Eating Disorders: When an Epidemic Expands

Earlier this year, an article in The Guardian out of the United Kingdom reported that hospital admissions resulting from young people experiencing anorexia and bulimia were on the rise. Though a variety of groups aimed at reducing the amount of imagery of skinny models has helped, today’s teens are still facing eating disorders. And when these eating disorders aren’t addressed, it can lead to a host of other health issues down the road.

Eating disorders are psychological disorders related to eating behaviors. The most commonly known eating disorders, including anorexia and bulimia, but overeating too is a common concern amongst health professionals, especially as the United States continues to battle a high obesity rate.

Teens with anorexia work hard to keep their weight lower than what would be considered normal. This is usually done through starvation or an obsessive over-focus on calorie restriction. Those with bulimia will often appear to eat normally in public, but will then resort to purging after a big meal. It is also common for those with bulimia to snack in private on a variety of unhealthy foods, also then turning to the purge process to remove those foods from their body shortly after consumption. Overeating is relatively self-explanatory but refers to the overconsumption of a healthy volume of calories on a regular basis.

Eating Disorder Symptoms to Look For

Any parent knows that a teenager can be unpredictable, often changing moods and interests from one minute to the next. This can make it hard for parents who are trying to be on the lookout for warning signs tied to any illness or affliction in their teen. That said, in the cases of an eating disorder, many symptoms are similar to that of other disorders. With any of these symptoms, it is important to seek medical attention so that your teen can receive help earlier than later.

For eating disorders in particular, parents should be on the lookout for the following:

• Distorted body image – The teen describes their physical attributes in a way that is far different from how most people would view them.
• Skipping meals or picking through food and eating very little at mealtime
• An obsession with the bathroom scale
• Fluctuations in weight that seem to be extreme
• Insomnia
• Constipation
• Dental cavities
• Erosion of tooth enamel
• Skin rash or dry skin that is not otherwise explained
• Hyperactivity or extreme and sudden interest in intense exercise
• Hair loss or diminished nail quality

Teens that are afflicted by an eating disorder will likely be in denial that anything is going on. They will often be moody or show signs of anxiety or depression. Teens with an eating disorder are known to withdraw from family and friends and are often very sensitive to constructive feedback or other criticisms. In many cases, these insecurities will trigger an eating disorder.

However, what can be even more troubling about eating disorders is the long-term risk associated with a lack of treatment.

The Bigger Risks Associated with Teen Eating Disorders

According to ANAD’s website, at least 30 million people across the United States are suffering from an eating disorder. And, every 62 minutes, there is an eating-disorder related death. If you do the math, this means that there are an estimated 23 deaths every day in the United States related to an eating disorder. That’s almost 8,500 deaths each year. Those numbers are staggering, especially when eating disorders can be prevented or treated when addressed by trained medical professionals.

As suggested previously, most eating disorders manifest due to some other stress or trauma in a teen’s life. Genetics and biology can be an underlying culprit as those with specific genes may be at higher risk. However, it is more often the case that psychological and emotional health problems are likely to contribute to the onset of an eating disorder.

When eating disorders are not addressed promptly, they can lead to a variety of long-term health effects.

Cardiovascular Risks

When fewer calories are consumed than what the body needs for fuel, it will lead to a breakdown of the muscles. And, the heart is the most important muscle in the body. Blood pressure and pulse will begin to lower as the heart has less fuel to pump the blood throughout the body, and fewer blood cells to pump the blood with. As a result, the risk of heart failure will increase.

Unfortunately, it is not uncommon for medical professionals to overlook eating disorders, especially in athletes. The slow pulse of someone with an eating disorder can look similar to the low pulse of an athlete. However, in the case of someone with an eating disorder, the slow pulse is due to an undernourished heart.

Further, the purging that is common with bulimia, and the laxative use that is common with those with anorexia will lead to the depletion of critical electrolytes in the body. Potassium is important to help the heartbeat and for muscles to contract, but these chemicals are depleted through the purging process. And, sodium and chloride can become out of balance when excessive water is consumed. An imbalance in electrolytes often leads to an irregular heartbeat, and also to heart failure, or even worse, death.

Gastrointestinal Risks

The practice of food restriction and vomiting through purging can impede normal stomach processes including the digestion of foods and their associated nutrients. Slowed digestion, referred to as gastroparesis, can lead to:

• Stomach pain and bloat
• Vomiting and nausea
• Fluctuations in blood sugar level
• Intestinal blockage due to masses of undigested food
• Infections caused by bacteria
• A feeling of satiation (fullness) after only a small volume of food has been consumed

Other risks include:

• Constipation
• Stomach rupture
• Wearing down of the esophagus
• Swelling of the salivary glands
• Pancreatitis
• Intestinal obstruction or perforation

Neurological Risks

If you have ever seen the Tom Cruise film, Jerry Maguire, you have heard the famous quote that “the human head weighs eight pounds.” The brain itself, however, only weighs about three pounds, yet it consumes about one-fifth of the body’s calories. When teens participate in excessive exercise, dieting, starvation, or fasting, it results in the brain not getting the energy it needs to help operate the body. This can result in difficulty in concentrating, extreme hunger, fainting or dizziness, and more.

And, individuals that are heavier in weight can experience sleep apnea. When sleep apnea is left untreated, it can lead to a variety of life-threatening health concerns.

• High blood pressure
• Stroke
• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Sudden cardiac death
• Diabetes mellitus

Teens with untreated sleep apnea and untreated eating disorders will be very likely to develop various heart and vascular concerns as well including higher blood pressure, higher blood volume, a higher heart rate, and increased inflammation and stress to the body.

Endocrine Risks

The endocrine system consists of the glands in the body that help cells communicate with one another. These hormones that help the cells communicate are responsible for just about every organ, cell, and function in the body. When the endocrine system is not healthy, it results in problems during puberty, the ability to get pregnant, and stress management.

Those with unhealthy endocrine systems also experience a higher risk of weight gain, have weaker bones, and lack overall energy. As the endocrine system is responsible for making the hormones that control moods, development, and growth, poor health can be miserable overall.

Emotional and Psychological Risks

Though teens with emotional concerns are at greater risk for eating disorders, the very presence of an eating disorder can then exacerbate those same concerns. Those with eating disorders often struggle with the following:

• Anxiety or self-doubt
• A feeling of being out-of-control or helpless
• Feelings of failure, guilt, and shame
• Hypervigilance
• Obsessive thoughts or preoccupations
• Compulsive behaviors
• Excessive feelings of loneliness or alienation

Eating disorders are not a singular illness either. This means that the teen is not the only one affected by the disease. Eating disorders can bring suffering, pain, and sadness to family members and friends, as well. Even your teen’s co-workers can be negatively impacted. These struggles can include:

• Familial disruption tied to blame and arguments over food, weight, treatment options, etc.
• Struggles with guilt, anxiety, worry, and frustration as family members and friends feel that nothing that they are doing is helping the teen.
• Damaged or destroyed friendships and romantic relationships as the person with the eating disorder is often irritable, secretive and controlling, and emotionally withdrawn. Behavior is often passive-aggressive in nature.
• For athletes with eating disorders, teachers, coaches, and trainers may become worried and frustrated, and this concern can then plague and systemically spread to family members.

Getting Help for a Teens with Eating Disorders

If your teen is exhibiting signs of an eating disorder, it is essential to seek help sooner than later. As previously mentioned, a lack of treatment for an eating disorder can lead to a host of additional health concerns. Thus, parents must communicate with their teens about their concerns.

Parents should start by picking a time to chat with their teen when the conversation can remain focused. It is important to avoid distractions that can impede the discussion. And, it is best to avoid having a conversation about a suspected or known eating disorder right after an argument. Instead, parents should look to have this conversation when both parties are emotionally calm.

Parents should explain why they are concerned and be prepared for denial or resistance from the teen. Those with eating disorders will often become angry or defensive when confronted, so parents need to work hard to remain calm and stay focused. Parents also need to be respectful of the teen’s feelings and encourage them to share their point of view. Being patient and supportive will be the best way to get the teen to open up and potentially admit that there is a problem.

No matter how the conversations go, parents need to be sure to avoid the following:

• Ultimatums
• Commenting on the teen’s appearance or weight
• Shaming or blaming
• Providing overly simple solutions

Though parents need to encourage their teen to get help, sometimes the teen will remain resistant. In these cases, parents may be forced to make a difficult decision to seek help for their teen without their teen’s agreement.

Treatment for Teen Eating Disorders

A team approach is usually the best method for treating teenage eating disorders. This will likely include various medical professionals, including a medical doctor, mental health professional, and nutritionist. Residential treatment is a highly recommended solution for teens as it provides an opportunity for full-supervision of the teen’s eating and related behaviors. Further, in a residential setting, the teen is removed from various triggers and situations that can create compulsive eating (or starvation-related) behaviors.

During residential treatment, the teen will receive care from a medical doctor to address any resulting medical afflictions. This may mean treatment for severe malnourishment, depression and suicidal thoughts, or treatment resistance. Nutritional counseling will help your teen to develop better eating habits. And, therapy will help your teen to identify with the feelings that have caused the poor and dangerous eating habits.

Therapy will often include multiple approaches, such as individual therapy, family therapy, and group therapy. Each of these approaches provides a different level of support for the teen and ensures that the teen has the proper level of support on the home front.

When the teen returns home from residential treatment, parents must maintain a positive environment that will allow the teen to thrive. Parents are encouraged to make mealtimes fun, to set a positive example as a role model with good eating habits, and to help promote self-esteem in the teen.

Finally, parents who seek to understand their teen’s point of view but also do their own research on eating disorders will be best equipped to create a positive and nurturing environment for their child.

Here at Hillcrest, we understand how teens dealing with an eating disorder can suffer in their day to day lives. Because of our experience working with teenagers that are dealing with mental health issues and eating disorders, we believe that we’re a fantastic place to send your teenager for help with developing coping mechanisms for their eating disorder – or any other form of mental health issue. Not sure how we can help? Why not reach out for a callback or to set up a tour?