Teen Eating Disorders
February 22-28, 2015 is National Eating Disorders Awareness Week, which is perfect timing since we tend to see a surge of new eating disorder diagnoses after the holidays (and during summer…and fall…). I’m often asked, “Are eating disorders more common now than they were years ago?” If the number of consults I’m seeing is any indication, the answer is a resounding “Yes!” However, I am biased, so let’s look at the data.
Eating disorders are the third most common chronic condition in adolescence. The number of eating disorder diagnoses has been increasing since 1950. In the United States, 20 million females and 10 million males suffer from a clinically significant eating disorder at some time in their life, including anorexia nervosa, bulimia nervosa, or binge eating disorder. The severity has also been increasing: The number of hospitalizations due to eating disorders rose 18% between 1999 and 2006 (the number of children under 12 years who were hospitalized for an eating disorder increased by a whopping 119% during the same time!). Females 15-24 years old who suffer from anorexia nervosa have a mortality rate that is 12 times higher than females without an eating disorder.
Even in those that haven’t been officially diagnosed with an eating disorder, there have been some disturbing trends in behaviors. According to 2013 Youth Risk Behavior Survey:
- 13% of teens nationwide (18.7% females, 7.4% males) did not eat for 24 hours in the past month in order to lose weight or prevent weight gain. This number has been increasing over the past few years, but is below the highest percentage seen in 2001.
- 5% of teens (6.6% female, 3.4% male) took diet pills, powders, or liquids in the past month in order to lose weight or prevent weight gain. This number has been trending down from high of 9.2% in 2001 (seriously, what was going on in 2001?!).
- 4% of teens (6.6% female, 2.2% male) vomited or took laxatives in the past month in order to lose weight or prevent weight gain; this number has been more or less stable over the years.
The next logical question is “Why?”
Why are eating disorder diagnoses increasing in numbers? Why are they increasing in severity? Why are these behaviors so prevalent? Sadly, there is no one answer. One theory that I find particularly intriguing is society’s changing body ideals (which do not necessarily match the medical community’s body ideals). An article that I found very interesting discusses the contest to find the woman that represents our country on a global stage: Miss America. A quote posted on the Miss America website states: “Miss America represents the highest ideals. She is a real combination of beauty, grace, and intelligence, artistic and refined. She is a type which the American Girl might well emulate.” A study in 2010 looked at this pageant and found that the average body mass index (BMI, looking at ratio of height and weight) of Miss America winners has decreased from around 22 in the 1920s to 16.9 in the 2000s. FYI, a “normal” BMI falls between 18.5 and 24.9. A similar incident occurred last month when Sports Illustrated boasted about putting a “plus sized” model in their swimsuit issue (for the record, she is 6’2” and a size 12, where the average American women is right around 5’4” and a size 14. While this Sports Illustrated issue is a step in the right direction, it is still not reflective of the average woman (and not necessarily a healthy goal to strive for).
Now that I’ve freaked you out with the statistics (and maybe made you angry at the media), here are a few behaviors that you should keep an eye out for:
- Wearing inappropriate clothes for the weather – for example, wearing long sleeves when it’s hot outside. This can happen for a couple of reasons: your child may have some temperature intolerance (always cold) or he/she may want to hide their body.
- Making excuses to avoid eating, like “I just brushed my teeth” and “I had a big lunch at school.”
- Going to the bathroom immediately after meals
- Preoccupation with food – reading labels, counting calories, etc. And just so you know, it is common for someone with an eating disorder to enjoy grocery shopping and watching cooking shows; often times I hear, “He/She even LOVES to cook and bake!” They just won’t eat what they prepare.
If you are concerned that you or someone you know has an eating disorder, talk to your healthcare provider. For more information about National Eating Disorders Awareness Week (#NEDAwareness for those of you who are hip and Tweet), go to http://nedawareness.org/