if you know that your child is under extreme pressure to look a certain way.

If you think your child has an eating disorder, you should contact a doctor for help immediately. Eating disorders are very serious and can be deadly.

Originally published on February 29, 2016

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