The teenage years can be a confusing time. With so many hormonal changes and transitionary life steps, this period can feel overwhelming, leading to low self-esteem. This is just one of the many reasons why eating disorders impact adolescents. Having an eating disorder can be scary for the young person and for their family members too.
If you or your loved one has anorexia you are likely to have a lot of questions. You might wonder why your teenager isn’t eating, or what happens if a person has anorexia during puberty. This article looks at questions about anorexia and the options for treatment and recovery.
What Is Anorexia Nervosa?
Anorexia nervosa (also known as anorexia) is a common eating disorder characterized by a distorted perception of one’s weight or body shape. The person often sees themselves as overweight even though they may be at a healthy weight or underweight. People with anorexia experience intense fear about gaining weight and go to extreme lengths to pursue weight loss, often to the point that it negatively impacts their health and life.
The eating disorder commonly first manifests as dieting to “get into shape” or “eat healthier,” but then progresses into unhealthy and extreme weight loss. Individuals with anorexia nervosa will usually recruit a variety of methods to lose weight, including:
- extreme exercise
- excessively limiting their caloric intake
- using laxatives
- vomiting after eating, called purging
- diet aids
- binge eating food
Research shows that when someone has an eating disorder, the brain’s processes that control hunger and food intake adjust to reinforce this behavior. The structures of the reward response and impulse control centers are altered by this process, worsening the person’s difficult relationship with food.
A common misunderstanding about eating disorders is that people who have them are always overly thin. However, it is impossible to diagnose someone purely from the way they look. This is the case across all common eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, and more.
Another common misconception is that eating disorders are about choice or that the person is doing it for attention. However, this condition is a serious mental illness that commonly coincides with anxiety and depression.
Who Is Affected by Anorexia Nervosa?
Compared to males, females are twice as likely to have an eating disorder. Data from the National Comorbidity Survey Replication (NCS-R) shows that 3.8% of females develop an eating disorder while 1.5% of males do.
Although teenage boys are less at risk for developing anorexia, they may experience more barriers when accessing treatment due to the stigma around men’s mental health and the stereotypes associated with eating disorders.
What Age Does Anorexia Nervosa Usually Begin?
Research has found that the median age for the onset of anorexia nervosa is 18 years old and that this is also the case for bulimia. This is slightly younger than the median age for binge eating disorder, the most common eating disorder in the US, which has been found to be 21 years old. It’s worth noting that eating disorders can develop at any time in life. Some people may be diagnosed late in adulthood and others when they are children.
What Is the Cause of Eating Disorders in Teens?
While the exact cause of developing an eating disorder is still unknown, there are a number of risk factors that increase the chances of experiencing one. These are complex to pinpoint, including a range of biological, psychological, and sociocultural influences. In the past, families were blamed for teen eating disorders. It is now clear that parents do not cause the condition.
The Biology of Adolescence
Developing during adolescence is a confusing time, with teenagers experiencing many physical and emotional challenges as they go through puberty. These can include:
- the onset of the menstrual cycle
- an increased amount of sexual thoughts and urges
- changes in body shape
- emotional instability
- weight changes
These sudden changes in body and character can be confusing for young people, leaving many feeling unsure of who they are. Due to puberty being the trigger of these changes, it is usually regarded as the starting point of behaviors linked to eating disorders. The less comfortable a person feels with their physical body, the higher the likelihood of developing an eating disorder.
During adolescence, teenagers undergo changes in brain chemistry and activity. This can result in strong emotional reactions and feelings of frustration. Whether they are feeling angry, tired, or moody, these intense emotions can become overwhelming for many. This increases the risk of developing mental health conditions, including eating disorders.
It is common for people with an eating disorder to also have a co-occurring mental health condition, such as anxiety disorder, depression, or obsessive-compulsive disorder.
Social Attitudes to Body Appearance
Advertising and social media commonly push a body image that is unattainable, leaving many feeling like they aren’t good enough and striving towards an unrealistic goal. This used to be seen as something that mainly affected young women, but teenage boys can be susceptible to this message too. Every person is on the receiving end of messages about how people should look, what is desirable, and what gives a person social value.
Seeing these messages at any age, but especially during adolescence, can be extremely damaging to self-esteem and body image. It can leave young people with unrealistic ideas about what is considered a “normal” weight. Looking up to celebrities who have regularly undergone surgery can leave fans feeling dissatisfied with their own bodies.
Due to these same mechanisms, social judgment or bullying about body image from others is common during this time. This judgment exacerbates the negative relationship a person may have with their body and contributes further towards eating disorders.
Genetics and Biology
There have been certain genes found that contribute to the risk of developing an eating disorder. Biological factors such as brain chemistry changes and brain function also result in an increased risk of anorexia nervosa.
Being a teenager in the current political and social climate is extremely stressful. Teens are experiencing increased political unrest, a looming climate crisis, high academic pressures, the minefield of social media, and a 24-hour news cycle, among many other stressors. On top of this are the general stressors of life such as making friends, navigating relationships, illness, family issues, or starting a new job. Closely monitoring food intake is a way that some people regain a sense of control over life when they feel stressed. This unhealthy behavior contributes to the development of eating disorders.
The coronavirus pandemic worsened many people’s mental health problems due to the disruption, isolation, and stress it brought into everyone’s lives. Group activities that people did to regulate their well-being were suspended, plus, an increased amount of exposure to social media for teens may have reinforced unhealthy ideas about body image.
What Are the Symptoms of Anorexia Nervosa?
Mental disorders in teenagers can be difficult to understand. This time of hormonal change can make it hard to decipher if what they are displaying is simply teenage moodiness or something more serious. Another reason that diagnosing an eating disorder can be difficult is that teenagers may deny that anything is wrong when confronted about the issue.
However, loved ones can look out for some warning signs that may reveal that the young person has a problem with eating.
- The young person may describe an intense fear of gaining weight and express unhappiness about their current weight.
- Their remarks about their appearance may suggest a distorted body image.
- There might be behaviors such as cutting food, taking laxatives, or self-induced vomiting.
- Their weight goes up or down in a way that seems unusual or extreme.
- The person frequently weighs themselves.
- Their conversations focus on food, its nutritional content, and its bodily impact.
- Their eating is restricted, regimented or ritualistic.
- They avoid situations where they have to eat in front of others.
- They decline to eat as they “aren’t hungry” or have “already eaten”.
- They seem to have an unusually high interest in exercise.
- They have mood swings and seem to have difficulty thinking clearly and focusing.
- They report constantly feeling cold.
- There is downy hair growth on their arms and upper back, known as lanugo. Other changes appear such as poor nail quality, hyperactivity, or dry skin.
- Their menstrual cycle is absent or irregular.
Possible Complications of Anorexia Nervosa
Anorexia nervosa is a potentially life-threatening mental illness and should be treated very seriously. When a person experiences an untreated eating disorder over a long period of time they are more likely to experience long-term complications. Eating disorders can affect every area of life, causing issues at work or school, and in relationships with loved ones. Research shows that anorexia nervosa can cause a wide range of medical complications leading to:
- heart disease
- skin issues
- gastrointestinal problems
- hormone problems
- blood disease
- brain disease
- eye issues
- lung problems
What Happens if You Have Anorexia Nervosa During Puberty?
Early detection of anorexia is crucial to head off health problems in adolescence and early adulthood. Anorexia can disrupt puberty as the person’s body does not have enough nutrients to grow and develop. The illness also lowers bone mass. This in turn leads to osteopenia and osteoporosis, conditions that lead to early bone loss, shortened height, and painful fractures.
Diagnosis and Treatment for an Eating Disorder
With professional help, eating disorders are treatable. As they are complex conditions, a holistic approach is required to overcome them. If you notice any of the behaviors mentioned above (such as skipping meals, unusual eating habits, or compulsive exercise) and have concerns about your teen’s health, speak to a doctor. Even if your suspicion is wrong, it creates an opportunity for a conversation about healthy eating and body image which could prevent an eating disorder in the future. Early intervention is often useful in treating mental health problems.
How Is Anorexia Nervosa Diagnosed?
To diagnose eating disorders, a doctor will carry out a number of tests. This includes a physical exam, where the individual’s vital signs, body weight, and height are measured. Blood and urine lab tests will also be carried out to investigate the health of the inner body workings, such as liver, kidney, and thyroid function.
A psychological evaluation is vital to make a diagnosis. Here, an individual’s thoughts, feelings, and eating habits will be assessed. Sometimes this step is completed through psychological self-assessment questionnaires.
What Does the Treatment Process for Anorexia Nervosa Look Like?
The first step some people take when treating anorexia nervosa is hospitalization. The condition may cause severe malnutrition, dehydration, electrolyte imbalances, psychiatric emergencies, and heart issues. Depending on the specific situation, day treatment may be applicable or a more intense program could need to be laid out.
Medical monitoring needs to be continued over time due to the numerous complications eating disorders can cause. Alongside this, a nutritional rehabilitation program should be crafted. The goal of this is to allow the individual to build healthy eating habits and get back to their healthy body weight.
Both individual and family-based psychological treatments are key when approaching anorexia nervosa. Cognitive behavioral therapy (CBT) is commonly used to treat eating disorders. The technique helps with the identification of unhelpful thoughts and triggers, then builds coping mechanisms to counteract them. Individual therapy is also valuable to work through any trauma associated with the eating disorder and work on improving low self-esteem.
Eating disorders not only impact the individual with the diagnosis but their loved ones also. Attending family therapy can provide an opportunity for education, allowing for more understanding towards the teen and the chance to learn how best to help them going forward. Any dysfunctional dynamics that could be involved in triggers for unhealthy eating can also be tackled under the supervision of an unbiased third party.
Eating disorders are difficult to deal with at any age. However, you are not alone, with the expertise of the Clearfork Academy staff here to assist you or your loved one through this difficult time.
Clearfork Academy specializes in helping teens recover from all kinds of mental disorders, taking a holistic and personalized approach in doing so. Our staff is trained in a wide range of therapeutic approaches, such as CBT and Eye Movement Desensitization and Reprocessing (EMDR), to ensure we are flexible and well-equipped to approach each young person’s needs.
We use a family systems approach, as the support of loved ones is vital to sustaining recovery long into the future. To find out more about our treatment facility based in Fort Worth, Texas, please do not hesitate to contact us.