Eating Disorders: Susceptibility of Adolescents

 Anorexia Nervosa: Protecting our Adolescents.

Understanding Eating Disorders:

Many Eating Disorders have their roots in psychological disturbances which manifest in food-related behaviors and practices that are abnormal and that can result in serious physiological consequences.

In addition to the psychological component, other contributing factors are environmental, social, genetic and biological.

Stephenson et al (2022) specifically point out the following observations:

• "People with eating disorders are more likely to have close relatives with depressive and anxiety disorders, phobias, and obsessive-compulsive disorder than people who do not have eating disorders."
•  "Frequent social media use in young adults has also contributed to rising rates of eating disorders, depression, anxiety, and other mental illnesses."
• "People with eating disorders frequently have a distorted view of their body weight or shape, and they often place a great deal of importance on having an “ideal” body weight, shape or specific body parts."
• "Individuals who participate in activities or occupations that encourage thinness, such as ballet, acting, and fashion modeling, have an increased risk for developing an eating disorder, especially Anorexia Nervosa and Bulimia Nervosa."
• Characteristics such as race, income level, occupation, and lifestyle choices can also contribute to eating disorders. 
• "Adolescents who are at risk of an eating disorder, such as Anorexia Nervosa, may develop the condition in response to a stressful life event (a “trigger”)."  Experiences such as moving away from home or losing an emotionally supportive family member may trigger an eating disorder.  "Additionally, the stress of coping with a dysfunctional family may tip a vulnerable adolescent member of that family over the brink and into an eating disorder." (Stephenson et al, 2022).

Common Risk Factors for Eating Disorders:

The following traits increase the chances of development of an eating disorder such as Anorexia Nervosa:

• Poor self-image or poor self-esteem
• Dissatisfaction with body shape
• History of dieting
• Female
• Adolescent life stage
• Close relative diagnosed with mental illness or an eating disorder.
• Emphasis on "ideal body" weight and shape
• Occupation or sport that requires a lean body mass
• Victim of bullying
• Socially challenged 
• Member of dysfunctional family
• Perfectionist

Signs, Symptoms and Common Behaviors associated with Anorexia

Based on information from National Institute of Mental Health, National Institutes of Health (2016), the following are common manifestations:

• Fear of becoming 'fat.'
• Frequent dieting and/or fasting.
• Excessive exercising
• Distorted body image and low self–esteem
• Extremely structured eating
• Extreme thinness
• Mild anemia
• Brittle hair and nails
• Chronic fatigue
• Slow breathing and resting pulse rate
• Constipation

                           

Consequences of Severe Dietary Restriction & Untreated Anorexia Nervosa:

Based on information obtained from National Institute of Mental Health, National Institutes of Health (2016), the severe dietary restriction that accompanies Anorexia Nervosa compromises major organ systems and results in the following observed consequences:

• Decreased metabolic rate
• Decreased heart rate
• Muscle wasting
• Muscle weakness
• Hypotension
• Dehydration
• Low thyroid hormone
• Intolerance to cold
• Presence of Lanugo-"white, delicate, and dense hair"
• Weakened immune system
• Decreased bone density
• Inadequate body fat
• Estrogen Insufficiency
• Delayed menarche or amenorrhea in adolescent females

In addition, complications can result in heart failure, kidney failure and death.  Also as indicated by (Ishigami et al, 2016), premature death may occur as a result of suicide and abuse of alcohol.  

How can we protect our adolescents?

• Train your adolescents to value themselves and their self-worth by their inner attributes as opposed to outward appearance.
• Discuss openly the unrealistic expectations that are triggered by media advertisements utilizing models for standards of weight, beauty, diet and exercise.
• Do not impose your own weight and dietary insecurities on your adolescents.
• Encourage a balanced and healthy attitude and relationship with food and nutrition in your household.
• Keep the communication going in your household to reduce the effects of peer opinions and pressure.
• Despite preventative measures, if affected, seek out treatment programs, interventions and support groups that are specifically tailored towards adolescents. 

 

    References:

Ishigami, A et al (2016). Postmortem diagnosis of anorexia nervosa: An endocrinological and immunohistochemical approach. Journal of Medical Investigation 63(3-4):305, 2016. DOI: 10.2152/jmi.63.305

National Institute of Mental Health, National Institutes of Health: Eating disorders (Updated February 2016). Https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml. Accessed November 26, 2020.

Stephenson, T et al, (2022).  Human Nutrition: Science for Healthy Living. 3rd Edition.  McGraw Hill. 

Lorna Hylledig Ed.D, MSPH, RD,  LD