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They take a devastating toll on American youth, especially young girls. Getting diagnosed and treated can be a matter of life and death. Here’s what you need to know to help your child.

Eating disorders, such as anorexia, bulimia, and binge eating, involve fixation on weight that can lead to severe disturbances in eating and body function. Eating disorders can arise quickly and become dangerous just as fast. In a matter of weeks, people who develop eating disorders can land themselves in the hospital. They have a significantly higher death rate than any other psychiatric condition.

“If parents suspect that their child has an eating disorder, this is not a wait-and-see situation,” warns Dave Rosen, M.D., FAAP, clinical professor, Department of Pediatrics and Communicable Diseases, University of Michigan Medical School. Recognizing the signs of an eating disorder and intervening quickly could mean the difference between life and death.

Perceptions of Weight

Of the millions who suffer from eating disorders, 90 percent are women between ages 12 and 25. At the root of eating disorders may be a perception by an individual that he or she has an abnormally high body weight. This is typically true of anorexia.

Anorexia, which occurs more often in younger adolescents, is a condition in which the afflicted will literally starve themselves and refuse to maintain even the lowest normal body weight. Anorexics may also purge food by vomiting or abusing laxatives. They may exercise excessively. Although they are extremely thin, they will still “see” themselves as fat. Doctors diagnose anorexia when someone weighs 15 percent below normal body weight for her age and height.

Binge and Purge

Bulimia occurs more often in older teenagers, who may be anywhere from slightly underweight to obese, but never as underweight as those with anorexia. People with bulimia binge eat frequently, gulping down thousands of calories, often high in carbohydrates and fat. During the binge, sufferers feel completely out of control. The binge ends only when their stomachs hurt, they fall asleep, or another person interrupts them.

After the binge comes the purge. Stomach pains and fear of weight gain drive the person to induce vomiting (sometimes by using the medication ipecac) or use laxatives or diuretics to rid their bodies of the food as quickly as possible. The cycle repeats at least two times a week, or at its most severe, several times a day.

Binge eating is similar to bulimia in that it involves a binge but is not followed by a purge. It is a very real disorder for some, but it’s not yet defined as a psychiatric disorder due to a lack of research. “We think that there are genetic and other physiological abnormalities that underlie anorexia and bulimia,” says Rosen. “We don’t know that about binge eating disorder.” Binge eating affects almost as many men as women. Feelings of guilt after one binge will lead the binge eater to repeat the behavior.


Signs That Something’s Wrong

The most common symptoms of eating disorders may include:


  • Interruptions in the menstrual cycle
  • Fatigue
  • Depression
  • An irregular heartbeat

Children with eating disorders may appear anxious at mealtimes or prefer to eat alone. Anorexics may develop insomnia, anemia, a baby-fine hair covering the body called lanugo, or brittle hair and nails.

If your child is suffering from bulimia, she may also take frequent, long bathroom visits during or just after meals. A bulimic may have swollen cheeks or glands, tooth decay, and reddened fingers from inducing vomiting. Binge eaters may also suffer from joint pain.

With all eating disorders, denial can become one of the symptoms. Friends or family may need to insist that the sufferer get help, because complications can be severe or even fatal.


Serious Consequences

As many as one in ten people with anorexia will die due to severe weight loss or suicide. Heart muscles may become weakened. Hormonal changes can lead to infertility, bone loss, or delayed growth. A disruption of the body’s levels of minerals and fluids can create an electrolyte imbalance, which can be fatal. There may be brain and nerve damage, seizures, or loss of feeling.

Bulimia sufferers may experience dehydration, peptic ulcers, or pancreatitis. Bulimics and anorexics may have long-term constipation.

Binge eaters may suffer from high blood pressure, elevated cholesterol levels, heart disease, type 2 diabetes, or gall bladder disease.


Seeking Medical Help

If you suspect your child may have an eating disorder, Dr. Rosen suggests a calm approach. “If parents approach their kids in a supportive, non-confrontational way, and in a way that invites disclosure,” he says, “kids who are struggling with this are more likely to look to their parents for help in whatever issue they may have.”

A doctor will often diagnose an eating disorder by questioning the patient about his eating and exercise habits and body image. He or she may perform a complete blood count (CBC) to detect anemia, or order an electrocardiogram, chest x-ray, bone density test, imaging tests to detect damage in the brain or digestive tract, or tests of various organs.

While eating disorders cannot be cured, early diagnosis and appropriate treatment can ensure a lasting recovery. Treatment often includes nutrition education, psychotherapy, and family counseling. While Dr. Rosen agrees that some medications can be helpful for bulimia, he advises against treating anorexia with medication. However, people suffering from anorexia may also suffer from other emotional disorders. Doctors may simultaneously treat these conditions with medication.


Not Just for Girls

While eating disorders disproportionately affect women, Rosen warns parents not to ignore the fact that boys can have eating disorders. There is no singular cause. Rather, circumstances can pave the way for a disorder to emerge in a boy predisposed to the condition. A variety of factors — which cross gender lines — can influence risk, including genetics, the presence of emotional disorders, family behavior, and unhealthy media messages.

Still, parents can help prevent eating disorders by being role models of a healthy body image. “If you’re a mother of girls and you diet all the time, it’s pretty hard to tell your daughter to be satisfied with her own appearance,” Dr. Rosen cautions.

It’s also very important to be wary of the messages the media transmits to your children — media literacy, as it’s called. “If you’re a young person and all of the images you see in the media demonstrate that particular body shape, you could incorrectly assume that that’s the body everybody is supposed to have,” Dr. Rosen says. “Kids need to be taught to question what they see in all types of media and to set more realistic expectations for themselves.”

Of course, plenty of adults could use the same advice.

This article was featured in Healthy Children Magazine. To view the full issue, click here.


Last Updated
Healthy Children Magazine, Fall 2007
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.