It’s not uncommon for middle school and high school students to express dissatisfaction with their bodies and how they look. This is true for both girls and boys, but girls tend to have more concerns about food and appearance because of today’s societal pressures on women to be thin. As a result, many girls diet at some point in their childhood and adolescence. Most of the time, short-term dieting is harmless and nothing to worry about. However, a small percentage of girls who diet develop an eating disorder, which is very serious and needs to be treated by a mental health professional.
We spoke to Albert John Sargent III, MD, Chief of Child and Adolescent Psychiatry at Tufts Children's Hospital, about what parents should know about eating disorders in adolescents.
What is an eating disorder?
Eating disorders are medical and psychiatric illnesses that result in extreme emotions, attitudes and behaviors surrounding weight and food issues. Two of the most common eating disorders are anorexia and bulimia. Anorexia occurs in 1% of adolescent girls and bulimia in around 2% of adolescent and college aged females. Both disorders also occur in males but much less frequently.
Anorexia is characterized by an irrational fear of weight gain and a relentless focus on thinness, which is usually expressed through starvation. Bulimia is characterized by binge eating and then purging through self-induced vomiting, excessive exercise and excessive laxative use. People with anorexia tend to be dangerously underweight, while people with bulimia may be overweight, underweight or a normal weight.
What to do if you’re concerned about your child
Both anorexia and bulimia have very serious and life-threatening health consequences. They are associated with significant mental health and emotional difficulties including social isolation, depression, substance use, and self-harming. Commonly someone with an eating disorder will deny difficulties and may resist treatment, because people with anorexia are committed to weight loss and those with bulimia are ashamed of the problem and can act defensive.
Be alert to problematic eating — intense dieting and calorie restriction resulting in dramatic weight loss in anorexia, and purging after eating either at meals or after binging on snack foods in bulimia. If you suspect your child may have an eating disorder, speak with your child’s primary care physician as soon as possible. If the diagnosis is confirmed, you should be immediately referred to a mental health professional with experience in treating eating disorders.
How are eating disorders treated?
Treatment for an eating disorder is a team effort involving the child’s primary care doctor, a nutritionist and a therapist — either a child and adolescent psychiatrist, a psychologist or a social work therapist. Treatment may also include a specialized eating disorder program. In some instances, medication may be helpful.
Parents also play a significant role in treatment. It’s important that parents ensure their child’s treatment team is familiar with adolescent eating disorders, and that they trust their team to keep the family informed about progress and challenges throughout treatment. Parents should also follow through with treatment at home by working to resolve the underlying problem their child is facing, which can take several months or longer.
To make an appointment with a pediatric mental health professional at Tufts Children's Hospital, click here.