Deb is a freelance writer and mom. She lives in Brooklyn with her husband, toddler son and a sweet but neurotic corgi. Deb is a runner who has completed two marathons and countless other races. She is also a certified yoga instructor. She blogs regularly about parenting and life as a young urban professional mom at Urban Moo Cow.

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Eating Disorders and Adolescents

We’ve been talking a lot in the blogosphere about body image and eating disorders recently (see Introduction to Eating Disorders). The bounty of comments here and elsewhere confirmed my suspicion that none of us is immune from horrible, soul-sucking, negative body image issues. Many of the women who commented have or have had true, full-blown eating disorders.

I’ve been thinking a lot, however, about conflating negative body image — and some really bad eating habits — with full-blown, clinically diagnosed eating disorders.

This past week, a friend of mine returned – again – to a residential program for an eating disorder she’s had since she was 13 years old. I cannot begin to explain how heartbreaking it is to watch someone cycle through the ups and downs of an eating disorder. As much as my brain slays my body every day (I’m working on it!), it truly pales in comparison to what my friend has gone through for more than half her young life.

In an effort to avoid doing a disservice to those who truly need clinical intervention, today I’m writing strictly about eating disorders.

How Common Are Eating Disorders?

The negativity with which we view our bodies seems ubiquitous. There is, however, a big difference between having a negative body image and developing an eating disorder, which is a mental illness with complex roots. The National Eating Disorders Association (NEDA) says in its Parent Toolkit:

“Eating disorders are usually related to emotional issues such as control and low self-esteem and often exist as part of a dual diagnosis of major depression, anxiety, or obsessive-compulsive disorder….

While sociocultural factors (such as the ‘thin ideal’) can contribute or trigger development of eating disorders, research has shown that the causes are multifactorial and include biologic, social, and environmental contributors….

Eating disorders such as anorexia nervosa have been documented in the medical literature since the 1800s, when social concepts of an ideal body shape for women and men differed significantly from today—long before mass media promoted thin body images for women or lean muscular body images for men.” (emphasis is mine)

Adolescent Eating Disorders

This stock photo makes me super sad. Credit

The statistics on eating disorders for adolescents are disheartening. According to the National Institute of Mental Health (NIMH), the lifetime prevalence for any eating disorder in the U.S. for adolescents (aged 13-18) is 3.8% for girls and 1.5% for boys. (Lifetime prevalence means, simply, the percentage of people in a given population who have had the disorder up until that point.)

NEDA’s Parent Toolkit includes the following information:

Among U.S. females in their teens and 20s, the prevalence of clinical and subclinical anorexia may be as high as 15%. Anorexia nervosa ranks as the 3rd most common chronic illness among adolescent U.S. females. Recent studies suggest that up to 7% of U.S. females have had bulimia at some time in their lives. At any given time an estimated 5% of the U.S. population has undiagnosed bulimia. Current findings suggest that binge-eating disorder affects 0.7% to 4% of the general population.” (emphasis is mine)

This is not a joke or a nuisance. It’s a disease.


Eating Disorders Are Gender Blind

The other day I was waiting for a friend for lunch in Williamsburg, Brooklyn’s hipster central. There were two young men — obviously dressed to impress one another with their physiques – seated beside me discussing their weight and musculature.

“I’m working to get down to my ideal weight. The lowest I’ve been is 159. That was last summer,” one said.

I glanced over at him. He looked pretty thin to me already and kind of tall for 159 to be a healthy weight.

“You look good now,” the other replied. “You must have been, like, a stick.”

“I just want to be healthy.” (Really?)


Men have body image issues, too. Credit

As this anecdote highlights, men are not immune to societal pressure about their bodies. Nor are they immune to the real possibility of preoccupation with weight and appearance turning into a full-fledged illness.

In fact, NEDA claims that 10 million men in the U.S. will develop an eating disorder at some point in their life. And a November 2012 article in Pediatrics entitled “Muscle-enhancing Behaviors Among Adolescent Girls and Boys” concluded:

“Muscle-enhancing behaviors were common in this sample for both boys and girls. For example, 34.7% used protein powders or shakes and 5.9% reported steroid use. Most behaviors were significantly more common among boys.” (emphasis is mine)


Symptoms of an Eating Disorder

As a parent, how do you know if your adolescent is just being difficult or if there really is a problem? The Mayo Clinic has a succinct page on symptoms of the three main eating disorders, Anorexia Nervosa (self-starvation), Bulimia Nervosa (purging food) and Binge Eating Disorder (overeating without compensating by purging or starvation).

The Mayo Clinic cautions parents not to assume every whim or phase is an eating disorder. They list some “red flags” that may indicate an eating disorder, including:

  • Skipping meals
  • Making excuses for not eating
  • Eating only a few certain “safe” foods, usually those low in fat and calories
  • Adopting rigid meal or eating rituals, such as cutting food into tiny pieces or spitting food out after chewing
  • Cooking elaborate meals for others, but refusing to eat them themselves
  • Collecting recipes
  • Withdrawing from normal social activities
  • Persistent worry or complaining about being fat
  • A distorted body image, such as complaining about being fat despite being underweight
  • Not wanting to eat in public
  • Frequent checking in the mirror for perceived flaws
  • Wearing baggy or layered clothing
  • Repeatedly eating large amounts of sweet or high-fat foods
  • Use of syrup of ipecac, laxatives, the over-the-counter weight-loss drug orlistat (Alli), or over-the-counter drugs that can cause fluid loss, such as menstrual symptom relief medications
  • Use of dietary supplements or herbal products for weight loss
  • Food hoarding
  • Leaving during meals to use the toilet
  • Eating in secret


And if you think you might have an issue yourself, try these two brief quizzes from the Renfrew Center. And see a doctor. Really.


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Comments (11)

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  3. Jen 06/26/2013 at 10:03 am

    This is a great article, my close friend’s daughter is in treatment. She has been abusing laxatives, they already say she may have done permanent damage to her organs and she’s only 19. She actually said in treatment that if getting better means gaining weight, she would rather die. I watch my friend have to try and come to grips with her daughters inability to help herself and it breaks my heart. Thank you for sharing this.

  4. Sarah Almond 06/24/2013 at 12:08 am

    I suffered from anorexia in college after a lifetime of struggling with horrible self esteem and body image. I dieted down to 90 pounds. Luckily I was able to conquer it and get back up to a healthy weight. Now I am heavier than I have ever been, and as much as I would like to be a little thinner I know that I am healthy the way I am. Being healthy is more important than how I look in a pair of jeans.

    • Deb Gaisford 06/24/2013 at 8:33 am

      There are just so many stories out there. It’s so prevalent. Then many of us leave it all behind and forget that it’s still a problem for the women behind us. Then again, some never leave it at all. I’m glad you are in a healthier place.

  5. Rachel 06/21/2013 at 7:32 pm

    I’ve known so many women who have had bulimia. It was almost matter of fact in college. I actually knew more women who had it than women who didn’t. The weird part is that no one talked about it. It’s good to raise awareness of the issue of eating disorders. Thank you.

    • Deb Gaisford 06/22/2013 at 11:05 am

      Wow, really? I definitely knew a few but maybe I was naive. It wouldn’t have been the first time I was so clueless in college.

  6. Kristi Campbell 06/21/2013 at 5:25 pm

    This is so important. I’d be interested in seeing statistics on how long people were bulimic or anorexic prior to seeking help and for how many of them it becomes a lifetime illness. For those who quit – what were the triggers that helped them to see the problem? Did they seek profesional help or were they able to stop on their own?
    I remember years ago, I worked with a woman whose daughter (17) so obviously had an eating disorder. Her poor mom had no idea. It took Melissa getting down to 74 pounds for them to recognize it. So sad, and frustrating for those around her who wanted nothing but to help and were unable to do so. She ended up entering a program and becoming healthy again only to begin cutting. I wish I’d have stayed in touch with her mom because I’d really like to know how she’s doing today. Great topic, great writing, and thank you for raising awareness.

    • Deb Gaisford 06/21/2013 at 7:28 pm

      Great questions, Kristi. I will definitely look into them. Data exists, but I don’t know if anyone knows the answers.

  7. Katia 06/21/2013 at 12:01 pm

    Such an important topic, thank you so much for raising awareness. I think that food’s become such a dominant feature of our culture (even pop culture through tv reality shows, pinning recipes etc) that it’s easy to overlook the negative attention some, or maybe most of us, pay food. I am bookmarking this.

    • Deb Gaisford 06/21/2013 at 7:26 pm

      Such a good point about the contrast between glamorizing food and the “darker” side. There is also a big obesity and diabetes problem in the U.S., which is its own problem.