CORONAVIRUS (COVID-19) RESOURCE CENTER Read More
Add To Favorites

Clues to help diagnose anorexia in teenagers

Topeka Capital Journal (KS) - 7/18/2016

Dear Doctor K: I'm worried about my 15-year-old daughter. She eats like a bird. She is very thin, but thinks she is fat. I'd like to think this is just a phase some teenagers go through, but could she have anorexia nervosa?

Dear Reader: As with most illnesses, there is not a magic dividing line between having anorexia and not. In fact, there's a big gray zone where people don't meet the criteria for a disease, yet they're not normal, either.

It's the same with anorexia. People in the middle may meet some criteria for anorexia. They don't have an officially recognized eating disorder, yet they don't have a healthy relationship with food, either. Many of these people have what a Harvard Medical School colleague calls "almost anorexia."

My colleague Dr. Jennifer Thomas, with Jenni Schaefer, has written an informative book on this topic called "Almost Anorexic: Is My (Or My Loved One's) Relationship With Food a Problem?"

What causes anorexia? We don't know. Some psychiatrists have considered it a psychiatric disorder, strongly influenced by social pressures that equate beauty with thinness. I suspect it is predominantly a disorder of brain chemistry.

Could this just be a "phase" in your daughter's turbulent teenage life? Consider the following red flags that increase the likelihood that your daughter has what Dr. Thomas calls "almost anorexia" or even full-scale anorexia:

- Does your daughter have drastic intentional weight loss or frequent weight changes?

- Does she follow rigid dietary rules, such as eating only at specific times or eating only a specific number of calories? And if she breaks these self-imposed rules, does she feel extremely guilty?

- Does your daughter occasionally force herself to vomit or use laxatives inappropriately? Does she sometimes exercise excessively to burn off the calories she just consumed?

- You've indicated that your daughter has a negative body image: She thinks she's fat, even though she's thin. Is that affecting how she lives her life?

If you suspect your daughter may have -- or almost have -- anorexia, speak to her doctor. Indeed, her doctor may refer her to an anorexia specialist to decide if she has anorexia, or is at risk for becoming anorexic. If so, now is the time to take steps to prevent it from developing. Eating disorders can cause serious medical problems, and in the most extreme cases, even death.