By Johanna Curtis

Does Your Teenage Boy or Girl Show Weight Loss, Increased Body Hair, Acne?: How to Spot the Signs of an Eating Disorder

Is your teen losing weight, suffering skin problems like severe acne, hiding food, binging, vomiting or fasting? He or she might have an eating disorder.

Anorexia nervosa and Bulimia are serious eating disorders that have severe health impacts, sometimes even causing death in teens as young as eleven or twelve.

Weight loss, over-exercising, teenage acne, counting calories, depression and distorted body image, binging or uncontrolled eating, vomiting, and hiding food.  These are just some of the symptoms.  There are many others.

Symptoms of Anorexia:

• Weight loss-15% below the ideal weight for her age and height.

• Being obsessive about counting calories and eating fat-free foods.   

• A fear of gaining weight.

• Being cagey about eating habits.

• Obsessive and compulsive or excessive exercising.

• Abusing laxatives or diuretics.

• Mood and emotional problems like depression or anxiety.

• A severely distorted self and body image.

• Loss of bone mass.

• Absence of menstrual periods.

• Low body temperature.

• Death-from dehydration, heart failure or other causes.

The main symptom of Anorexia Nervosa is a marked fear of being fat and obsessions about being and becoming thin.  This usually translates into intense and secretive efforts to avoid food.  No matter how thin an anorexic girl or by becmes they will still see themselves as fat.  Ultimately the person will starve themselves, and use exercise and laxatives to aid this process.

Unfortunately attempting to force an anorexic teen to eat will likely end in failure and might even make the problem worse.  This is because the disorder isn’t really about food or weight.  Some patients become obsessed with other health concerns like treating acne, hair care, or how they dress and behave.

Anorexia is more than just a desire to look good or be accepted.  Teens with these diseases are looking for more than just a perfect body.  Anorexia is a complex psychological disorder that is linked to severe depression and low self-esteem.

Symptoms of Bulimia:

• Uncontrollable eating (binge eating).

• Dieting, fasting and vomiting as weight control measures.  

• Visiting the bathroom often after eating –usually to purge.

• Heartburn, indigestion or sore throat.

• Being obsessive about body weight.

• Mood changes and depression.

• Hoarding or hiding food.

• Dental changes such as loss of enamel, cavities and abrasions –due to frequent vomiting.

• Dehydration and electrolyte loss.

• Bowel, kidney and liver damage.

• Irregular heartbeat and possible cardiac arrest.

Teens with bulimia eat very large amounts of food and then induce vomiting to remove the food from their bodies.  They are not comfortable or happy with their self and body image. 

Most appear to be of normal weight, which can make the disorder difficult to spot, but some are underweight or overweight.  Some sufferers also abuse drugs and alcohol.  Bear in mind that many obese people have binge eating disorder but this is not the same as Bulimia.

Who gets Anorexia and Bulimia?

Around 75% of girls are not happy about their weight or feel they are too fat.  Anorexia occurs only in 1% of girls worldwide.  Do bear in mind that while eating disorders are more common in girls they also affect teen boys. 

About 90% of sufferers are girls between 12 and 25 (National Alliance for the Mentally Ill). Fewer than 10% are boys or men.  It is more prevalent in groups that value slim physiques such as athletes, dancers or models. As already mentioned eating disorders may be masked in seeking treatment for acne, skin problems, tooth decay etc. just as an adult might.

What causes eating disorders?

It is not known exactly why one person will develop an eating disorder and another won’t.  In two thirds of cases dieting can trigger the disease, but this is not the only important trigger mechanism.  Most girls and boys with eating disorders have low self and body image or co-existing emotional disorders like anxiety and depression.

How dangerous are eating disorders?

The effects of both Anorexia Nervosa and Bulimia can be very damaging to the general health.  They can even cause death.  Diuretics (water pills), laxatives, and weight loss pills can be very damaging to the body’s organs.  Syrup of ipecac is often used to induce vomiting and is also deadly if used in excess. Very low body weight on its own offers some life-threatening complications. 

Some effects are minor such as skin, hair problems and back acne, for which treatment might be sought. Most teenagers do not need any type of diet, except a healthy one.  If your teen is overweight good eating habits and exercise is usually all that is needed to bring the problem under control.   

The body mass index (BMI) of a teen is more important than calorie and pound counting.  A body mass index below the 5th percentile for the child’s age and sex can be considered underweight.  Consult BMI tables for more information. 

How to help your teen cope with an eating disorder:

Teens can be helped to avoid falling prey to unhealthy obsessions with food or weight by learning early on to associate healthy eating with good health and self-love.  Avoid excessive focus on weight within the family and place the emphasis on lifestyle changes not dieting. 

If you suspect that your teen has an eating disorder, use "I” statements and make sure he or she understands that you are concerned not judging.  It is important to LISTEN.  The average teen finds it hard to share emotions, and these teens are especially blocked or sensitive.

In Anorexia nervosa it is very important that some weight is regained as soon as possible so this should be an important goal of treatment.  To do this, teens will need to overcome fears and perceptions in a therapeutic setting.  In most cases any eating disorder is best dealt with at a clinic or facility especially tailored for this. 

Concerned parents can call the National Eating Disorders Association’s Toll-Free Information and Referral HelpLine at 1-800-931-2237.

If you uncover that your child does have an eating disorder he or she needs to be evaluated as soon as possible. Eating disorders need to be properly diagnosed by medical and psychiatric professionals. They always need medical attention.

The National Institute of Mental Health has an online brochure on eating disorders that discusses current research. 

Eating Disorders will also provide parents with information. Teens should read: Eating Disorders: Facts for Teens.