We all expect our teenagers to be self-conscious about their appearance at some stage, or even regularly, throughout their adolescence. For some teenagers and younger children, however, emotional and social pressures and body consciousness can develop into an obsession that can become an eating disorder.
The two most common eating disorders are anorexia nervosa and bulimia nervosa. However, binge eating disorders, food phobias and body image disorders are also becoming increasingly common in adolescence.
Current estimates of the prevalence of eating disorders suggest that 1 to 2% of children and teenagers will develop eating disorders. In the majority of cases it will be girls who develop eating disorders although, more rarely, boys can be affected.
Researchers describe that 81% of 10-year-olds are afraid of being fat. It is no surprise, therefore, that further research statistics show that over three quarters of eating disorders will start between the ages of 11 and 20 years, with the majority of youngsters beginning their disordered eating between the ages of 11 and 13.
Anorexia nervosa is characterised by a striving to maintain a very low body weight. People with anorexia have a distorted view of their body size and shape. They will restrict their food intake by dieting, fasting or excessive exercise.
Bulimia nervosa is characterised by habitual binge eating and purging. Someone with bulimia may undergo weight fluctuations but will rarely experience the low weight associated with anorexia. Because there isn't the same dramatic weight loss, bulimia nervosa can be much harder to identify.
For youngsters with eating disorders, there is a large gap between the way they see themselves and how they actually look. People with anorexia or bulimia frequently have an intense fear of gaining weight or being overweight and frequently think they look bigger than they actually are.
But the most consistent factors linked to eating disorders seem to be emotionally based. The disorder often develops slowly over time as a response to upset or distress in a person’s life. This upset is likely to be caused by a specific traumatic event or a series of traumas and stresses. Examples can include sexual abuse, loss, significant change, bullying, critical comments about size and weight, constant general criticism or an overload of stress.
You may find that your teenager reacts in a defensive or angry way the first time you suggest that something about their eating is not normal. Many of them have trouble admitting, even to themselves, that they have a problem.
The general experience of many families is that if an eating disorder has developed then you are unlikely to be able to deal with it alone. You will probably need to seek professional assistance, ideally from a team of doctors, psychologists, psychiatrists, other therapists and nutritionists. I would suggest that you start this process by making contact with your family doctor.
Generally, the earlier the intervention the shorter the treatment period required. The longer an eating disorder is in place the more solidified the distorted thinking becomes and the more resistant it is to change. So as soon as you have concerns about your teenager’s restrictive eating patterns it may be worth addressing them.