The COVID-19 pandemic has been linked to worsening mental health among adolescents, including increasing numbers of patients with eating disorders.
In fact, research indicates that the number of teens with eating disorders has at least doubled during the pandemic. Here’s what to keep in mind, says Sidney Hartman-Munich assistant professor of pediatrics, UMass Chan Medical School
This is especially concerning given that eating disorders are the most lethal of all mental health diagnoses, and adolescents with eating disorders are at higher risk of suicide than the general population.
While experts don’t know exactly why eating disorders develop, studies suggest that body dissatisfaction and the desire to lose weight are major contributors.
This can make conversations about weight and healthy behaviors especially difficult with teens and young adults.
As an adolescent medicine physician specializing in eating disorders, I have seen firsthand the increase in patients with eating disorders as well as the harmful effects of eating disorders. I regularly work with families to help teens develop positive relationships with body image, eating, and exercise.
Recognizing the signs of a possible eating disorder is important, as studies show that timely diagnosis and treatment leads to better long-term outcomes and a better chance of full recovery.
eating disorders defined
Eating disorders, which often begin in adolescence, include anorexia nervosa, bulimia nervosa, binge eating disorder, other specified feeding and eating disorders, and avoidant restrictive food intake disorder.
Each eating disorder has specific criteria that must be met in order to receive a diagnosis, which is made by a professional with expertise in eating disorders.
Research suggests that up to 10 percent of people will develop an eating disorder in their lifetime.
Medical complications from eating disorders, such as low heart rate and electrolyte abnormalities, can be dangerous and result in hospitalization, and malnutrition can affect growth and development.
Many of the patients I see in the clinic show signs of stunted puberty and stunted growth, which can affect bone health, adult height, and other aspects of health if not addressed early.
Teens are also at risk for disordered eating behaviors such as intentional vomiting, calorie restriction, binge eating, over-exercise, use of weight loss supplements and abuse of laxatives.
A recent study estimated that 1 in 5 teens may struggle with disordered eating behaviors. While these behaviors alone may not qualify as an eating disorder, they may predict the development of later eating disorders.
Treatment methods for eating disorders are varied and depend on a number of factors, including the patient’s medical stability, family preference and needs, local resources, and insurance coverage.
Treatment may involve a team consisting of a medical provider, nutritionist, and therapist, or may involve the use of a specialized eating disorder program. Referral to one of these treatment methods may come from a pediatrician or a specialized eating disorders provider.
busting myths and stereotypes
Traditional ideas and stereotypes about eating disorders have left many people with the impression that it is primarily thin, white, affluent women who develop eating disorders.
However, research shows that anyone can develop these conditions regardless of age, race, body size, gender identity, sexual orientation or socioeconomic status.
Unfortunately, stereotypes and perceptions about eating disorders have contributed to health disparities in screening, diagnosis, and treatment.
Studies have documented negative eating disorder treatment experiences among transgender and gender-diverse individuals, Black and Indigenous people, and people with larger body sizes.
Some contributors to these negative experiences include diversity and lack of training among treatment providers, treatment plans without cultural or economic nutritional considerations, and varying treatments when the patient is not clearly underweight.
Contrary to popular belief, studies show that teenage boys are also at risk for eating disorders. These often go undetected and may be disguised as a desire to become more muscular. However, eating disorders are just as dangerous for boys as they are for girls.
Parents and loved ones can help address these stereotypes if concerns arise and can advocate for their child at the pediatrician’s office by recognizing red flags for eating disorders and disordered eating behaviors.
warning signs
Given that eating and eating disorders are common among teens, it’s important to understand some of the possible signs of these worrying behaviors and what to do about them.
Problematic behavior can include eating alone or in secret, and a hyperfocus on ‘healthy’. Foods and distress when those foods are not readily available. Other warning signs include significantly decreased portion sizes, skipped meals, fights at mealtimes, using the bathroom soon after eating, and weight loss. Because these behaviors often feel secretive and shameful, they can be difficult to bring up with teens.
It can be helpful to take a warm but direct approach when the teen is calm, while letting them know that you have noticed the behavior and are there to support them without judgment or blame. I always make sure to tell my patients that my job is to be on their team, not just tell them what to do.
Teens may not be open about their concerns right away, but if such behaviors are present, don’t hesitate to have them seen at their pediatrician’s office. Following up with patients who have shown signs of having an eating disorder and promptly referring them to a specialist who can further evaluate the patient is important for teens to get the help they need.
Resources can be helpful for families to navigate the fear and uncertainty that can come with a diagnosis of an eating disorder.
Focus on health, not size Research shows that poor body image and body dissatisfaction can put teens at risk for disordered eating behaviors and eating disorders.
Parents play an important role in the development of adolescents’ self-esteem, and research shows that negative comments from parents about weight, body shape, and eating are associated with eating disorder-type thoughts in adolescents. .
Therefore, when talking to teens, it can be beneficial to adopt a weight-neutral approach, one that focuses more on overall health rather than weight or size. Unfortunately I have had many patients with eating disorders who were scolded or teased about their weight by family members; This can actually be harmful in the long run.
One helpful strategy is to incorporate lots of variety into a teen’s diet. If possible, trying new foods as a family can encourage your teen to try something they haven’t tried before.
Try to avoid words like junk? Or? guilty feeling? When discussing foods. Teaching teens to appreciate the variety of foods in their diets allows them to develop a healthy, knowledgeable relationship with food. If you’re feeling stuck, you can ask your pediatrician about setting you up with a dietitian.
It’s important to remember that teens have a lot of nutritional needs to support growth and development, often more than adults, and eating regularly helps avoid extreme hunger that can lead to overeating. may cause.
Letting teens listen to their bodies and learn to use their own hunger and fullness cues will help them eat healthily and create healthy long-term habits.
In my experience, teens are more likely to exercise consistently when they find an activity they enjoy.
Exercise doesn’t have to mean lifting weights in the gym; Teens can move their bodies by taking a walk in nature, listening to music in their room, or playing a pickup game of basketball or football with a friend or sibling.
Exercise can focus on positive things for the body such as improving mood and energy can help to avoid movement feeling compulsive or forced.
When teens are able to move around as they please, it can help them appreciate their bodies for all they can do.