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ANOREXIA NERVOSA in Marin County Teens
Teen anorexia dangers are numerous.
Anorexia is characterized by severe weight loss, a dangerously low body weight, extreme exercise and a
distorted body image. Our guide outlines how to spot the signs and symptoms of anorexia, guidelines for
diagnosing the disorder and current treatment options.
WHAT IS IT?
Anorexia nervosa is an eating disorder characterized by severe weight loss, a significantly low body
weight, intense fear of getting fat, and a distorted body image that drives an otherwise high-functioning
person-usually a young woman-to starve herself. Anorexics keep themselves underweight by eating
sparsely and infrequently, as well as purging-voiding food by induced vomiting, laxative use, etc.-and
exercising intensely, often without recognizing that their actions are unhealthy or that their perceptions of
their bodies are not normal.
Anorexia usually manifests during adolescence and is diagnosed overwhelmingly among females, though
one in 10 of those diagnosed are male, and the actual prevalence could be higher as symptoms of
starvation in young men are less obvious than in young women. Adolescents and young adults with
anorexia are often high-achievers and perfectionists-successful in school and popular with peers-
making it difficult for parents and other adults to see how troubled they are. But anorexia is an extremely
serious condition-a life-threatening psychiatric disorder that, untreated, leads to fatal medical problems
and a high rate of suicide. The earlier it is treated, the better the odds of the patient recovering, and
avoiding future relapse.
WHAT TO LOOK FOR
Behavioral signs that a teen might be anorexic include rejection of a healthy amount of food, dramatic
dieting, compulsive exercise, and a gross overvaluing of shape and weight as components of her identity.
Visible signs that she is starving herself include extreme weight loss, abnormal thinness, brittle nails, hair
loss, constipation, irregular menstruation, and swelling. Still, in growing children and adolescents what
constitutes a normal weight is very difficult to ascertain; a failure to keep up with normal growth and
weight gain that might be perceived as being a "late bloomer" could be a sign of anorexia. But experts
agree that the defining characteristic of anorexia is body image distortion-what the teen sees in the
mirror as unacceptably fat is, to anyone else, disturbingly thin.
RISK FACTORS
Girls are more likely to have anorexia, as are children with a first-degree biological relative who has the
disorder. Participating in activities that emphasize thinness, such as modeling and athletics, are a risk
factor. Teens with anxiety disorders or obsessional traits are also more likely to become anorexic.
DIAGNOSIS
The first step a professional will take towards a diagnosis of anorexia is an evaluation of the teens's
weight relative to the average for her age. If she consistently maintains a body weight 15% below
average, whether by weight loss or failure to gain weight, a clinician will dig deeper, and try to find out if
she is extremely troubled by weight gain or the prospect of being fat, even though she's so thin. He will
look for evidence of an unrealistic body image or denial of the severity of her condition. Irregular periods
can also be a factor in diagnosis. The diagnosis can be of restricting type (no purging) or binge eating/
purging type (she uses self-induced vomiting or misuse of diuretics, laxatives, or enemas to keep her
weight down).
TREATMENT
Treatment for anorexia is psychotherapeutic and medical. No known medication can address the core
symptoms of anorexia, though drugs are often prescribed to treat co-occurring symptoms.
Psychotherapeutic
While one-on-one cognitive behavioral therapy is often used for adults with anorexia, the most successful
treatments for children and adolescents involve the whole family-intensive family therapy and education
that enables parents and siblings to help a child with anorexia return to normal eating patterns. The first
goal of any treatment is to restore your child to a healthy weight, and she should be immediately
hospitalized for this purpose if she is in any medical danger. Milder cases respond well to family therapy;
more severe cases require a hospital stay or a residential program. The disadvantage to residential
programs is that patients tend to relapse when they are back at home, unless the family lifestyle has
changed to make it incompatible with the dangerous behaviors. Treatment is more effective when the
disorder is caught early, and the longer a child stays at a healthy weight, the less likely she is to relapse.
Pharmacological
Some drugs, particularly antidepressants, have been effective in treatment, but they are most often
targeted at another condition the child might also have, such as depression or obsessive-compulsive
disorder. Treating the co-occurring disorder can make the therapy for anorexia more successful.
OTHER DISORDERS
Bipolar disorder, depression, anxiety disorders, obsessive-compulsive disorder, and substance abuse
have been associated with the occurrence of anorexia.
OTHER CONCERNS
The malnutrition associated with anorexia can create serious medical conditions, including anemia,
kidney trouble, brittle bones, and hormone and electrolyte imbalances. At worst, it can be fatal: the havoc
anorexia plays with the chemical balance in the body can cause the heart to shut down without notice,
even in a young woman who does not appear to be dangerously thin. And the disorder can so impair
social life, family connections, and personal development that suicide is a serious risk.
Sources:
Paradigm Malibu
National Eating Disorders
The information contained on this website should not be used as a substitute for the
mental healthcare of a professional, such as a psychiatrist, pediatrician or therapist.
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