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Eating Disorders in Children and Teens

Picture of teen with eating disorder
Although it’s not trending in the news much these days, eating disorders in kids, teens, and adults are still happening. Some sobering statistics are, according to Reel Stories. Real People., Inc. that 85% of kids age 10 fear being overweight. A total of more than 30 million Americans have identifiable eating disorders. Around every 62 minutes, someone dies directly from effects of an eating disorder. Twenty-three percent of those with eating disorders have medical complications like cardiac arrest, arrhythmia, brain damage, osteoporosis, etc. The National Association of Anorexia Nervosa and Associated Disorders add that “eating disorders have the highest mortality rate of any mental illness.”  Have you ever heard of Karen Carpenter from the famous singing duo, the Carpenters? Karen had an eating disorder and died of congestive heart failure due to consequences of anorexia nervosa at just under 33 years of age. (Very sad. She was very gifted.) Eating disorders do not discriminate between race, ethnicity, age, sexual orientation, or gender. Boys, girls, teens, and adults all are vulnerable to eating disorders. The combination of our gene combinations and the interaction with the environment, plus personality traits “all combine to create risk for an eating disorder.”

            Do we still need to pay attention? You betcha!


What is It?


The American Psychiatric Association tells us in the Diagnostic and Statistical Manual of Mental Disorders (5th edition, DSM-5), the official diagnostic manual for identifying mental health disorders, that “feeding and eating disorders are characterized by a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning.” They identify multiple categories of eating disorders, such as pica, or “eating of nonnutritive, nonfood substances over a period of at least 1 month,” rumination disorder, “repeated regurgitation of food over a period of at least 1 month. Regurgitated food may be re-chewed, re-swallowed, or spit out,” avoidant/restrictive food intake disorder, “an eating or feeding disturbance (e.g., apparent lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating).”

The most common eating disorders we hear about are anorexia nervosa, “restriction of energy intake relative to requirements, leading to a significantly low body weight…, intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight,” bulimia nervosa, “recurrent episodes of binge eating … with … recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting” or, purging.” and binge-eating disorder, the same essentially as bulimia nervosa, except there is no purging.

WebMD tells us that we are not sure about what causes eating disorders. It is likely caused by a number of factors, such as genes, social dynamics (think about the images put out by our media industry), overall fears, being generally anxious, depressed, or substance use may also influence whether a person develops an eating disorder. (Just as a reminder, do not be overly concerned about genetic influences as a person has the ability, through diet, supplementation, and coping skills to quell adverse expression of genes, such as might result in an eating disorder.) 

What it Looks Like

Remember especially that with children and teens, those who have anorexia have distorted body images. They view themselves as being overweight, even when they are at a normal weight or underweight. They are often in denial about having an eating disorder. Those who have eating disorders may be, according to WebMD, anxious, depressed, perfectionists, and abnormally self-critical. They often diet even when they are dangerously thin. They may also engage in way too much exercising. They live with an intense fear of being heavy. Their menses, if they have started, often slow down or stop completely. They experience very quick weight loss, which they try to hide with clothing choices, and engage in behaviors like avoiding meals, eating secretively, or eating certain foods in very tiny amounts. They show an abnormal interest in food.

If your child or teen has bulimia, according to WebMD, they also fear gaining weight and are very unhappy with their body image. They consume large amounts of food in a short period of time, and then feel like they have lost control. With bulimia, they then try to compensate for these binges by vomiting, using laxatives, diet pills, diuretics, or enemas; they feel relieved after they have purged.

If your child or teen has binge eating disorder, expect them to look like they have bulimia because they will be engaging in “out-of-control eating of large amounts in a short time, even to the point of discomfort.” Unlike bulimia, binge eaters do not generally engage in purging activities. So, they may just gain weight and become obese. They also struggle with handling emotions, such as anger, stress, anxiety, being sad and bored; these feelings may trigger a binge.

Medication and How That Affects Eating Disorders

Conventional approaches to treatment of eating disorders often include antidepressants, behavior modification therapy, individual, family, or group therapy, and nutritional counseling. Since we are living in a time where the medical model of mental health treatment is reigning supreme, children and teens who present to treating professionals are usually put on medications and talk therapy is recommended. There are a multitude of antidepressants that are given to children and teens. Here are some:

  • Fluoxetine – a prescription medication known as Prozac. Side effects can include insomnia, strange dreams, headaches, dizziness, changes in vision, shaking, feeling anxious or nervous, pain, weakness, upset stomach, loss of appetite, etc.
  • Clomipramine – a prescription medication also known as Anafranil. Side effects can include dry mouth, nausea, upset stomach, loss of appetite, constipation, feeling anxious or nervous, weight changes, trouble concentrating, memory problems, etc.
  • Duloxetine – a prescription medication also known as Cymbalta. Side effects include nausea, dry mouth, constipation, diarrhea, fatigue, drowsiness, sleeping issues, etc.
  • Escitalopram – a prescription medication also known as Lexapro. Side effects may include dizziness, drowsiness, weakness, sweating, feeling shaky, insomnia, nausea and constipation, yawning, decreased sex drive, impotence, trouble having an orgasm, etc.
  • Sertraline – a prescription medication also known as Zoloft. Adverse side effects include drowsiness, dizziness, feeling anxious, sweating, tremors, insomnia, etc.

You get the picture! Sometimes the side effects can be worse than the actual disorder itself. Some kids and teens (and even young adults) can also become suicidal as a result of taking the medication – it may actually drive them toward suicide ideation, attempts, and in worst-case scenarios, completed suicides. Some children and teens have an increased risk for suicide if they have bipolar disorder (manic-depressive disorder is an older name), there is a family history of bipolar, or someone in the family has tried to or committed suicide.

Be extremely careful if you choose to give your child/teen these drugs as they can all have negative interactions with other drugs, illicit or prescription…buyer beware!

How Holistic Interventions Assist in Treating Eating Disorders

Thomas Edison (1847-1931) said, “the doctor of the future will no longer treat the human frame with drugs, but rather will cure and prevent disease with nutrition.” As we know better than any other time in our history, there is a very succinct, direct connection between the physical body, the mind, the feelings, and one’s spirit or soul. In 2014, a large meta-analysis (a study of all studies done on a particular subject) was conducted by multiple researchers and results were reported in the American Journal of Public Health. These authors found “a significant, cross-sectional relationship between unhealthy dietary patterns and poorer mental health in children and adolescents.” There was also a positive relationship “between good-quality diet and better mental health.” So, one’s diet can literally make or break your child’s mental health.

It stands to reason then that eating healthy foods consistently would help create good mental health. That has been proven to be true. Last year NPR wrote about a study which demonstrated how changes in diet – eating lots of vegetables and fruits and limiting processed foods – can reduce depressive symptoms. Diets high in refined carbohydrates, processed foods, and sugary foods and drinks seems to cause inflammation and is a definite risk factor for depression. So, we know that changing a kid’s or teen’s diet can be very challenging, but well worth the effort.  Some supplements that may be helpful (and check for contraindications if your child is on any medication) are St. John’s wort, an herb, SAMe, a compound made naturally by the body, 5-HTP, a chemical the body makes from the amino acid tryptophan, often found in turkey, omega-3 fatty acids (fish oil, cod liver oil), the B vitamins, vitamin D, and others. A combination of healthy diet and supplements should bring about a greater change. There have been studies demonstrating this effect. Amino acid therapy is also showing great promise as a substitute for antidepressant drugs. Many treatment facilities are beginning to offer such services, and more. Mindfulness activities are also helpful in centering a person and there are many approaches, such as doing yoga, meditation, EFT, and others.
You – the parent or caretaker – can participate in your child’s or your teen’s recovery by starting slowly with dietary changes and participating in some of these activities with your child/teen. Also, find out whether your child or teen has food sensitivities, which foods your kids may be sensitive to – there are numerous, lower-cost ways to test for these. Also, take foods containing refined wheat (and other grains) way down or out of your diet, and try to reduce/eliminate all sugar. There are very palatable and healthy sugar substitutes (not aspartame, etc., but rather stevia, monk fruit, etc.) There are many recipes free of charge that help you make nearly every dish you and your child love using healthier ingredients, including pizza! Yes, there’s even a healthy version of pepperoni. Almond flour makes a fine substitute for wheat, by the way. Try to stop eating foods which are more than “minimally processed” – highly processed foods like vegetable oil do not create healthy kids. Watch out for chemical food additives and genetically modified ingredients. For optimal results, please work with a competent health care provider!

Additionally, there are some specific alternative approaches to treating eating disorders. According to healthline, there is body awareness therapy, which “focuses on quality movement awareness. After going through treatment, people with anorexia, bulimia, and unspecified eating disorders reported reduced body and self-awareness.” Yoga may also be very useful with eating disorders. It “can help reduce stress levels and lead to clearer thinking. Yoga is a low-impact exercise with slow movements that help people become more ‘in tune’ with their body. One study saw that women reported significant changes in positive feelings and sense of well-being, less self-objectification, more positive body image, fewer poor eating habits.” Acupuncture may also help with improving depression, physical and mental health, and give a person a “sense of control and social support.” Relaxation therapy, such as getting a massage, “can increase levels of serotonin and dopamine. It also decreases levels of depression, anxiety, and stress.” One study shared that its participants who had anorexia, after getting two massages per week for five weeks, had “lower stress hormones, decreases in body dissatisfaction, increased dopamine and norepinephrine levels.” Meditation has been shown to “reduce emotional and binge eating, increase self-acceptance, improve awareness of your body’s hunger cues, help with anxiety, addiction, and pain management.” Biofeedback also was shown to reduce anxiety in many.
 
Suggested Courses
​
  • Living Healthy Holistically
  • Amino Acid Therapy for Recovering Individuals and Those with Mental Health Disorders
  • Prevention – Healthy Living & Avoiding Substance Use

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