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A parent’s guide to eating disorders

Eating disorders have long been associated with younger women taking drastic measures to lose weight. Recent research, however, contradicts that premise and shows that myriad eating disorders impact a more varied population than previously believed. Foong-Yi Lin, MD, a pediatrician with Northeast Medical Group in Gales Ferry and Yale New Haven Children’s Hospital, said parents of adolescent girls and boys should look for warning signs that their child may be suffering.

"Eating disorders are now the fifth most prominent mental health condition among all teens in the United States,” she said. “Usually, when we think of eating disorders, we think of someone who is fit or underweight. We picture someone who is thin, white and female. Now, the medical community is paying more attention to non-stereotypical groups like boys, ethnic minority groups and people who are not necessarily thin. Everyone is at risk.”

The National Institute of Mental Health identifies an eating disorder as a serious and often fatal illness. These illnesses are usually associated with an obsession with food, body weight or body shape. The three most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.

“All of these can be life-threatening,” Dr. Lin said. “Anorexia, for example, has the highest mortality rate among all psychiatric disorders. That shows that these issues are far more serious than they may seem.”

People who suffer from anorexia eat very little or avoid food completely for long periods. They also weigh themselves frequently along with the fasting.

Bulimia is different because people with this condition eat large amounts of food followed by attempts to rid their bodies of the excess. These attempts often include the use of laxatives, fasting, excessive exercise or forced vomiting. The bulimic cycle is commonly referred to as binging and purging.

Binge eating is similar to bulimia because people lose control and repeatedly eat too much. The difference is they do not follow the overeating with attempts to purge. As a result, those who suffer from binge eating disorder are usually overweight.

“It’s important for parents to know that these are not passing phases,” Dr. Lin said. “These disorders impact all races, genders, sizes, ethnic backgrounds and socio-economic backgrounds.”

Gregory Germain, MD, associate chief, Pediatrics, Yale New Haven Children’s Hospital, explained that, because of the diversity involved with eating disorders, there is no “eye test” that parents can perform. Instead, he recommends looking past outward appearances and focusing on changes in behavior.

“Are they eating far more, or far less than they used to,” Dr. Germain said. “Do you notice a significant change in their weight, either up or down? Are they eating alone or disappearing after mealtime? Maybe they’ve started obsessively exercising or asking more questions about how many calories and how much fat is in their food. These are all potential warning signs. Ultimately, you know your child best and if they’re not acting like themselves, there may be something going on.”

While boys and girls can suffer from an eating disorder, some symptoms are specific to gender.

“For girls, there can be missing or irregular menstrual cycles,” Dr. Lin said. “In boys, there is more of a focus on leanness and muscle. They may ask to start taking protein supplements.”

If you suspect your child may have an eating disorder, Dr. Lin advises a soft approach.

“Depending on your relationship, you may be comfortable asking them if they have any concerns about their eating habits, or weight,” she said. “If you think they might get defensive or shut down when asked, you can turn the focus to yourself by saying, ‘I’ve noticed you’ve been tired a lot lately. Let’s make a doctor’s appointment just so I feel better.’”

Dr. Germain added, “Once you have an appointment with your child’s doctor, you can tell them your concerns and they can act as a mediator to help. But there is no question that if you think your child may have an eating disorder, speak with their doctor.”

Northeast Medical Group pediatric physicians provide exceptional medical care from prevention to early detection to managing acutely or chronically ill children. Our skilled and compassionate pediatricians care for babies, children, adolescents and young adults, from birth to age 21 years old. Northeast Medical Group’s patients have access to specialists at Yale New Haven Children’s Hospital.