About Eating Disorders

From: The Healthy Teen Project




Adolescent Eating Disorders such as Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder are treatable.


Eating disorders are complex illnesses that affect people of all ages; the onset of eating disorders typically occurs during pre-adolescence or adolescence. Eating disorders affect millions of adolescents and young adults in the U.S. alone. Given the serious medical complications that may result from eating disorders, it is imperative to identify, diagnose and treat them as early as possible. With early diagnosis and proper treatment, recovery is possible.


Diagnosing Eating Disorders

The earlier eating disorders are diagnosed and treated, the more likely the probability of complete recovery. However, many adolescents go undiagnosed and do not receive treatment until their eating disorders are at an advanced stage. One reason is teenagers with eating disorders often try to hide their behaviors. Or teenagers (as well as family and friends) may be in denial about their eating disorders, or simply unaware of the signs and symptoms of an eating disorder.

It can be difficult to identify a teenager with an eating disorder, as they may appear to be a ‘normal weight’. Yet teenagers can be very malnourished even at seemingly ‘normal weights’. They may also appear to eat normally in front of peers or family while secretly restricting food intake, bingeing, purging, or over exercising.

Different types of eating disorders produce different warning signs, about which friends, family and patients themselves should become aware.



Types Of Eating Disorders

The most common eating disorders among adolescents are Anorexia Nervosa, Bulimia Nervosa and Binge-Eating Disorder. Even patients that do not meet all of the clinical criteria for an eating disorder can be at serious risk and should seek medical treatment.



Anorexia Nervosa

Teenagers with Anorexia Nervosa may take extreme measures to avoid eating and control the quantity and quality of the foods they do eat. They may become abnormally thin, or thin for their body, and still talk about feeling fat. They typically continue to diet even at very unhealthy weights because they have a distorted image of their body.



Signs of Anorexia Nervosa may include:

  • A distorted view of one’s body weight, size or shape; sees self as too fat, even when very underweight

  • Restricting, hiding or discarding food

  • Obsessively counting calories and/or grams of fat in the diet

  • Denial of feelings of hunger

  • Developing rituals around preparing food and eating

  • Compulsive or excessive exercise

  • Social withdrawal

  • Pronounced emotional changes, such as irritability, depression and anxiety


Physical signs of Anorexia Nervosa include rapid or excessive weight loss; feeling cold, tired and weak; thinning hair; absence of menstrual cycles in females; and dizziness or fainting.


Teenagers with Anorexia Nervosa often restrict not only food, but relationships, social activities and pleasurable experiences.



Bulimia Nervosa


Teenagers with Bulimia Nervosa typically ‘binge and purge’ by engaging in uncontrollable episodes of overeating (bingeing) usually followed by compensatory behavior such as: purging through vomiting, use of laxatives, enemas, fasting, or excessive exercise. Eating binges may occur as often as several times a day but are most common in the evening and night hours.

Teenagers with Bulimia Nervosa often go unnoticed due to the ability to maintain a normal body weight.

Signs of Bulimia Nervosa may include:

  • Eating unusually large amounts of food with no apparent change in weight

  • Hiding food or discarded food containers and wrappers

  • Excessive exercise or fasting

  • Peculiar eating habits or rituals

  • Frequent tips to the bathroom after meals

  • Inappropriate use of laxatives, diuretics, or other cathartics

  • Overachieving and impulsive behaviors

  • Frequently clogged showers or toilets


Physical signs of Bulimia Nervosa include discolored teeth, odor on the breath, stomach pain, calluses/scarring on the hands caused by self-inducing vomiting, irregular or absent menstrual periods, and weakness or fatigue.

Teenagers with Bulimia Nervosa often have a preoccupation with body weight and shape, as well as a distorted body image. The clinical diagnosis commonly defines Bulimia Nervosa if they binge and purge on average once a week for at least three consecutive months.



Binge Eating Disorders

Binge Eating Disorder is characterized by a sense of uncontrollable excessive eating, followed by feelings of shame and guilt. Unlike those with Bulimia Nervosa, however, teenagers with Binge Eating Disorder typically do not compensate for their binges.

Teenagers with Binge Eating Disorder may feel like they have no control over their behavior and eat in secret when they are not hungry.


Signs of Binge Eating Disorder might include:

  • Eating an unusually large amount of food in a distinct period of time (within 2 hours)

  • Hiding food or discarded food containers and wrappers

  • Eating in secret because of feeling embarrassed by how much they are eating

  • Eating when stressed or when feeling uncertain how to cope

  • Feeling that they are unable to control how much they eat and disgusted with themselves afterwards

  • Experimentation with different diets


Most of the physical signs and symptoms associated with Binge Eating Disorder are long-term, including weight gain, high blood pressure, diabetes, irregular menstrual cycle, skin disorders and heart disease.

Similar to Bulimia Nervosa, Binge Eating Disorder is commonly diagnosed if teenagers binge on average once a week for at least three consecutive months.



Eating Disorder Treatment

Recommended treatment for adolescent eating disorders usually involves a multidisciplinary approach. Treatment should include medical; psychiatric; individual, group and, in particular, family therapy; along with nutritional rehabilitation aimed at restoring health and body weight and eventually modifying behaviors related to eating and exercise. Treatment should always be based on a comprehensive evaluation of the individual and family.

The frequency of medical complications during the course of treatment requires the close supervision of a medical professional. Medication may be required if certain psychiatric disorders are also present; most commonly depression and anxiety disorders. Teenagers may have obsessive-compulsive disorder or tendencies, and may also suffer from trauma or substance abuse, or engage in self-harming behavior, such as cutting or burning. It is important that eating disorder treatment works to identify and address these co-occurring disorders.

Individual therapy usually includes both behavioral and cognitive techniques. Group therapy allows individuals struggling with eating disorders to find a place where they can open up and be honest and real about their struggles, relate to others, and receive much needed support. Family therapy is initially focused on supporting the family in nutritional rehabilitation and later, offering the opportunity to navigate other challenges of adolescence and mental health.

Nutritional counseling includes a combination of nutrition education, meal planning and goal setting. It also may include hands-on experiential and skills work. Treatment helps the individual recovering from an eating disorder cultivate a healthier relationship with food in order to gain the skills and education needed to eventually feed oneself going forward.



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