Does your teenager suffer from an eating disorder?

Patient is a golden child. At the age of 19, she is an honors student at a large university, is excited about her future career as a nurse and spends her weekends shopping with her sister at the local malls. Her honey-colored, shoulder-length hair swings when she walks, and her green eyes sparkle. But there is something else behind that twinkle – a shadow of darkness and fear, a story of unspeakable love and endless tears. Patient is a recovering anorexic, and just three short years ago she was on the brink of death, her 5-foot 6-inch body weighing in at a horrifying 88 pounds. Her parents say they were initially unaware of her deteriorating condition. A busy family they rarely were all together at meal times, and she was clever about concealing herself beneath layers of chunky clothing. And, then one day her mother accidentally walked in on her as she was undressing. Patient’s mother was so shocked by the deterioration of her daughter’s body. It was as if a skeleton looked back at her instead of her child.

Teenage starvation – An epidemic? The National Association of Anorexia Nervosa and Associated Disorders (ANAD) conducted a study in 1993 of senior high school students in 20 schools across 18 states. The results were disturbing – 12 percent of the young people surveyed suffered either from anorexia nervosa or bulimia. Projected nationally, these figures suggest that approximately 716,000 students nationwide may be seriously affected. These estimates are probably very conservative given that the study did not include early adolescent populations, a large group with growing incidence of eating disorders. Though girls seem to be more at risk, boys do make up a significant number of cases. It is important that parents familiarize themselves with a various eating disorders in order to recognize warning signs.

Anorexia nervosa. Anorexia nervosa literally translates to mean "loss of appetite." This, however, is not an accurate description because a person with this disorder is very hungry but prefers starvation due to a fear of becoming fat. Some of the characteristics of anorexia include self-starvation, a preoccupation with food and rituals, unusual amounts of exercise and a cessation of the menstrual cycle. An irregular heartbeat due to low potassium levels is the most common cause of death in untreated cases.

Bulimia nervosa. Binge eating (recurring episodes of eating large amounts of food in short time periods) characterizes bulimia. Sufferers are usually aware that their eating habits are cut of control, however, fear of being unable to stop eating as well as fear of fat continues to fuel the episodes. Self-induced vomiting, also known as purging, or abusing laxatives or diuretics (medications that decrease the amount of water in the body), may follow periods of bingeing. People with bulimia may even fast from time to time. Weight is usually normal or a bit above normal though it may swing plus or minus 10 pounds as result of bingeing and fasting.

Compulsive overeating. A compulsive overeater is a binge eater who does not purge and is usually overweight. In addition to three meals a day, he or she may also eat frequent snacks or may continually overeat all through the day. She has been a binge eater for about 15 years. She describes episodes of mass consumption, sometimes downing two boxes of Oreos, a half-gallon of ice cream, an entire cake and leftover fried chicken all inn one sitting. Once a cheerleader in high school, now weighs a dangerous 365 pounds. Though her size depresses her, the thought of dieting upsets her even more. She had her first binge during a time when she was experiencing tremendous personal trauma. Eating is a mental comfort to her when she’ feeling low. It’s almost as if someone injected her with a powerful drug that soothes her. Of course, that happiness is short-lived; one the binge is over, guilt sets in. However, it is not long before another binge occurs.

Physical consequences. The physical complications associated with eating disorders are many and can be very dangerous. According to a gastroenterological and professor of medicine at Washington University School of Medicine, "Medical complications include such diverse symptoms as constipation, ulcers, strictures (narrowing) of the esophagus, tooth decay (from vomit acids), heart irregularities, increased rate of miscarriage, irregular periods, aspiration pneumonia (caused by accidentally inhaling vomit), seizures (if the patient is abusing diet pills), and kidney dysfunction."

Customary treatments. Treatment for persons with eating disorders is essential because it can save lives. Physicians, dietitians, teachers, relatives, friends, support groups and therapists all may be required to work together to encourage the sufferer to seek and stick with a treatment program. According to doctor, "Customary treatments for a person with an eating disorder are varied. Antidepressant medications, behavior therapy, family therapy and hospitalization may ll play a role. If the body weight gets below 70 to 75 percent of a person’s ideal weight, forced tube feeding is usually necessary." Length of treatment for patients undergoing therapy varies. Sessions may be required for as little as 10 weeks to as long as three years. A researcher who specializes in eating disorders, states that improvement for severe cases "can be achieved with two to three years of psychotherapy, in which attention is directed to the problems of low self-esteem, guilt, anxiety, depression and a sense of helplessness."

Cost of treatment. Treatment for eating disorders can be extremely expensive. Severe cases require extensive monitoring and treatment. Considering that therapy generally lasts two years or more, the costs can be staggering. Inpatient treatment can reach in excess of $30,000 or more a month, and many patients require more than one hospitalization. Outpatient treatment, which generally includes therapy and medical monitoring, can run as high as $100,000 or more. Though it is proven that eating disorders are a problem, few states offer adequate programs or cost-effective services to combat these illnesses. Very few schools and colleges have education programs to warn young people about the dangers of eating disorders. However, every state in the nation, and thousands of schools, provide programs directed toward alcohol and drug abuse.

Their value has been proven and accepted as status quo in most school curricula. Considering the tremendous suffering, high cost and longevity of eating disorders, it would seem that more states would implement programs. The school systems may be the appropriate place to start, since approximately 76 percent of victims report onset between the ages of 11 and 20.

Finding help. When searching for a doctor or therapist, the ANAD suggests calling physicians, psychologists, social workers or psychiatrists listed in your phone book. Ask specific questions about the number of patients with eating disorders they treat, their treatment philosophy, how successful the treatment was, and the average length of treatment, if their responses are promising, try a few sessions to determine their effectiveness. You should then bed able to decide to continue or to seek treatment elsewhere. Effective therapy will be characterized by the progress made toward the goal of eating healthfully.

Cause for hope. Anorexics and binge/vomiters report considerable improvements with the aid of good therapy, the help of relatives and friends, and the support of self-help groups. As more information is discovered through research, new techniques emerge that may result in a higher cure rate. Patient was released from the hospital after reaching a healthier weight and, after three years. Still participates in both individual and group therapy. She comes such a long way. Though she eat normally now and enjoy it, there are times when that old nagging fear of fat tries to overcome her. Still, she is learning to be comfortable with herself and proud of her success at fighting the urges that still haunt her from time to time. She’s so grateful to her family, friends, doctors and therapists for not giving up on her.

Patient’s family has confronted her about her eating compulsions many times, and, as a result, she has sought treatment twice. However, both times she found it too difficult to continue. Her mom comes to visit her every weekend and cries when it is time to leave. She hates seeing her family upset because of her, but she can’t seem to stick with her therapy. Still she is determined to try it once more. Her mom found a new doctor in a different city that has a pretty good track record with binge eaters like her.