How To Know If Your Child Has Anorexia

Have you noticed that your teenager is hyper-focused on their weight or may be losing weight even when they appear to be eating? Is she/he more fatigued than usual, listless or complaining of feeling lightheaded or weak? These may be signs of anorexia nervosa, an eating disorder that when not identified and treated, can develop into a condition that can be life threatening.

Cindee J. Ivker, MD, FAAP

Anorexia nervosa (commonly called anorexia) is a potentially serious condition that has both a physical and emotional impact on the bodies of developing teens and young adults. Although it is more prevalent in girls, anorexia can affect people of all ages, genders, sexual orientations, races and ethnicities. According to the National Eating Disorders Association, at any given time there are between 0.3-0.4% of young women and 0.1% of young men suffering from anorexia nervosa.

Our pediatricians at Westchester Health stress that early diagnosis and intervention are paramount in helping your child recover. Please come see us.

What exactly is anorexia?

According to Medical News Today, someone suffering from anorexia loses more weight than is healthy for their height and age, often weighing of 85% or less of their normal weight. They intentionally restrict their food intake, due to a fear of being or becoming fat, even when their body mass index (BMI) is already low. They may also binge eat, exercise excessively, use laxatives, and make themselves vomit to lose or keep from gaining weight.

Health complications from anorexia can be severe. Eating disorders in general are reported to have the highest mortality rate of any mental illness, and are very difficult to “cure.” However, people with anorexia can learn to overcome their condition and maintain an acceptable weight.

Physical symptoms to watch for

Anorexia can be different for every person but the main sign is usually severe weight loss. Additional symptoms include:

  • dramatic weight loss
  • dresses in layers to hide weight loss or stay warm
  • talks about being overweight even though they’re not
  • refuses to eat
  • maintains an excessive, rigid exercise regimen despite weather, fatigue, illness or injury
  • uses laxatives
  • vomits after eating
  • severe loss of muscle mass
  • listlessness, fatigue, exhaustion
  • high blood pressure
  • lightheadedness, dizziness
  • low body temperature, cold hands and feet
  • bloated or upset stomach
  • constipation, stomach cramps
  • dry skin
  • swollen hands and feet
  • hair loss (alopecia)
  • cessation of menstruation or less frequent periods
  • infertility
  • insomnia
  • loss of bone density (osteoporosis)
  • brittle nails
  • irregular or abnormal heart rhythms
  • fine downy hair growing all over the body, increased facial hair
  • bad breath and cavities/tooth decay, due to acid in vomit
  • sleep problems
  • poor wound healing
  • impaired immune functioning

Psychological signs that indicate anorexia

Talking about anorexia may be difficult. But, there are some behavioral signs that may be helpful in guiding the conversation, including:

  • excessive concern about being fat or overweight
  • has a distorted body image (see themselves as fat when they’re very thin)
  • preoccupied with weight, food, calories, fat grams and dieting
  • denies feeling hungry
  • frequently inspect their bodies in the mirror
  • cooks meals for others without eating
  • lies about food intake
  • develops food rituals (eats foods in certain order, excessive chewing, rearranging food on a plate)
  • consistently makes excuses to avoid mealtimes or situations involving food
  • has strong need for control
  • lack of emotion, depressed mood
  • reduced sex drive
  • memory loss
  • obsessive-compulsive behavior
  • irritability

Can anorexia be treated?

According to Healthline, there is no proven method to prevent anorexia. But, it can be identified and managed with the help of your healthcare providers.

Is anorexia the same as bulimia?

People with anorexia and those with bulimia both have a distorted body image (body dysmorphia) which causes them to obsess about their bodies, especially one or more perceived defects or flaws which seem minor or nonexistent to others.

People suffering from anorexia eat very little and are at least 15% below their ideal body weight. They are unhappy with their bodies, have an intense fear of weight gain, are obsessed with their weight, and go to extreme measures to slim down and not gain weight.

People who suffer from bulimia are also obsessed with not gaining weight but their method for keeping weight off is to eat large amounts of food and then purge, either by vomiting or using laxatives or diuretics, or doing excessive strenuous physical exercise. They often report feeling out of control during their binge-eating episodes. Half of all anorexics have episodes of bulimia at one time or another.

Therapy, both individual and as a family, has been shown to be successful

According to Healthline, one of the biggest obstacles when attempting treatment for someone with anorexia is getting them to realize they need help. Many don’t believe they have a problem. The main goal of treatment is to restore the person’s body to a normal weight and establish normal eating habits. A dietitian can help them learn how to eat properly, and a combination of individual, family and group therapy is often recommended:

  • Individual therapy: Cognitive behavioral therapy helps change the person’s unhealthy thoughts and behaviors. Its goal is to help them learn to cope with strong emotions and build healthy self-esteem.
  • Family therapy: Family therapy includes family members, teaching them how to help the person stay on track with their eating and behavioral habits. Family therapy also helps resolve conflicts within the family.
  • Group therapy: Group therapy enables people with anorexia to interact with others who have the same disorder. To avoid turning this into a competition to see who can be the thinnest, it’s important that the group is led by a qualified medical professional.

We are here to listen, treat and guide you and your child

Please schedule an appointment either in person or via telehealth. As your child’s pediatrician, we feel that meeting either as a family or with your teen alone, we can help identify and develop a plan of care to help meet the physical and psychological needs of your teen.

Read our other blogs on eating disorders

We’ve written several informative blogs about a variety of eating disorders which you can read here.

Helpful eating disorder websites

Concerned that your child may have anorexia? Please come see us.

If you’re worried that your child may be suffering from anorexia or any type of eating disorder, please call (914) 232-1919 to make an appointment to see one of our Westchester Health pediatricians. If after an examination we determine that your child does in fact have an eating disorder, we’ll go over the available treatment options and make the appropriate referrals. Plus, we have an on-staff nutritionist who can help your child make smart, healthy choices about food, calories and nutrition. Most of all, we want to help your child be healthy and happy, now and throughout life. Whenever, wherever you need us, we’re here for you.

By Cindee J. Ivker, MD, FAAP, Lead Pediatric Physician with Westchester Health, member of Northwell Health Physician Partners

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