Is it a Diet or an Eating Disorder? Your teenager skips meals, becomes obsessed with weight loss and goes on wacky diets. You wonder if this is a passing phase or one of those eating disorders you hear so much about. While it's a leap to link a teen's poor eating habits to an eating disorder, experts contend poor dieting, if taken to the extreme, can in fact lead to a health-threatening, life-threatening eating disorder. Pamela Guthrie, an outreach director for the American Anorexia Bulimia Association (AABA) a nonprofit organization dedicated to the prevention and treatment of eating disorders, characterizes eating disorders and disordered eating as different degrees of eating abnormally. Disordered eating may mean frequently missing meals, yo-yo dieting, popping diet pills (diuretics) and cutting out whole groups of food. Eating disorders, she explains, are not triggered solely by the desire to be thin. "Eating disorders are about food, but they're really not about food," she says. "They are usually about psychological problems, low self-esteem, stress and depression." People with eating disorders tend to use food to gain a sense of control when they feel out of control, to gain a sense of self-esteem and self-worth, to manage depression and to express anger and rebellion, according to Guthrie, who as outreach director travels around high schools and colleges to educate students about eating disorders. A growing problem Both disordered eating habits and eating disorders have grown to be a major problem among teenagers, according to both psychiatric and nutrition experts. And both, they say, are dangerous. A teenager who has poor eating habits misses out on important vitamins and minerals that help prevent disease later on down the road. A teenager who has an eating disorder runs the risk of serious malnutrition, dehydration, heart disease or heart attack and other serious health consequences, according to AABA. It's estimated that 90 percent of high school juniors and seniors have been on a diet, although only between 10 percent and 15 percent are overweight, Guthrie says. What's more, 80 percent of 10-year-old girls and 50 percent of 9-year-old girls have been on a diet, according to the Council on Size and Weight Discrimination, a nonprofit organization in New York. As for true eating disorders, the American Psychiatric Association estimates that between 1 percent and 4 percent of teens and young adults have one type of eating disorder or another, such as anorexia nervosa or bulimia nervosa. Nutritionist Frances Berg, editor of the "Healthy Eating Journal" and author of the book "Afraid to Eat: Children and Teens in Weight Crisis," cautions parents that their own eating habits, particularly if they are rabid dieters, can set their children up for poor and even dangerous eating practices. "Adults keep running after every new weight-loss program or product while their kids watch their bizarre behavior and think it's normal," Berg says. Eating disorder characteristics How can you tell whether your child's dieting practices have gone too far and may be signs of an eating disorder? Guthrie says it's important for parents to first educate themselves about good nutrition and eating disorders. The characteristics of the two eating disorders associated with obsessive weight loss:
- People who have anorexia eat very little even though they are thin. They have an intense fear of body fat and weight gain.
- People with bulimia tend to binge and purge. That is, they will get rid of food that they have just eaten by vomiting or taking laxatives or diuretics (water pills). They also have a fear of body fat even though their size or weight may be normal for them.
"With an anorexic, the first things to look for are the physical signs. They will show distinct weight loss," Guthrie says. "The signs are harder to see with a bulimic. A parent should look for behaviors, such as a constant obsession with food and weight or constant comments about foods being too fattening." Another sign of someone having bulimia is not wanting to eat with the rest of the family. "They may want to eat in private, or they go to the bathroom (to purge) after they eat," Guthrie adds. They may also offer excuses for why they don't want to eat. "They say they're too busy to eat. They're not hungry in the morning. They don't like cafeteria food," Guthrie says. Parents and school coaches should also be on the lookout for what experts call "exercise bulimia." "Too much exercise can be just as dangerous as purging," Guthrie contends. "If they eat a piece of cake, they think they have to work that off. They exercise several hours every day." Finally, Guthrie advises parents to look for signs of depression or antisocial behavior closely related to eating disorders. If you suspect your teenager has an eating disorder, don't keep your suspicions to yourself. "Sit down with your child and let them know you're really worried about them," she says. Tips on helping The Office on Women's Health also has these suggestions for how friends can help friends who they suspect have an eating disorder. These suggestions can easily apply to parents:
- In a calm and caring way, tell your friend/child what you saw or heard. Use "I" statements and let the person know you are concerned. For example, "I'm worried about you because you haven't eaten lunch (or dinner) this week."
- Listen carefully to what your child says. Teens with eating disorders might feel ashamed or afraid. They may feel unimportant or think that life doesn't matter. Feeling out of control also is common.
- What if they get mad or deny it? It is very common for people with problems to say that there is nothing wrong. Tell them you want to help.
"It's important to get help. The earlier you catch an eating disorder, the better the chance for a full recovery," Guthrie says. "They are treatable, and there are a lot of specialists out there - therapists, medical doctors, psychiatrists who work exclusively with eating disorders." Sources: The National Eating Disorders Association The National Association of Anorexia Nervosa and Associated Disorders National Eating Disorders Association Something Fishy The Alliance for Eating Disorders Alliance The Council on Size and Weight Discrimination
This article was reviewed and updated June 2007.
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