My Teen Suspects Her Friend Has an Eating Disorder
Dr. Julianna Slattery offers some sound advice.
This month on Weekend Magazine, I want to help parents understand the challenges related to an eating disorder. This can be a very touchy topic for families, where issues related to food, weight, looks and expectations can all be wrapped up in complex relationships within the family. Because of the serious health and psychological ramifications tied to an eating disorder, I strongly urge families to seek immediate professional assistance if you suspect a family member is dealing with this problem. Focus on the Family has an in-house counseling team that can help you take the initial steps on the road to recovery.
The following is an article I wrote on this topic. I pray you find it helpful.
*******
A common concern I hear about from families is eating disorders. A typical question might be something like, "My teen daughter is wondering if her friend has an eating disorder. What do I tell her?"
Next time you are at your teen's school around lunchtime, take the opportunity to browse through the cafeteria. Most of the students will be so busy socializing, studying or just plain trying to fit in, they likely won't even know you are there. Just notice what is on the trays of the average teen. You will see lunches consisting of Twinkies, soda and French fries, all the way to a young girl pecking at a side salad and sipping water.
Most teens make poor food choices when left to their own devices. On top of that, research indicates that around 60% of adolescent girls diet, and 35% believe they are overweight. Most teenage girls count calories and fat grams, and ask each other, "Do I look fat in these pants?" Although disordered eating is an epidemic at any high school, eating disorders are far less common. One is a normal adolescent behavior; the other is a potentially life-threatening disease.
The first thing you need to help your daughter sort through is how serious her friend's symptoms are. Is she observing typical teen dieting and body image issues, or are there signs of an eating disorder?
As you probably know, there are two classes of eating disorders commonly found among teenagers. Although a person can exhibit symptoms of both anorexia and bulimia, the two patterns are fairly distinct in terms of symptoms and the typical personality of a person vulnerable to them. While anorectics obsess about being in control, bulimics struggle with being out of control.
Anorectics are obsessed with losing weight. They severely restrict food intake, sometimes limiting themselves to a few hundred calories a day. While observers see an emaciated body, an anorectic still sees fat on her frame.
All anorectics are very thin, but not all thin people are anorectics. To make diagnosis more difficult, anorectics are masters at hiding their illness. They wear baggy clothes, take tiny bites and move food around their plate to give the appearance of eating, and devise clever excuses to explain why they are not hungry (like "I have the flu," "I had a big lunch," "My stomach is upset because I'm nervous," etc.).
Girls with anorexia are often model students, citizens and Christians. They work hard, strive to please their parents and usually come from close, loving families. Because they have tremendous self-discipline and a high pain tolerance, they often are involved in competitive athletics. Despite displaying great character traits in other areas of life, anorectics will often tell bold-faced lies to avoid being confronted with their controlled eating or weight loss.
Bulimics are secretive eaters who have established a pattern of binging and purging. They try hard to restrain themselves from eating in public. However, when they are alone, they give into extreme hunger and binge on large quantities of food. Binges usually consist of high calorie foods like doughnuts, cookies, ice cream and crackers. An average binge may consist of 1,500 to 5,000 calories, rapidly consumed in an out-of-control type episode. During or soon after the binge, panic hits and the bulimic finds a way to purge. A bulimic will use any combination of vomiting, laxatives, diuretics and extreme exercise to relieve her bloated stomach and self-hatred.
Unlike anorectics, girls with bulimia typically have an average build and easily blend into the crowd. Obvious signs of bulimia include patterns of restricting and then binging as well as frequent trips to the bathroom after eating. Physically, bulimics may also exhibit tell tale signs. Their faces often have a puffy appearance and their hair, skin and nails have an unhealthy appearance. Additionally, bulimics who vomit often have bad breath, mouth sores and dental problems due to the frequent passing of powerful digestive acids.
Although bulimics will be very secretive about binging and purging, they are typically more open to an outstretched arm than a young woman with anorexia. While anorectics fight tooth and nail to project the image of a controlled, perfect life, a teen with bulimia is more likely to seek out the attention she desperately craves. In fact, bulimia is associated with other out-of-control behaviors like sexually acting out, low self-esteem, depression and substance abuse.
If you daughter suspects that her friend has either anorexia or bulimia, help her sort through the symptoms she has observed. Along with identifying symptoms, ascertain the danger of the situation. A full-blown eating disorder is very serious. Ten percent of young women with anorexia will eventually die from the disorder. Although bulimia doesn't pose as immediate a health risk, the physical toll of binging and purging is destructive to the esophagus, heart, internal organs, immune system and the body's chemical balance.
Your daughter can help by being there for her friend. Teen girls will often share feelings and problems with their friends before sharing with their parents. Your daughter can and should express her concerns for her friend by saying something like, "I'm worried about you. I've noticed that … ." Tell your daughter to avoid making on-going comments about food and weight. For example, expressing concern is different than saying "You should eat more" at every meal.
As difficult as it may be to do so, you will need to help your daughter intervene for her friend. Eating disorders are much like addictions. When confronted, the person with the disorder is likely to be defensive, angry and refuse help. The full responsibility of confronting is too much to place on the shoulders of a teen.
Most likely, if your daughter has noticed symptoms, other adults in the girl's life have as well. It is critical that the young girl in danger get professional help. Begin by bringing your concern to teachers, coaches, the school counselor and above all, the girl's parents. Be aware that her parents may respond with embarrassment, defensiveness and even anger. It is difficult for a parent (especially a mom) to acknowledge that her teen has an eating disorder.
Your daughter may feel like she is breaking her friend's trust by expressing her concern to you — especially after you tell other adults! Reassure her that she did the right thing and that not all secrets are safe to keep. Help her understand that when a person's health or life is in danger, the most loving thing to do is to get them help. To put it in perspective, remember that eating disorders have the highest mortality rate of any mental illness!
The following is an article I wrote on this topic. I pray you find it helpful.
*******
A common concern I hear about from families is eating disorders. A typical question might be something like, "My teen daughter is wondering if her friend has an eating disorder. What do I tell her?"
Next time you are at your teen's school around lunchtime, take the opportunity to browse through the cafeteria. Most of the students will be so busy socializing, studying or just plain trying to fit in, they likely won't even know you are there. Just notice what is on the trays of the average teen. You will see lunches consisting of Twinkies, soda and French fries, all the way to a young girl pecking at a side salad and sipping water.
Most teens make poor food choices when left to their own devices. On top of that, research indicates that around 60% of adolescent girls diet, and 35% believe they are overweight. Most teenage girls count calories and fat grams, and ask each other, "Do I look fat in these pants?" Although disordered eating is an epidemic at any high school, eating disorders are far less common. One is a normal adolescent behavior; the other is a potentially life-threatening disease.
The first thing you need to help your daughter sort through is how serious her friend's symptoms are. Is she observing typical teen dieting and body image issues, or are there signs of an eating disorder?
As you probably know, there are two classes of eating disorders commonly found among teenagers. Although a person can exhibit symptoms of both anorexia and bulimia, the two patterns are fairly distinct in terms of symptoms and the typical personality of a person vulnerable to them. While anorectics obsess about being in control, bulimics struggle with being out of control.
Anorectics are obsessed with losing weight. They severely restrict food intake, sometimes limiting themselves to a few hundred calories a day. While observers see an emaciated body, an anorectic still sees fat on her frame.
All anorectics are very thin, but not all thin people are anorectics. To make diagnosis more difficult, anorectics are masters at hiding their illness. They wear baggy clothes, take tiny bites and move food around their plate to give the appearance of eating, and devise clever excuses to explain why they are not hungry (like "I have the flu," "I had a big lunch," "My stomach is upset because I'm nervous," etc.).
Girls with anorexia are often model students, citizens and Christians. They work hard, strive to please their parents and usually come from close, loving families. Because they have tremendous self-discipline and a high pain tolerance, they often are involved in competitive athletics. Despite displaying great character traits in other areas of life, anorectics will often tell bold-faced lies to avoid being confronted with their controlled eating or weight loss.
Bulimics are secretive eaters who have established a pattern of binging and purging. They try hard to restrain themselves from eating in public. However, when they are alone, they give into extreme hunger and binge on large quantities of food. Binges usually consist of high calorie foods like doughnuts, cookies, ice cream and crackers. An average binge may consist of 1,500 to 5,000 calories, rapidly consumed in an out-of-control type episode. During or soon after the binge, panic hits and the bulimic finds a way to purge. A bulimic will use any combination of vomiting, laxatives, diuretics and extreme exercise to relieve her bloated stomach and self-hatred.
Unlike anorectics, girls with bulimia typically have an average build and easily blend into the crowd. Obvious signs of bulimia include patterns of restricting and then binging as well as frequent trips to the bathroom after eating. Physically, bulimics may also exhibit tell tale signs. Their faces often have a puffy appearance and their hair, skin and nails have an unhealthy appearance. Additionally, bulimics who vomit often have bad breath, mouth sores and dental problems due to the frequent passing of powerful digestive acids.
Although bulimics will be very secretive about binging and purging, they are typically more open to an outstretched arm than a young woman with anorexia. While anorectics fight tooth and nail to project the image of a controlled, perfect life, a teen with bulimia is more likely to seek out the attention she desperately craves. In fact, bulimia is associated with other out-of-control behaviors like sexually acting out, low self-esteem, depression and substance abuse.
If you daughter suspects that her friend has either anorexia or bulimia, help her sort through the symptoms she has observed. Along with identifying symptoms, ascertain the danger of the situation. A full-blown eating disorder is very serious. Ten percent of young women with anorexia will eventually die from the disorder. Although bulimia doesn't pose as immediate a health risk, the physical toll of binging and purging is destructive to the esophagus, heart, internal organs, immune system and the body's chemical balance.
Your daughter can help by being there for her friend. Teen girls will often share feelings and problems with their friends before sharing with their parents. Your daughter can and should express her concerns for her friend by saying something like, "I'm worried about you. I've noticed that … ." Tell your daughter to avoid making on-going comments about food and weight. For example, expressing concern is different than saying "You should eat more" at every meal.
As difficult as it may be to do so, you will need to help your daughter intervene for her friend. Eating disorders are much like addictions. When confronted, the person with the disorder is likely to be defensive, angry and refuse help. The full responsibility of confronting is too much to place on the shoulders of a teen.
Most likely, if your daughter has noticed symptoms, other adults in the girl's life have as well. It is critical that the young girl in danger get professional help. Begin by bringing your concern to teachers, coaches, the school counselor and above all, the girl's parents. Be aware that her parents may respond with embarrassment, defensiveness and even anger. It is difficult for a parent (especially a mom) to acknowledge that her teen has an eating disorder.
Your daughter may feel like she is breaking her friend's trust by expressing her concern to you — especially after you tell other adults! Reassure her that she did the right thing and that not all secrets are safe to keep. Help her understand that when a person's health or life is in danger, the most loving thing to do is to get them help. To put it in perspective, remember that eating disorders have the highest mortality rate of any mental illness!