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Eating Disorders: What Teens Need to Know

What should I know about eating disorders?

Most importantly, you should know that Eating disorders require medical attention!

The two best-known types of eating disorders are anorexia nervosa and bulimia nervosa.  They can occur separately or together in the same person.  A person who has an eating disorder is not necessarily skinny.  Some people with eating disorders are even overweight.  Binge eating disorder is another kind of eating disorder. 

Can men and boys have eating disorders?
Eating disorders most often affect girls and women, but boys and men can also have an eating disorder.  One out of every four pre-adolescent kids with anorexia is a boy.  Binge eating disorder affects about the same number of females and males1.

What is anorexia nervosa?
To be diagnosed with anorexia, a person must:

Anorexia usually affects teens, and mostly girls.  An estimated 1% of white females have anorexia nervosa.  It is more common among people in higher income groups, and in groups that value thinness (like athletes, ballet dancers and models).  It usually starts around ages 13-14 or ages 17-18.

What is bulimia?
To receive a diagnosis of bulimia nervosa, a person must:

People with bulimia may be anywhere from underweight, to normal weight, to overweight.  It is estimated that as much as 3% of college-aged women have bulimia. 

What is binge eating disorder?
Binge eating disorder is diagnosed when a person:

Binge eating disorder does not include the purging consistent with anorexia and bulimia.  About 40% of obese people may have this problem. 

What are the signs of an eating disorder?
Look for these warning signs and symptoms:

If your or your friend has some of these signs, it’s time to see the doctor right away.  There are some diseases that can appear to be an eating disorder that would need to be ruled out.  If the eating disorder is not treated, it can become life threatening. 

What causes eating disorders?
The exact causes of eating disorders are not known for sure. Many different factors working together probably cause a person to develop an eating disorder. Dieting can lead to eating disorders, with the greatest risk to severe dieters.  Around two-thirds of new cases of eating disorder are in girls and women who have dieted moderately.2

Are eating disorders dangerous?
Many dangerous medical and psychological problems can result from eating disorders. Eating disorders can be deadly. They require medical attention!

What if I think my friend may have an eating disorder?

How can I help my friend?

Is it dangerous to use medications to lose weight?
The products a person might use to lose weight can be very dangerous.  The regular use of diuretics (water pills), laxatives, and weight loss pills can cause a variety of life threatening problems, even if they don’t cause very much weight loss.  Using syrup of ipecac to cause vomiting can also lead to life threatening complications.

How can I tell what's a sensible diet?
Generally speaking, most kids and teens should not be on a restrictive diet.  In fact, restricting eating to control weight is not only doesn’t work, but dieting actually promotes weight gain in tweens and teens3 4.
Read up on dieting vs. sensible eating habits:

How can I tell if my weight is healthy for me?
If you are concerned about your weight, you should talk to your parents, your doctor, your gym teacher or another trusted adult.  Your doctor or nurse can tell you whether your weight is healthy for you.  They have checked your weight and height over time and will know if you are growing normally.  They can plot your weight and height on a growth chart.  Your health care provider can also check your body mass index (BMI). 

How do you get started in treatment for an eating disorder?
The first goal in treating severe anorexia is to improve your nutrition and eating habits.  Then, the goals will focus on learning about nutrition and normal eating patterns, improving self-esteem, relating to others, interacting with family, and treating medical and other psychological problems. 

What is body Dysmorphic disorder (BDD)?
Body Dysmorphic Disorder (BDD) means thinking about what you look like much more than normal.  It also involves thinking too much about real or imagined defects in how you look.  It is a kind of distorted thinking.  It affects males and females about equally. 
Find out more about BDD here:

If you think you have BDD or body image problems, you should talk to your parents, doctor, school counselor or other trusted adult.  They can assist you in getting help to feel better about yourself. 

How can these problems be prevented?
Our society is pretty confusing.  On the one hand, we see idealized (and often air-brushed!) pictures of “perfect,” skinny stars and models all over.  On the other hand, we get bombarded with ads for unhealthy foods.  Our families might talk about “good foods” and “bad foods,” and our parents and friends might often be on restrictive diets, and talk about what’s “wrong” with their bodies.

There are things you can do to feel good about yourself and your body, like these  ten steps to positive body image (diez pasos hacia una imagen positive.You can also learn to be media literate, which will help protect you from harmful messages about food, eating, and body size from TV, music videos, magazines, and ads.  Avoid women’s fashion magazines, which one study found linked to trying to lose weight. 

What are some good books about eating disorders, healthy eating and body image?
Here is a list of books on a range of eating and body image topics, many aimed at teens.

What are some other resources?

Citations:

1 National Institute of Mental Health (NIMH).  Eating Disorders. NIH Publication No. 07-4901. Revised 2007.  Available here: Accessed 4 February 2008.

2 Patton GC, Selzer R, Coffey C, Carlin JB, Wolfe R. Onset of eating disorders: population based cohort over 3 years. BMJ.1999; 318:765 –768

3. Field AE, Austin SB, Taylor CB, Malspeis S, Rosner B, Rockett HR, Gillman MW, and Colditz GA.  Relation Between Dieting and Weight Change Among Preadolescents and Adolescents.  Pediatrics, Oct 2003; 112: 900-906.

4. Neumark-Sztainer D, Wall M, Guo J, Story M, Haines J, Eisenberg M. Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later? J Am Diet Assoc. 2006 Apr;106(4):559-68.

Written and compiled by Kyla Boyse, RN.  Reviewed by David Rosen, MD, MPH.

May 2008

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