Eating Disorders in Adolescents
Eating Disorders in Adolescents--

Having an Eating Disorder is much more than just being on a diet. An Eating
Disorder is an illness that permeates all aspects of each sufferer's life, is caused
by a variety of emotional factors and influences, and has profound effects on the
people suffering and their loved ones.

Eating Disorders are about:

·  Trying to make your whole life better through food and eating (or lack of)

·  Seeking approval and acceptance from everyone through negative attention

·  How life won't be good until a bit (or a lot) of weight is lost, and there's no concern for what kind of
damage you do to yourself to get there

·  Being convinced that your whole self-esteem is hinged on what you weigh and how you look

·   Attempting to control your life and emotions through food/lack of food -- and are a huge neon sign
saying "look how out of control I really feel”

·  Everything going on in life -- stress, coping, pain, anger, acceptance, validation, confusion, fear --
cleverly (or not so cleverly) hidden behind phrases like "I'm just on a diet"

Anorexia Nervosa
Those who are suffering with this illness have a low self-esteem and often a tremendous need to control
their surroundings and emotions. The Eating Disorder, Anorexia, is a unique reaction to a variety of
external and internal conflicts, such as stress, anxiety, unhappiness and feeling like life is out of control.

Diagnostic Criteria

1.  Refusal to maintain body weight at or above a minimally normal weight for age
and height

2.  Intense fear of gaining weight or becoming fat, even though underweight.

3.  Disturbance in the way in which one's body weight or shape is experienced,
undue influence of body weight or shape on self-evaluation, or denial of the
seriousness of the current low body weight.

4.  In post-menarcheal females (women who have not yet gone through menopause), amenorrhea (the
absence of at least three consecutive menstrual cycles).

  • Restricting Type: during the current episode of Anorexia Nervosa, the person has not regularly
    engaged in binge-eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives,
    diuretics, or enemas)

  • Binge-Eating Type or Purging Type: during the current episode of Anorexia Nervosa, the person
    has regularly engaged in binge-eating OR purging behavior (i.e., self-induced vomiting or the
    misuse of laxatives, diuretics, or enemas)

Bulimia Nervosa
Men and women who live with Bulimia seek out binge and purge episodes -- they
will eat a large quantity of food in a relatively short period of time and then use
behaviors such as taking laxatives or self-induced vomiting -- because they feel
overwhelmed in coping with their emotions, or in order to punish themselves for
something they feel they should unrealistically blame themselves for. This can be
in direct relation to how they feel about themselves, or how they feel over a
particular event or series of events in their lives. Those suffering with Bulimia
may seek episodes of binging and purging to avoid and let out feelings of anger,
depression, stress or anxiety.

Diagnostic Criteria

1.  Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the
following:

  • eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is
    definitely larger than most people would eat during a similar period of time and under similar
    circumstances

  • a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating
    or control what or how much one is eating)

2.  Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-
induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive
exercise.

3.  The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a
week for 3 months.

4.  Self-evaluation is unduly influenced by body shape and weight.

5.  The disturbance does not occur exclusively during episodes of Anorexia Nervosa.

  • Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in
    self-induced vomiting or the misuse of laxatives, diuretics, or enemas

  • Non-purging Type: during the current episode of Bulimia Nervosa, the person has used other
    inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly
    engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas

Binge Eating Disorder
Men and Women living with Binge Eating Disorder suffer a combination of
symptoms similar to those of Compulsive Over-eaters and Bulimia. The
sufferer periodically goes on large binges, consuming an unusually large
quantity of food in a short period of time (less than 2 hours) uncontrollably,
eating until they are uncomfortably full. The weight of each individual is
usually characterized as above average or overweight, and sufferers tend
to have a more difficult time losing weight and maintaining average healthy
weights. Unlike with Bulimia, they do not purge following a Binge episode.

Reasons for Binge Eating can be similar to those of Compulsive Overeating; Using Binges as a way to
hide from their emotions, to fill a void they feel inside, and to cope with daily stresses and problems in
their lives. Binging can be used as a way to keep people away, to subconsciously maintain an overweight
appearance to cater to society's sad stigma "if I'm fat, no one will like me," as each person suffering may
feel undeserving of love. As with Bulimia, Binging can also be used as self-punishment for doing "bad"
things, or for feeling badly about themselves.

Diagnostic Criteria

1.  Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the
following:

  • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is
    definitely larger than most people would eat in a similar period of time under similar
    circumstances;

  • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating
    or control what or how much one is eating).

2.  The binge eating episodes are associated with at least three of the following:

  • Eating much more rapidly than normal
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of being embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or feeling very guilty after overeating

3.  Marked distress regarding binge eating.

4.  The binge eating occurs, on average, at least 2 days a week for 6 months.

5.  The binge eating is not associated with the regular use of inappropriate compensatory behaviors
(e.g., purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia
nervosa or bulimia nervosa.

Compulsive Overeating
People suffering with Compulsive Overeating have what is characterized as an
"addiction" to food, using food and eating as a way to hide from their emotions,
to fill a void they feel inside, and to cope with daily stresses and problems in
their lives.

People suffering with this Eating Disorder tend to be overweight, are usually
aware that their eating habits are abnormal, but find little comfort because of
society's tendency to stereotype the "overweight" individual. Words like, "just
go on a diet" are as emotionally devastating to a person suffering Compulsive Overeating as "just eat"
can be to a person suffering Anorexia.

Men and Women who are Compulsive Over-eaters will sometimes hide behind their physical
appearance, using it as a blockade against society (common in survivors of sexual abuse). They feel
guilty for not being "good enough," shame for being overweight, and generally have a very low self-
esteem... they use food and eating to cope with these feelings, which only leads into the cycle of feeling
them ten-fold and trying to find a way to cope again. With a low self esteem and often constant need for
love and validation he/she will turn to obsessive episodes of binging and eating as a way to forget the
pain and the desire for affection.

It is important to remember that most Eating Disorders, though their signs and symptoms may be
different, share a great number of common causes and emotional aspects.


Signs & Symptoms: Anorexia/Bulimia


1. Dramatic weight loss in a relatively short period of time.
2. Wearing big or baggy clothes or dressing in layers to hide body shape and/or weight loss.
3. Obsession with weight and complaining of weight problems (even if "average" weight or thin).
4. Obsession with calories and fat content of foods.
5. Obsession with continuous exercise.
6. Frequent trips to the bathroom immediately following meals (sometimes accompanied with water
running in the bathroom for a long period of time to hide the sound of vomiting).
7. Visible food restriction and self-starvation.
8. Visible binge and/or purge rituals.
9. Use or hiding use of diet pills, laxatives, ipecac syrup (can cause immediate death!) or enemas.
10. Isolation. Fear of eating around and with others.
11. Unusual Food rituals such as shifting the food around on the plate to look eaten; cutting food into
tiny pieces; making sure the fork avoids contact with the lips (using teeth to scrap food off the fork or
spoon); chewing food and spitting it out, but not swallowing; dropping food into napkin on lap to later
throw away.
12. Hiding food in strange places (closets, cabinets, suitcases, under the bed) to avoid eating (Anorexia)
or to eat at a later time (Bulimia).
13. Flushing uneaten food down the toilet (can cause sewage problems).
14. Vague or secretive eating patterns.
15. Keeping a "food diary" or lists that consists of food and/or behaviors (i.e., purging, restricting,
calories consumed, exercise, etc.)
16. Preoccupied thoughts of food, weight and cooking.
17. Visiting websites that promote unhealthy ways to lose weight.
18. Reading books about weight loss and eating disorders.
19. Self-defeating statements after food consumption.
20. Hair loss. Pale or "grey" appearance to the skin.
21. Dizziness and headaches.
22. Frequent soar throats and/or swollen glands.
23. Low self-esteem. Feeling worthless. Often putting themselves down and complaining of being "too
stupid" or "too fat" and saying they don't matter. Need for acceptance and approval from others.
24. Complaints of often feeling cold.
25. Low blood pressure.
26. Loss of menstrual cycle.
27. Constipation or incontinence.
28. Bruised or calluses knuckles; bloodshot or bleeding in the eyes;
light bruising under the eyes and on the cheeks.
29. Perfectionistic personality.
30. Loss of sexual desire or promiscuous relations.
31. Mood swings. Depression. Fatigue.
32. Insomnia. Poor sleeping habits.