Eating disorders are so common throughout the world that 1 or 2 out of every 100 students will
struggle with one. Each year, thousands of teens develop eating disorders, or problems with weight,
eating, or body image.
Eating disorders are more than just going on a diet to lose weight or trying to exercise every day.
They’re extremes in eating behavior — the diet that never ends and gradually gets more restrictive,
for example. Or the person who can’t go out with friends because he or she thinks it’s more
important to go running to work off a snack eaten earlier.
The most common eating disorders are anorexia nervosa and bulimia nervosa (usually called simply
“anorexia” and “bulimia”). But other food-related disorders, like binge eating, body image disorders,
and food phobias, are becoming more and more common.
ANOREXIA
People with anorexia have a real fear of weight gain and a distorted view of their body size and shape.
As a result, they can’t maintain a normal body weight. Many teens with anorexia restrict their food
intake by dieting, fasting, or excessive exercise. They hardly eat at all — and the small amount of food
they do eat becomes an obsession.
Others with anorexia may start binge eating and purging — eating a lot of food and then trying to get
rid of the calories by forcing themselves to vomit, using laxatives, or exercising excessively, or some
combination of these.
BULIMIA
Bulimia is similar to anorexia. With bulimia, someone might binge eat (eat to excess) and then try to
compensate in extreme ways, such as forced vomiting or excessive exercise, to prevent weight gain.
Over time, these steps can be dangerous — both physically and emotionally. They can also lead to
compulsive behaviors (ones that are hard to stop).
To be diagnosed with bulimia, a person must be binging and purging regularly, at least twice a week
for a couple of months. Binge eating is different from going to a party and “pigging out” on pizza, then
deciding to go to the gym the next day and eat more healthfully.
People with bulimia eat a large amount of food (often junk food) at once, usually in secret. Sometimes
they eat food that is not cooked or might be still frozen, or retrieve food from the trash. They typically
feel powerless to stop the eating and can only stop once they’re too full to eat any more. Most people
with bulimia then purge by vomiting, but may also use laxatives or excessive exercise.
Although anorexia and bulimia are very similar, people with anorexia are usually very thin and
underweight but those with bulimia may be a normal weight or can be overweight.
BINGE EATING DISORDER
This eating disorder is similar to anorexia and bulimia because a person binges regularly on food
(more than three times a week). But, unlike the other eating disorders, a person with binge eating
disorder does not try to “compensate” by purging the food.
Anorexia, bulimia, and binge eating disorder all involve unhealthy eating patterns that begin gradually
and build to the point where a person feels unable to control them.
SIGNS OF ANOREXIA AND BULIMIA
Sometimes a person with anorexia or bulimia starts out just trying to lose some weight or hoping to
get in shape. But the urge to eat less or to purge or over-exercise gets “addictive” and becomes too
hard to stop.
NOT JUST A GIRL THING
More guys are seeking help for eating disorders. Guys with eating disorders tend to focis more on
athletic appearance or success than on just looking thin.
Teens with anorexia or bulimia often feel intense fear of being fat or think that they’re fat when they
are not. Those with anorexia may weigh food before eating it or compulsively count the calories of
everything. People to whom this seems “normal” or “cool” or who wish that others would leave them
alone so they can just diet and be thin might have a serious problem.
How do you know for sure that someone is struggling with anorexia or bulimia? You can’t tell just by
looking — a person who loses a lot of weight might have another health condition or could be losing
weight through healthy eating and exercise.
But there are some signs to watch for that might indicate a person has anorexia or bulimia.
Someone with anorexia might:
become very thin, frail, or emaciated
be obsessed with eating, food, and weight control
weigh herself or himself repeatedly
only eat certain foods, avoiding foods like dairy, meat, wheat, etc. (of course, lots of people who
are allergic to a particular food or are vegetarians avoid certain foods)
exercise excessively
feel fat
withdraw from social activities, especially meals and celebrations involving food
be depressed, lethargic (lacking in energy), and feel cold a lot
Someone with bulimia might:
fear weight gain
be intensely unhappy with body size, shape, and weight
make excuses to go to the bathroom immediately after meals
only eat diet or low-fat foods (except during binges)
regularly buy laxatives, diuretics, or enemas
spend most of his or her time working out or trying to work off calories
withdraw from social activities, especially meals and celebrations involving food
be depressed, lethargic (lacking in energy), and feel cold a lot
WHAT CAUSES EATING DISORDERS?
No one is really sure what causes eating disorders, although there are many theories about it. Many
people who develop an eating disorder are between 13 and 17 years old. This is a time of emotional
and physical changes, academic pressures, and a greater degree of peer pressure.
Although there is a sense of greater independence during the teen years, teens might feel that they
are not in control of their personal freedom and, sometimes, of their bodies. This can be especially
true during puberty.
For girls, even though it’s completely normal (and necessary) to gain some additional body fat during
puberty, some respond to this change by becoming very fearful of their new weight. They might
mistakenly feel compelled to get rid of it any way they can.
A NOT SO PERFECT PICTURE
We’re overloaded by images of thin celebrities – people who often weigh far less than their healthy
weight (and who may have histories of eating disorders). So it’s easy to see why people may develop
a fear of weight gain, even if that gain is temporary and healthy.
When you combine the pressure to be like celebrity role models with the fact that bodies grow and
change during puberty, it’s not hard to see why some teens develop a negative view of themselves.
Celebrity teens and athletes conform to the “Hollywood ideal” — girls are petite and skinny, and guys
are athletic and muscular, and these body types are popular not only in Hollywood but also in high
school.
Many people with eating disorders also can be depressed or anxious, or have other mental health
problems such as obsessive-compulsive disorder (OCD). There is also evidence that eating disorders
may run in families. Although part of this may be genetics, it’s also because we learn our values and
behaviors from our families.
SPORTS AND EATING DISORDERS
Athletes and dancers are particularly vulnerable to developing eating disorders around the time of
puberty, as they may want to stop or suppress growth (both height and weight).
Coaches, family members, and others may encourage teens in certain sports — such as gymnastics,
ice skating, and ballet — to be as thin as possible. Some athletes and runners are also encouraged to
weigh less or shed body fat at a time when they are biologically destined to gain it.
be depressed, lethargic (lacking in energy), and feel cold a lot
EFFECTS OF EATING DISORDERS
Eating disorders are serious medical illnesses. They often go along with other problems such as stress,
anxiety, depression, and substance use. Eating disorders can lead to the development of serious
physical health problems, such as heart conditions or kidney failure.
Someone whose body weight is at least 15% less than the average weight for that person’s height
may not have enough body fat to keep organs and other body parts healthy. In severe cases, eating
disorders can lead to severe malnutrition and even death.
With anorexia, the body goes into starvation mode, and the lack of nutrition can affect the body in
many ways:
a drop in blood pressure, pulse, and breathing rate
hair loss and fingernail breakage
loss of periods
lanugo hair — a soft hair that can grow all over the skin
lightheadedness and inability to concentrate
anemia
swollen joints
brittle bones
With bulimia, constant vomiting and lack of nutrients can cause these problems:
constant stomach pain
damage to the stomach and kidneys
tooth decay (from exposure to stomach acids)
“chipmunk cheeks,” when the salivary glands permanently expand from throwing up so often
loss of periods
loss of the mineral potassium (this can contribute to heart problems and even death)
swollen joints
brittle bones
A person with binge eating disorder who gains a lot of weight is at risk of developing diabetes, heart
disease, and some of the other diseases associated with being overweight.
The emotional pain of an eating disorder can take its toll, too. When someone becomes obsessed
with weight, it’s hard to concentrate on much else. It can be exhausting and overwhelming to monitor
food intake and exercise, and be in a constant state of stress about food and how your body looks. It’s
easy to see why when you develop an eating disorder you could become withdrawn and less social. It
gets too hard to join in on snacks and meals with friends or families, or too hard to stop the addictive
exercising or working out to have fun.
Having an eating disorder also can use up a lot of mental energy planning what to eat, how to avoid
food, planning a binge, getting money to buy food or laxatives or other medications, making up
reasons to use the bathroom after meals, or figuring out how to tell people around you that you want
to be alone after a meal.
TREATMENT FOR EATING DISORDERS
Fortunately, eating disorders can be treated. People with eating disorders can get well and gradually
learn to eat well and more like their family and friends again. Eating disorders involve both the mind
and body. So medical doctors, mental health professionals, and dietitians will often be involved in a
person’s treatment and recovery.
DON’T WAIT TO GET HELP
Like all bad habits, unhealthy eating patterns become harder to break the longer a person does them.
The most critical thing about treating eating disorders is to recognize and address the problem as
soon as possible. Eating disorders can do a lot of damage to the body and mind if left untreated, and
they don’t get better by themselves.
Therapy or counseling is a very important part of getting better — in many cases, family therapy is
one of the keys to eating healthily again. Parents and other family members are important in
supporting people who have to regain weight that they are afraid of, or to learn to accept the body
shape that their culture, genes, and lifestyle allows for.
If you want to talk to someone about eating disorders but are unable or not ready to talk to a parent
or close family member, try reaching out to a friend, teacher, school nurse or counselor, coach,
neighbor, your doctor, or another trusted adult.
Remember that eating disorders are very common among teens. Treatment options depend on each
person and their families, but many treatments incorporate journaling, talking to therapists, and
working with dietitians and other professionals.
Learning to be comfortable at your healthy weight is a process. It takes time to unlearn some
behaviors and relearn others. Be patient, you can learn to like your body, understand your eating
behaviors, and figure out the relationship between feelings and eating — all the tools you need to feel
in control and to like and accept yourself for who you are.
SIGNS OF EATING DISORDERS
So how do you know if a friend has an eating disorder? It can be hard to tell — after all, someone who
has lost a lot of weight or feels constantly tired may have another type of health condition.
But certain signs can be an indication of a problem, such as if a friend:
Has an obsession with weight and food. It might seem like all your friend thinks (and talks) about
is food, calories, fat grams, weight, and being thin.
Feels the need to exercise all the time, even when sick or exhausted, and might talk about
compensating for eating too much by exercising.
Avoids hanging out with you and other friends during meals.
Starts to wear big or baggy clothes as a way to hide his or her body and shape.
Goes on extreme or highly restrictive diets (for example, eating only clear soup or only raw
veggies), cuts food into tiny pieces, moves food around on the plate instead of eating it, and is
very precise about how food is arranged on the plate.
Seems to compete with others about how little he or she eats. If a friend proudly tells you she
only had a diet soda for breakfast and four chips for lunch, it’s a red flag that she could be
developing a problem.
Goes to the bathroom a lot, especially right after meals, or you’ve heard your friend vomiting
after eating.
Always talks about how fat he or she is, despite losing a lot of weight, and sometimes focuses on
body parts he or she doesn’t like (hair, skin, arms, stomach) to the point of excess.
Appears to be gaining a lot of weight even though you never see him or her eat much.
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