Obese teenagers who lose weight are at risk of developing eating disorders such as anorexia nervosa and bulimia nervosa, Mayo Clinic researchers imply in a recent Pediatrics article. Eating disorders among these patients are also not being adequately detected because the weight loss is seen as positive by providers and family members. It often starts a view of self that I can relate to all too well.
As a young child, I was very frail and remember being urged to eat and being given daily malt tablets to help me gain weight. However, at about 9 years old, something happened and I started to gain weight and turned into a chubby girl which continued until I was about 15 years old when I lost weight although I wasn’t dieting. My next weight gain was with my first pregnancy. I never really lost the baby weight afterwards and it wasn’t until I was about 28 when I lost weight (Weight Watchers) and maintained the loss until I went into early stages of menopause. During that period in my early thirty’s, I was often low enough weight that my menses ceased. Since menopause I have struggled with gaining and losing the same weight over and over. As someone who has struggled with my weight fluctuations since I was pre-pubescent, I can give a comprehensive witness to the positive, unsolicited, and ego stroking comments made when I have lost weight. With this pattern, I soon adapted an attitude that I am OK when I lose weight but become invisible and “NOT OK” when I gain weight. Our culture’s peer pressure is aggressively pervasive. It has taken me years (and therapy) to come to peace with who I am.
“At least 6 percent of adolescents suffer from eating disorders, and more than 55 percent of high school females and 30 percent of males report disordered eating symptoms including engaging in one or more maladaptive behaviors (fasting, diet pills, vomiting, laxatives, binge eating) to induce weight loss.
Eating disorders are associated with high relapse rates and significant impairment to daily life, along with a host of medical side effects that can be life-threatening,” says Dr. Sim, a Mayo Clinic Researcher.
“Although not widely known, individuals with a weight history in the overweight (BMI-for-age greater than or equal to the 85th percentile but less than the 95th percentile, as defined by CDC growth chart) or obese (BMI-for-age greater than or equal to the 95th percentile, as defined by the CDC growth chart) range, represent a substantial portion of adolescents presenting for eating disorder treatment,” says Dr. Sim.
“Given research that suggests early intervention promotes best chance of recovery, it is imperative that these children and adolescents’ eating disorder symptoms are identified and intervention is offered before the disease progresses,” says Dr. Sim.
This report analyzes two examples of eating disorders that developed in the process of obese adolescents’ efforts to reduce their weight. Both cases illustrate specific challenges in the identification of eating disorder behaviors in adolescents with this weight history and the corresponding delay such teenagers experience accessing appropriate treatment.
The article is published online September 9 in the journal Pediatrics. Dr. Sim’s co-authors include Mayo Clinic researchers Jocelyn Lebow, Ph.D., and Marcie Billings, M.D.
Signs and symptoms of Anorexia, Bulimia, and Binge Eating
These behaviors and emotional symptoms suggest anorexia nervosa:
Loss of a significant amount of weight.
Continuing to diet and “feeling fat” even after reaching a goal weight, or becoming visibly thin.
Irrational fear of gaining weight.
Obsession with food, calories, fat content and nutrition.
Weighing oneself once a day or more.
Refusal to discuss a diet with others.
Cooking for others but not eating.
Lying about eating.
Depression and anxiety.
Eating large amounts of food and getting rid of it by throwing up, fasting, taking laxatives or exercising excessively. This is called bingeing and purging.
Physical symptoms of anorexia:
Loss of monthly menstrual period.
Cold hands and feet.
Weakness and exhaustion.
Growth of body hair on arms, legs and other body parts.
Dry, brittle skin.
Shortness of breath.
Behaviors and emotional symptoms of bulimia:
Binge eating, or eating uncontrollably and/or secretively.
Purging by dieting, fasting, exercise, vomiting or using laxatives or diuretics.
Using the bathroom frequently after meals.
Obsession with weight.
Feelings of being out of control.
Swollen glands in the neck and face.
Weakness and exhaustion.
Behaviors and symptoms of binge eating:
Binge eating episodes.
Eating when not hungry.
Awareness that eating patterns aren’t normal.
Feelings of shame, depression or antisocial behavior.
If you detect any of these behaviors in your teenager, yourself, or a friend, it is imperative that you seek medical help. These disorders are not fads; they are killers.