Eating disorders are complicated illnesses that affect adolescents with increasing frequency. They are ranked as the 3rd most common chronic illness in adolescent female, with a dramatic increasing rate over the past three decades. The causes of eating disorders are broadly accepted to be a combination of several factors: genetic, psychological, and sociocultural.
Eating disorders are extensive patterns of behavior driven by tremendous fear, anxiety and guilt from the person suffering it.

The three main eating disorders are: Anorexia nervosa, Bulimia nervosa and Binge eating disorder

  • Anorexia nervosa is an eating disorder in which people maintain a weight that is below average for their age and height. People with anorexia nervosa have an intense fear of gaining weight, therefore, always worried with food, and having a distorted body image. To stay underweight, they may starve themselves, eat sparsely and infrequently, purge food by vomiting or using laxatives, or exercise extremely.
  • Bulimia nervosa is manifested by series of extreme overeating and feelings of loss of control about eating, followed by purging or other behaviors to compensate for the overeating like vomiting, exercise or use of laxatives. Binge eating is often done in private because most people with bulimia nervosa are of average weight or even slightly overweight, it might not be readily apparent to others that something is wrong.
  • Binge eating disorder is characterized by recurrent episodes of extreme overeating and in secret but do not attempt to get rid of calories once the food is consumed. People with binge eating disorder may be embarrassed or feel guilty about binge eating, but they feel such a compulsion that they cannot stop. These people can have average weight, overweight or obese.

Unique features of adolescents and the developmental process of adolescence are often crucial considerations in determining the diagnosis, the treatment or outcome of the eating disorder.

Therefore, each adolescent has to be considered separately and differentiated from adults patients with eating disorders. It is important to realize that the list of red flags given below serve as a guidance, however, it can diverge for each adolescent.

12 Red Flags

1. Body insecurity
Having negative or obsessive thoughts about body size or shape. Persistent worries or complaints about being fat or the need to loose weight. Comparisons to other individuals and their shape/weight. (However, eating disorders are possible without body insecurity).

2. Intense and extreme exercise
Obsessive about doing exercise, sometimes even daily. Also, obsessive about exercise even when injured, tired or sick.

3. Fear of eating in front of others
Avoids situations that include eating in front of other or in public. Becoming more avoidant, secretive, irritable or anxious in the content of food (ex: difficulty at the family meal or going out for meals) Makes excuses about not being able to eat with friends or family.

4. Pleasure in others’ eating
Prepares elaborate meals for others, especially foods with high caloric intake that he/she will not eat.

5.Changes in appearance and clothing
Significant weight loss or again. Major hair loss, dry hair or skin or excessive facial or body hair. Also, change of clothing style (ex: baggies and bigger clothes).

6. Physiological changes
Develops unusual sleep patterns (ex: insomnia) and high sensitivy to low temperatures, feels tired most of the time, menstruation changes or there is an absence of it (amenorrhea). Also, constipation, stomach pain and dental cavities might be signs of having an ED.

7. Excessively restricting foods
Considers certain foods or groups of food completely off limits. Denying to eat or making excuses not to eat even to the point of skipping meals. There exists a incessant worry about dieting and calories.

8. Disproportionate fear
Avoids certain foods because of fear of choking or fear of purging after its intake.

9. Purging
May compensate for the food eaten through vomits, use of laxatives or diuretic abuse. As soon as the meal is over, leave the table immediately to purge.

10. Secretive eating
Large amounts of food disappear over short periods of time. Also, hoarding food can become part of the disease. A person may stockpile large amounts of food in various places where are binge may typically occur for them: car, home, break room, etc. Finding wrappers or containers that might indicate secret consumption of large quantities of food.

11. Eating rituals
When it comes time to eat in public, there exists a fixation to cut food into very small pieces or arrange food in a certain way to make it seem like they’re eating, while little or no food is consumed.

12. Isolation
There exists withdraws from usual friends, family and activities that used to be enjoyed before. Tends to isolate themselves in the room and get moody especially after eating. There is constant irritability and persistent low mood.

If your son/daughter or close friend you care about has changed their relationship with food, is skipping meals, making excuses for not eating, following a very limiting diet or focuses compulsively on eating, they could be suffering from an eating disorder. If left untreated, eating disorders can lead to serious illness and even death. Those girls with lower body weight can lose their menstrual periods, which could possibly lead to osteopenia, early bone loss that can lead to painful fractures. Also, eating disorders are highly related to other serious health troubles such as kidney disease and heart disease. Therefore, it is important to express your concerns in a caring and loving manner. If it’s your kid, speak with a professional, since teens are especially at risk and early intervention is key.

Rita Lara
Division of Psychology, Psychotherapy and Coaching
Rita Lara
Adults and adolescents
Languages: English and Spanish
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