You notice changes in your daughter’s behavior. She is not seeing friends as much, or her grades are suffering, or maybe her diet is different. She has alway been a great kid, worked hard at school, played sports, some would even consider her a bit of a perfectionist, but she’s 15, and everything seems to end in an argument lately, so you bite your tongue.
It could be anything from teen angst to drug use. Or it could be an eating disorder.
Eight million Americans have an eating disorder, almost 7 million of whom are women, age 12 to 25. Eating disorders have the highest mortality rate of any mental illness. The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of all causes of death for females 15 to 24 years old. Although rates of eating disorders in boys have risen, as they have in middle-aged women, it is still considered a “girl thing.”
Parents need to be compassionate not confrontational; circle in, as Erwin puts it. Ask about friends, notice changes in schedules as well as behavior. Although the exact causes of eating disorders are not known, the Mayo Clinic suggests the following factors can put certain adolescents and teens at risk: genetic and biological factors such as anxiety and perfectionism; participating in activities that encourage low weight such as ballet or wrestling for boys; low self-esteem; pressure from society; and/or bullying.
Eric Alcera, M.D., medical director of Hackensack/ Meridian Behavioral, is a child psychiatrist and has spoken to parents about many of the changes in behaviors Erwin mentioned. “There are traits to keep an eye on, body image, perfectionism, rigidity in the child. There is a size-weight prejudice prevalent in our society. Kids are being bullied for how they look, what they wear. When you see withdrawal, an increase in anxiety, maybe the child isn’t getting as much sleep, it is time to engage in a conversation.”
If, as a parent, you suspect an eating disorder, Alcera recommends you contact your primary care doctor. Eating disorders can be deadly, and not just for the drastically underweight. Generally your primary care doctor will give you a referral, but it is not one-size-fits-all, so he advises people do their own research also, and go with an eating disorder specialist you and your child feel comfortable with. Whether you decide on inpatient or family-based therapy, a treatment team, including a psychologist or psychiatrist and a nutritionist, needs to be assembled.
While family and friends can be a huge help in providing support, you and your child may also want to join an eating disorder support group. They provide a safe environment where you can talk freely and get advice and support from peers going through the same process. There are many types of support groups, some are led by professional therapists, while others are moderated by trained volunteers. Erwin runs a group that meets at Riverview Medical Center the fourth (not last) Saturday of every month from 10:30 a.m. to noon. To find a support group: ask your doctor or therapist, call local hospitals/universities or try the school nurse or counseling office.
This article was first published in the Health section of the Sept. 7-14, 2017 print edition of The Two River Times.