Back to school is time to look for eating disorders

Published: Sunday, September 8, 2013 at 6:01 a.m.
Last Modified: Friday, September 6, 2013 at 10:51 p.m.

As summer draws to a close, it can be tempting for students to try and reinvent themselves for the upcoming academic year. For some students, body image concerns and a desire to be accepted by their peers interferes with healthy choices.

Such disruption in body image may result in an eating disorder, one of the deadliest mental health conditions. The National Eating Disorder Association reports that 5 to 20 percent of people with anorexia will die from the illness, its complications or suicide.

Eating disorders affect 10 in every 100 young women in the United States, according to the American Academy of Child and Adolescent Psychiatry. While these disorders have been addressed in the media for decades, the perception has been that they only affect rich, educated, Caucasian females; however, these disorders are increasingly found among youth in all income brackets, educational levels, races and genders due to globalization.

Anorexia is the restriction of calorie intake leading to a body weight less than what is expected for one's age, sex, development and physical health; intense fear of gaining weight or persistent behavior that interferes with weight gain; and disturbance in how one's body weight or shape is experienced or a lack of recognition of the seriousness of current low body weight.

Symptoms can include loss of menstrual periods, bone loss, brittle hair and nails, dehydration, heart attacks, constipation, low blood pressure, feeling cold all the time, depression, tiredness or development of fine hair all over one's body. Warning signs may include skipping family meals, a sudden change in dietary choices or the initiation of an intense exercise program. Parents should look for peculiar eating behaviors, such as cutting food into small pieces, excessive chewing and pushing food around the plate without eating.

While someone with anorexia may be easily recognized due to their low body weight, people with bulimia can be normal weight, underweight or even overweight. Nevertheless, bulimia is also a serious medical condition that can result in death. It is defined as frequent episodes of eating a large amount of food in one sitting without a sense of control and inappropriate behaviors to prevent weight gain, including self-induced vomiting, fasting, excessive exercise or misuse of medications like laxatives and diuretics, or “water pills.” These individuals also suffer from low self-esteem related to their body image.

Symptoms of bulimia include “chipmunk” cheeks, sore throats, worn tooth enamel and tooth decay, scars on the knuckles and hands from repetitive self-induced vomiting, heartburn, side effects of laxative and diuretic abuse and heart attacks. Warning signs might include immediate trips to the bathroom after meals, hoarding of food and refusals to eat in front of others.

Parents, educators and health professionals should be aware of these serious conditions and work to prevent and minimize the risks to our youth. This may include monitoring students' Internet use, as there are websites, blogs and social media outlets that promote these unhealthy habits These pro-anorexia and bulimia websites often glamorize these illnesses through personal testimonies and share restrictive diets and avenues to avoid detection.

Eating disorders endanger the health and well being of those who have the illness. Therefore, members of the community need to be diligent in recognizing when youth exhibit signs or symptoms of unhealthy eating habits.

If there is concern about a possible eating disorder, one should seek medical treatment. This starts with a visit to the doctor for a general assessment. More complex cases may require seeing a specialist, and the most severe cases may eventually require hospitalization.

For more information, including local treatment facilities and providers, please visit

Nicole Graham, Mustafa Pirzada and Mathew Nguyen are child psychiatrists and Deepa Sunkari is a recent medical school graduate at the University of Florida.

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