It’s that time of year again, swimsuit season! Imagine you have a “girls’ day” planned with your teen daughter complete with lunch, manicures and shopping. You’ve noticed your teen has lost some weight recently but attribute it to her time competing in cross country. But the glimpse you get in the department store mirror tells a different story. As you crack the door and hand her more suits to try, you are confronted with a shocking sight; a gaunt, emaciated, unhealthy adolescent stands before you. How did this happen? How did you not know?

Anorexia Nervosa can be very difficult to detect in the teen population. Young people that suffer from this disorder are usually adept at hiding their maladaptive behaviors from parents, teachers and trusted peers. Many problem behaviors leading to AN are acted out in isolation, making detection extremely difficult.

Anorexia is not just a diet. It is not a choice or a phase an adolescent will grow out of. It is not found solely in females; males are also at risk.  Anorexia Nervosa is the restriction of intake relative to the energy requirements needed for the teen. AN presents as extreme weight loss, or an inability to maintain a healthy weight. Those that suffer from this disorder value low weight as his or her primary source of identity and self-worth. This is accompanied by an irrational fear of weight gain or loss of control of eating. These adolescents have an extremely negative and distorted body image that impacts many areas of their lives. Many view an eating disorder as a way to establish a feeling of control and manage anxiety.

What are some signs of Anorexia Nervosa? Parents and teachers should look for rapid weight loss in their students and loved ones, even if the teen is above a healthy weight. The teen may refuse to eat certain foods or have odd food preferences. Some adolescents with this disorder have a high need for control and seem like perfectionists. Take note if the teen skips meals, won’t eat in front of others, or escapes to the bathroom immediately following a meal. Ask questions if your teen has stopped menstruating. Those that suffer from AN may enjoy cooking, watching cooking shows and vicariously watching others eat without partaking themselves. Dieting is the leading behavior associated with the development of Anorexia.

Anorexia has two main types. The restricting type involves limiting calories by diets, fasting or over-exercising. The binge eating/purging type involves purging by vomiting, diuretics or laxatives. Both types of anorexia can lead to life threatening electrolyte shifts, cardiac problems, bone loss, loss of cognitive functioning and damage to vital organs. Some are genetically vulnerable to anorexia nervosa and life changes or transitions (even positive ones) can trigger these behaviors.

Early intervention is crucial when diagnosing anorexia nervosa. These interventions enhance the chance of favorable outcomes in adolescent populations. When a child is diagnosed with cancer, what happens? Family and peers encircle the sick individual. Friends accompany the patient to chemotherapy and doctor appointments. Support is usually ample and constant, and the child is not left to fight the disease alone.

The same attention is needed when treating eating disorders. Hope can be restored with the aid of parents, teachers and clinicians. Family therapy is preferred as the entire family unit rallies around the teen suffering from AN.  Family Based Treatment (FBT) is an evidence-based treatment plan proven effective with anorexia nervosa. It utilizes parents as a resource and teaches adolescents that food is fuel.  Recovery is possible, and a multidisciplinary team approach is usually best including parents, physicians and mental health providers.  Treatment outcomes for adolescents are significantly better than for adults; there is hope for teens suffering from anorexia nervosa!

Resources for those that would like more information on eating disorders:

Journal of Clinical Sport Psychology Special Issue: Eating Disorders and Body Image in Sport and Exercise, December 2018.

This information was in part compiled and consolidated from a lecture given by Laura M. Huff, Ph.D for The St. Louis Behavioral Medicine Institute.