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Overeating related to tension, poor
nutritional habits and food fads are relatively common eating problems for
youngsters. In addition, two psychiatric eating disorders, anorexia nervosa and
bulimia, are on the increase among teenage girls and young women and often run
in families. In the United States, as many as 10 in 100 young women suffer from
an eating disorder. These two eating disorders also occur in boys, but much
less often. The child and adolescent psychiatrist is trained to evaluate,
diagnose, and treat these psychiatric disorders which are characterized by a
preoccupation with food and a distortion of body image.
Parents frequently ask how to identify symptoms of anorexia
nervosa and bulimia. Unfortunately, many teenagers successfully hide these
serious and sometimes fatal disorders from their families for many months or
years.
Parents should be on the lookout for various symptoms and warning
signs of anorexia nervosa and bulimia:
o A teenager with anorexia nervosa is typically a
perfectionist and a high achiever in school. At the same time, she suffers from
low self-esteem, irrationally believing she is fat regardless of how
thin she becomes. Desperately needing a feeling of mastery over her life, the
teenager with anorexia nervosa experiences a sense of control only when she
says "no" to the normal food demands of her body. In a relentless pursuit to be
thin, the girl starves herself. This often reaches the point of serious damage
to the body, and in a small number of cases may lead to death.
o The symptoms of bulimia are usually different
from those of anorexia nervosa. The patient binges on huge quantities of
high-caloric food and/or purges her body of dreaded calories by
self-induced vomiting and often by using laxatives. These binges may alternate
with severe diets, resulting in dramatic weight fluctuations. Teenagers may try
to hide the signs of throwing up by running water while spending long periods
of time in the bathroom. The purging of bulimia presents a serious threat to
the patient's physical health, including dehydration, hormonal imbalance, the
depletion of important minerals, and damage to vital organs.
With comprehensive treatment, most teenagers can be relieved of
the symptoms or helped to control eating disorders. Treatment for eating
disorders usually requires a team approach; including individual therapy,
family therapy, working with a primary care physician, working with a
nutritionist, and medication. Many adolescents also suffer from other problems;
including depression, anxiety, and substance abuse. It is important to
recognize and get appropriate treatment for these problems as well.
Research shows that early identification and treatment leads to
more favorable outcomes. Parents who notice symptoms of anorexia or bulimia in
their teenagers should ask their family physician or pediatrician for a
referral to a child and adolescent psychiatrist who works comprehensively in
the treatment of eating disorders and can coordinate the treatment team.
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nearly 12.5 million children and adolescents in an effort to de-stigmatize
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Copyright © 1997 by the
American Academy of Child & Adolescent Psychiatry
Presented with permission of the
AACAP
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