If you suspect that your pre-teen or teenager has an eating disorder, it’s a good idea to talk to your child’s doctor right away. This is not the time for you as a parent to wait and see, or hope for the best.
“Trust your instincts,” says pediatrician and adolescent medicine expert Ellen Rome, MD, MPH. “A parent’s concern is a strong indicator of an eating disorder, or that one is developing. You want to recognize and treat it as soon as possible to keep it from being hardwired into the brain.”
You know your child best, so you likely will notice a problem before anyone else. In fact, Dr. Rome emphasizes that parents should seek a second opinion from a specialist if the child’s doctor doesn’t share their concerns.
“An eating disorder may occur without obvious physical signs or symptoms,” she says. “Even experienced clinicians may not recognize the medical consequences of an eating disorder. Test results may be entirely normal even in a patient with a significant eating disorder.”
What a parent can do
Here are three things you as a parent can do to better understand eating disorders and help keep your teen safe:
- Get the facts
Eating disorders generally start in adolescence, but are found in people of all ages, backgrounds, body types and weights. Boys and men make up about 15 percent of total cases, so don’t assume that it couldn’t happen to a son.
Eating disorders are serious mental illnesses with life-threatening physical and psychological complications. The most common types are:
- Anorexia nervosa — An illness characterized by self-starvation
- Bulimia nervosa — Overeating followed by self-induced vomiting or other means of purging to prevent weight gain
- Binge eating disorder — Overeating without any purge
- Avoidant/restrictive food intake disorder: Persistent failure to meet appropriate nutritional and/or energy needs, leading to weight loss or failure to grow along an appropriate developmental path, often accompanied by significant psychosocial dysfunction.
Left untreated, an eating disorder can impact every organ system in the body and can be fatal. In fact, of all psychiatric disorders, anorexia nervosa carries the highest mortality rate, at around 6 percent.
- Watch for the signs
Although teens at a normal weight can still have an eating disorder, parents should look for any sudden weight loss or gain, or substantial weight fluctuations. In pre-teens and teens who are still growing and developing, weight loss or failure to gain the expected weight and height is cause for concern.
Other signs of an eating disorder include:
- Low energy, fatigue, exercise intolerance
- Palpitations, lightheadedness
- Feeling bloated or full
- Abdominal pain, constipation or diarrhea
- Cold intolerance
- Hair loss
- Poor wound healing
- Depression or anxiety
- Obsessive-compulsive behaviors
- Changes in relationships and school/work performance
- Learn about treatment options
Treatment varies based on how severe the eating disorder is and each individual’s needs. But generally teens get help with psychological therapy, nutritional rehabilitation and health monitoring.
Teens can receive treatment as inpatient or residential therapy, partial hospital treatment or intensive outpatient therapy. In more serious cases, an eating disorder is life-threatening and a patient needs constant medical supervision in a hospital.
Dr. Rome says one promising treatment for anorexia nervosa is the Maudsley Approach, which is family-based refeeding that strives to bring the teen to a healthy weight and to restore normal psychological development.
“The younger the patient, the greater a need for family therapy or interventions,” Dr. Rome says. “For those under 18, the Maudsley Approach is recommended. It puts parents 100 percent in charge of all food, and they receive coaching so they know what to do to help.”
Act on your concerns
Dr. Rome offers one final bit of advice for parents: Take action if you have concerns.
Teens may not realize that they are ill or need treatment. They sometimes actively try to hide eating disorder symptoms or behaviors. Recognizing the problem and getting help for your teen is up to you.