Our culture places constant pressure on teens ( and adults) to lose weight. The trend in the US is towards obesity, with about a third of our population being considered overweight or obese, so the messaging about weight loss makes sense. But this constant message to lose weight can back fire. Often this pressure to be thin results in participation in fad diets, extreme workouts, and losing weight too quickly. All of these behaviors may be the start of an eating disorder, but the warning signs can be missed because the person losing weight is being complimented on their achievements.
An article in the medical journal sponsored by the American Academy of Pediatrics will come out soon that shows what I often see in clinical encounters: teens who are overweight or obese and lose weight too quickly may have an eating disorder for years before it is caught. A common myth is that people who are overweight or obese can’t have an eating disorder. This is absolutely false! Someone can be 100 lbs overweight and still have an eating disorder. I describe eating disorders as behaviors that a person does to lose weight that end up getting out of their control. For example, a teen who starts trying to ‘eat healthy’ starts to cut out sugary drinks and fast food. But then this behavior becomes more rigid. They will only eat fruits and veggies; They refuse to eat at restaurants or in public, they punish themselves by adding extra workouts if they eat a cookie; they start using phrases like ‘all carbohydrates are bad.’ At this point, the food is now controlling them. Often, with this rigid behavior comes social isolation (for example: they stop going out for pizza with friends) and rapid weight loss. They may start to have dizziness, low energy, cold hands and feet, or if they’re a female, their period becomes very light, irregular, or stops.
The medical complications of an eating disorder (dizziness, chest pain, fatigue, electrolyte abnormalities) can happen in anyone who loses weight too fast. It’s a sign their body is being malnourished and requires professional help to get better. It’s just more common for friends, family, and medical professionals to pick up on the complications when a person goes from 140lbs down to 90lbs instead of 300 to 250 in a very short period of time.
So what should parents look out for? What can they do if they suspect an eating disorder? We’ll offer a few tips here, but we have an entire video series about eating disorders that we’re going to post this Fall, so keep reading for more information.
1. Listen to your intuition. If you notice that none of your teen’s clothing fits, or they seem to be losing a lot of weight very quickly, let them know you’re concerned.
2. Seek medical help. Check in with your teen’s medical provider and review growth curves. If your teen is quickly falling off their growth curve, something may not be right. Sometimes medical providers can miss the tell tell signs of an eating disorder, so go with your gut.
3. You know your teen better than anyone else. Double check with your provider to make sure they ask about eating disorder behaviors (food restriction, binging/purging, diet pills, laxative use, extreme or compulsive exercise).
4. If you notice rapid weight loss (more than 1 lb per week) that’s probably too fast. Seek help early on. A team with a nutritionist and medical provider can help ensure your teen is as healthy as possible.
Eating disorders are never really about food, they are truly mental health disorders that are caused by a complex mix of factors. If your teen has an eating disorder, know that it is not their fault and it is not your fault either! Seek help from a team of experts and be sure you feel supported.