related to tension, poor nutritional habits and food fads
are relatively common eating problems for youngsters. In addition,
two psychiatric eating disorders, anorexia nervosa and bulimia,
are on the increase among teenage girls and young women and
often run in families. In the United States, as many as 10
in 100 young women suffer from an eating disorder. These two
eating disorders also occur in boys, but much less often.
The child and adolescent psychiatrist is trained to evaluate,
diagnose, and treat these psychiatric disorders which are
characterized by a preoccupation with food and a distortion
of body image.
frequently ask how to identify symptoms of anorexia nervosa
and bulimia. Unfortunately, many teenagers successfully hide
these serious and sometimes fatal disorders from their families
for many months or years.
should be on the lookout for various symptoms and warning
signs of anorexia nervosa and bulimia:
- A teenager
with anorexia nervosa is typically a perfectionist
and a high achiever in school. At the same time, she suffers
from low self-esteem, irrationally believing she is fat
regardless of how thin she becomes. Desperately needing
a feeling of mastery over her life, the teenager with anorexia
nervosa experiences a sense of control only when she says
"no" to the normal food demands of her body. In a relentless
pursuit to be thin, the girl starves herself. This often
reaches the point of serious damage to the body, and in
a small number of cases may lead to death.
symptoms of bulimia are usually different from those of
anorexia nervosa. The patient binges on huge quantities
of high-caloric food and/or purges her body of dreaded
calories by self-induced vomiting and often by using laxatives.
These binges may alternate with severe diets, resulting
in dramatic weight fluctuations. Teenagers may try to hide
the signs of throwing up by running water while spending
long periods of time in the bathroom. The purging of bulimia
presents a serious threat to the patient's physical health,
including dehydration, hormonal imbalance, the depletion
of important minerals, and damage to vital organs.
treatment, most teenagers can be relieved of the symptoms
or helped to control eating disorders. Treatment for eating
disorders usually requires a team approach; including individual
therapy, family therapy, working with a primary care physician,
working with a nutritionist, and medication. Many adolescents
also suffer from other problems; including depression, anxiety,
and substance abuse. It is important to recognize and get
appropriate treatment for these problems as well.
shows that early identification and treatment leads to more
favorable outcomes. Parents who notice symptoms of anorexia
or bulimia in their teenagers should ask their family physician
or pediatrician for a referral to a child and adolescent psychiatrist
who works comprehensively in the treatment of eating disorders
and can coordinate the treatment team.
#1 Updated 8/98
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American Academy of Child and Adolescent Psychiatry (AACAP)
represents over 6,900 child and adolescent psychiatrists
who are physicians with at least five years of additional
training beyond medical school in general (adult) and child
and adolescent psychiatry.
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