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Anorexia Nervosa in Teenagers

July 15, 2013

Anorexia is characterized by an obsession to be thin. It may begin with a diet to reduce weight for a sport or because of overweight, or after receiving a negative comment about weight or body shape. When the diet results in weight loss and positive comments from others, dieting behaviors may escalate.

Some teens develop anorexia in relation to extreme stress or a need to feel in control.

Teenagers and adults with anorexia are terrified of gaining weight. They worry constantly about fat grams and calories in food and may use diet pills in order to restrict intake. Excessive exercise-and guilt when unable to exercise excessively-is common. They may check themselves many times a day by looking in the mirror or weighing themselves. In spite of a thin or even emaciated appearance, they believe themselves to be fat.

Over time, severe food restriction may result in bingeing behaviors (excess consumption of food) followed by purging of the food by self-induced vomiting or laxative use. There may be other mental health issues, such as depression and self-harm behaviors such as cutting, burning or hair-pulling.

Physical problems related to anorexic behavior are many. They include dizziness and fainting, cold intolerance, dry skin and hair, growth of fine hair over the body, constipation, stunted growth, heart abnormalities, anemia, kidney problems, changes in brain function, loss of menstrual periods and osteoporosis (weak bones). Over exercise can also lead to stress fractures.

Anorexia occurs in about 1% of the adolescent population and is more common in girls than in boys, perhaps because of greater societal pressures on females to be thin. It may affect children as young as 8 years old but is more common in those from 12-20. It can be very difficult to treat because there are perceived benefits to the behavior, such as safety and structure. Treatment is often prolonged, and only about 50% of those with anorexia fully recover. An additional 30% have residual symptoms throughout life and 20% become chronic, which sometimes results in death from complications or by suicide.

Researchers believe that the shorter period of time between the onset of the anorexia and the initiation of treatment, the greater likelihood of recovery.