Winter is here and it is an important time to raise your awareness of eating disorders. The stressors of school, peers and activities can overwhelm some teenagers, triggering the beginnings of Anorexia. Unfortunately, the hard truth is that more and more clients enter therapy or treatment already in the throes of a full blown eating disorder. According to the National Institute of Mental Health, once the diagnosis of “Anorexia Nervosa” is given, the statistics are grim, including high mortality rates and severe medical and mental illnesses (www.NIMH.gov). Eating Disorders do not discriminate by age or gender, but the majority of eating disorders, especially Anorexia, begin to appear in early adolescence.
In my treatment of Anorexia, there are many signs that a serious problem has developed. These are some of the more frequent symptoms and concerns observed. If any of these signs are present, seek help and get an evaluation by a doctor or therapist who specializes in eating disorders.
- Dieting. No teenager should be on any type of diet, unless they are under the care of a doctor or nutritionist. I cannot stress this enough.
- While low body weight is the biggest clue, it’s also important to consider how much weight your teen has been dropping within a short period of time. By the time a severe weight loss is noticed, chances are high that the disorder has already developed.
- An increase in exercise. Even If your loved one has already been exercising, is the pattern changing in frequency or type? Discuss with a Doctor the appropriate amount of exercise for your individual teen.
- Preoccupation with losing additional weight or preoccupation with changing body shape, in spite of being thin. This usually includes an intense and persistent fear of gaining weight.
- Mood changes. Becoming easily annoyed, angry, or anxious, especially around the issues of food and weight are frequently reported. An increase in sadness, along with isolation from peers and family, are common.
- Using the bathroom immediately after a meal.
- Refusing to eat with others, unwilling to eat foods eaten the past, and/or a decrease in portion size of the foods that are eaten.
- Eating behaviors that appear habitual and/or unusual. Examples can include eating very slowly, cutting/ripping food into small pieces, or eating at odd times.
- A sudden change into a vegetarian or vegan. Many teenagers do this to cut down on food choices – this can be a covert way to stop or limit carbs, fats, sugars or protein.
Of all the psychiatric illnesses, Anorexia is associated with the highest mortality rate (NIMH). Serious, long-term medical and psychological problems may persist for life. Once given the diagnosis of Anorexia, the likelihood of recovery drops significantly. And estimates indicate that 20% of teens may never fully recover. Professionals agree that the earlier eating disordered behaviors are treated, the greater the likelihood of recovery.
My advice to parents and loved ones: if you think your daughter, son, friend, or loved one might be showing signs of an eating disorder, take action. With a serious case of Anorexia, the average teenager may be in treatment for over five years. Anorexia can be a slow developing disease, making it hard to notice behavior and appearance changes as they happen gradually. Heed the warning signs that the disorder is in development. That is the time when psychological treatment will yield the best results.
Gail C. Welkes, LCSW is a clinical psychotherapist, practicing in the Philadelphia area.