Eating Disorder In Teenagers: Signs, Causes, Treatment And Prevention

Eating disorders in teenagers are common psychiatric conditions, which lead to unhealthy or erratic eating habits. Most people develop eating disorders in adolescence or early adulthood (1). Anorexia nervosa, bulimia nervosa, and binge-eating disorders are common eating disorders diagnosed in teenagers. Early detection and appropriate treatments can help prevent eating disorders, long-term health risks, and improve quality of life. Read on to know the types, causes, diagnosis, treatment, and prevention of eating disorders in teenagers.

What Are The Symptoms Of Eating Disorders In Teens?

Signs and symptoms of an eating disorder vary depending on the type of eating disorder. Some of the common symptoms that may indicate an eating disorder are (2) (3) (4):

• Eating less food or skipping meals
• Hoarding and hiding food and eating in secrecy
• Obsession with appearance and weight
• Dry, scaly skin and loss of hair
• Amenorrhea or infertility
• Dental damage, especially in young patients
• Excessive exercising and frequent weight checking
• Acting stressful while eating or talking about food
• Excessive weight gain or loss with physical signs, such as cold sensitivity, fatigue, and dizziness
• Social withdrawal, anxiety, and depression
• Constant and excessive dieting
• Frequent trips to the washroom, especially after meals

What Are The Different Types Of Eating Disorders?

There are different types of eating disorders, depending on the symptoms. Below are some of the common eating disorders to affect adolescents and teens.

1. Anorexia nervosa: Also known as anorexia, is a psychiatric eating disorder in which an individual has a warped body image. They view themselves as overweight or obese, even if they are severely underweight. The intense fear of weight gain causes forceful limitation of food and beverage intake to the point of starvation. This disorder often starts during adolescence and affects teenage girls more than boys (5) (6).

2. Bulimia nervosa: Commonly known as bulimia, it is a psychiatric eating disorder in which an individual eats unusually large amounts of food in a short duration until they are painfully full. Then, to relieve the guilt of overeating and purge the food, they indulge in forced vomiting and the use of laxatives, enemas, and diuretics (7). The person may also fast and perform intensive exercise later. Bulimia is more common in teenage girls than boys.

3. Binge-eating: According to the National Institute Of Mental Health, binge-eating is one of the most common eating disorders in the US (8). Its onset is usually seen in adolescents with a peak prevalence at 16 to 17 years of age (9). In this disorder, individuals eat unusually large amounts of food but don’t exhibit compensatory behavior to purge the food, commonly seen in bulimia. Thus, such people tend to be overweight or obese.

4. Pica: Pica involves the intentional consumption of non-nutritive substances, such as dirt, soil, soap, paper, chalk, cloth, and cornstarch. A confirmed diagnosis of pica warrants the behavior to persist for up to at least a month. Pica can occur in children, teens, pregnant women, and individuals with mental disabilities. Depending on the non-nutritive substance consumed, pica can be life-threatening (10).

5. Avoidant/restrictive food intake disorder: ARFID is a new term for a condition previously referred to as “Selective Eating Disorder.” Similar to anorexia, an individual with ARFID intentionally restricts the intake of food and beverages. However, the restriction isn’t related to body shape, size, or fear of weight gain (11).

Some other specified feeding or eating disorders (OSFED) seen in teens are purging disorder, night eating syndrome, orthorexia, and diabulimia (12).

What Are The Possible Causes Of Eating Disorders In Teens?

The exact cause of eating disorders might be unknown in most cases. Research shows that eating disorders could occur due to a complex interplay of genetic, biological, emotional, and social factors (13).

The following factors may play a role in the development of an eating disorder in teens.

1. Psychological factors: Teenagers with extreme perfectionism, body image dissatisfaction, and emotional issues, such as anxiety, depression, and low self-esteem, tend to stay stressed and isolated. Many teens may vent out these emotions and feelings by indulging in binge-eating or restricting food (14).

2. Biological factors: Research shows that genetic factors raise the chances of anorexia nervosa, bulimia nervosa, and binge eating disorder by 40 to 60 percent (15). Abnormality in the structure and function of the hypothalamus and fluctuations in neurotransmitters’ levels could also impact eating pathology, resulting in eating disorders (16).

3. Social factors: Some inimical social situations, such as a preference to appear slim and attractive to the opposite sex, peer acceptance, body shaming, and bullying at school, may lead to eating disorders in teens. Media and celebrity influence, acculturation, and traumatic incidents may also play a role in several cases.

How To Prevent Eating Disorders In Teens?

The prevention of eating disorders usually involves active interaction between the parents and the teens. Here are some tips that you could follow (17).

1. Educate about eating disorders and their health complications. Make the teen understand the importance of identifying and accepting eating disorders. Teaching them unguided dieting can hamper their growth, development, and mental well-being.

2. Encourage them to talk and share their feelings, thoughts, and emotions with parents and family members. Explain how sharing one’s feelings and emotions can help vent out and ease uncomfortable feelings, such as anxiety and frustration.

3. Discuss media and celebrity influence. Encourage them to question every message they hear or see on different media types, especially body image and complexion, which can be easily misconstrued.

4. Promote a positive body image. Talk to your teen about their self-perception and educate them on how body image and appearance vary person-to-person. Motivate them to practice positive coping skills if anyone says anything hurtful.

5. Foster self-esteem and self-confidence. Celebrate your teen’s accomplishments, listen to them carefully, and express how much you appreciate them. Guide them on how an individual’s personality is more than body image and appearance.

6. Encourage healthy-eating habits. Guide your teen about the importance of healthy eating practices. Discuss how one’s diet can affect their appearance and overall health. You can support your teen by cooking healthy foods for the family.

7. Set the right examples. Follow healthy eating habits and display positive body image behavior. If you are constantly dieting to look good, using food to cope with your emotions, or expressing self-pity about your shape, size, or look, then you are sending out the wrong message to your teen.

How Are Eating Disorders Diagnosed In Teens?

Below are some diagnosis methods that a healthcare professional may use to diagnose eating disorders (18).

1. Physical examination: A doctor would check the teen’s height and weight to ascertain if they are in a healthy weight range. It would be followed by an examination of the vital signs, such as pulse rate, blood pressure, and breathing, to rule out any irregularities. The doctor would also examine the teen’s nails for chipping or brittleness, skin and hair for flakiness and dryness, and abdomen for swelling, pain, or any other discomfort.

2. Laboratory tests: Total blood count, urine test, liver, kidney, and thyroid function test are some tests a doctor would recommend to assess the teen’s health further. Additionally, the doctor may ask for a dental check, X-ray, or EKG/ECG (electrocardiogram) to check for irregularities due to nutritional deficiencies, which may indicate an eating disorder.

3. Psychological evaluation: The mental health professional may ask questions about the teen’s eating habits and how they perceive their body image. These questions could be uncomfortable, but a teen must be motivated to answer honestly. Psychological evaluation could be vital to corroborate the results of the physical exam and lab tests.

Based on the diagnosis, the doctor would chart a comprehensive treatment plan to treat the eating disorder and its associated health issues.

How Are Eating Disorders Treated?

The treatment plan is tailor-made for the specific eating disorder of the teen. A group of health professionals, such as pediatricians, dietitians/nutritionists, and mental health experts, may work together to treat the teen (8) (18). A combination of the following treatment methods could be employed to treat the teen effectively.

1. Nutrition counseling: Dietary counseling helps a teen understand the importance of healthy eating practices. It also provides teens an opportunity to retrospect and analyze how their bad eating habits have led to their current health issues. Nutrition sessions also focus on diet planning that helps overcome nutritional deficiencies and gain healthy body weight.

2. Psychotherapy: Psychotherapies, such as cognitive-behavioral therapy (CBT) or family therapy, could be recommended for the teen and their family to talk and share their emotions and feelings. It could help them vent out their frustration and anxieties and focus on learning coping skills to manage emotions through rational thinking.

3. Medications: Psychological issues, such as anxiety and depression, often accompany eating disorders. Thus, doctors may prescribe medicines, such as antidepressants and antipsychotics, to teens. These medications help treat and manage mental health issues and possibly relieve eating disorders.

A teen may need to be hospitalized or admitted to a residential treatment program in severe cases of eating disorders.

What Are The Complications Of Eating Disorders In Teens?

Eating disorders could severely affect the mental, physical, and physiological well-being of the teen. Some of the likely complications that eating disorders can cause are (19):

1. Muscle wasting occurs due to extreme food and beverage restrictions.

2. Low immunity, anemia, and malnutrition due to nutritional deficiencies.

3. Low blood sugar or consistently high blood sugar levels that may turn into type-2 diabetes over time.

4. Blood pressure fluctuations, such as high or low blood pressure, may progress to cardiovascular diseases.

5. Permanent loss of bone mass affecting motility and the quality of life.

6. Irreversible damage to organs, such as stomach, liver, kidney, and gallbladder.

If left untreated, eating disorders could turn life-threatening. Therefore, timely identification, treatment, and management are necessary.

References

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Dr. Richa A KaushalMD

 

Dr. Richa Kaushal works as an Assistant Professor in the Department of Pediatrics at UCSF Fresno, California. She is also a physician at Community Regional Medical Center, Fresno, California, and Clovis Community Hospital, Clovis, California.

Read full bio of Dr. Richa A Kaushal