Eating Disorders and Young Teens

By Deborah M. Mollo, MD FAAP | Pediatrics 

Self-image issues surrounding weight are extremely prevalent, regardless of age.  However, young teens are especially impressionable, and thus, more likely to develop eating disorders, such as bulimia and anorexia nervosa.

If a teen develops a poor self-image early in life and/or fosters a bad attitude toward eating and his/her weight, it can develop into a lifelong pattern of unhappiness and poor health. Spotting potential eating disorders early on is crucial in preventing potential problems, such as hormonal imbalance, infertility, irregular heart rhythm, and kidney abnormalities.

Prevention:

Prevention of eating disorders begins at home. Many adolescents observe their parents worrying about their weight and diet. Often times, adults don’t realize the messages they convey to their kids through these actions. A parent/guardian who is frequently exercising and dieting to lose weight can unknowingly influence their child’s own self-image and eating habits. Children mimic the actions of those around them, and if a parent is consistently counting calories and fat grams, their child may pick up this behavior as well. Parents must therefore be careful about what they say and do around the home, particularly as it concerns food, diet, and weight. They need to foster their teen’s self-confidence, and remind them of how much potential they possess.

Indicators:

A major indicator of poor self-image and a potential eating disorder is when a normal-weight teen frequently talks about dieting and exercising, and expresses a desire to be thinner.

These teens will often ask how many calories they should be consuming per day and will usually express dissatisfaction with their weight. Some describe their diet as vegetarian, when, in reality, they are simply trying to avoid eating fat and protein.

More serious indicators of an eating disorder are when the teen begins binging or purging, or if female, when her menstrual cycle stops. Often, teens will leave the dinner table quickly or make frequent trips to the bathroom after eating, in order to self-induce vomiting. They may use mints, mouthwash or chewing gum frequently, or brush their teeth often to hide the habit. Teens may also use over-the-counter diet aids or diuretics to help them lose weight.

As the pattern develops, these teens may begin to exercise more and become overly concerned with things like fat grams and calories. They might show signs of weight loss, such as decreasing a size in clothing and, sadly, get reinforcement by comments like “you look great!” At this point, intervention by a physician and a counselor is critical to reverse the process before it becomes obsessive or uncontrollable.

Since teens spend most of their time away from home and in school, a friend may be able to spot the warning signs more quickly than parents. When the warning signals are ignored, this behavior can develop into a serious problem with potential life-long implications, both physically and emotionally.

Treatment:

For some teens, talking to a doctor, keeping a food diary, and attending regular check-ups is enough to improve their attitude toward food and themselves. A physician may also refer the patient to a counselor or therapist who can help treat the underlying psychological and emotional issues. Counseling can assist the teen in correcting their underlying self-image issues. However, some may need more structure. They need to realize that the pressure to lose weight is something they put on themselves, and that they alone are the only ones who can ultimately help themselves.