Teens and Eating Disorders: Signs, Causes and Treatment for the Next Generation
Written by ‘Ai Pono Hawaii Staff Writer
Teens grow up fast. Sometimes, it seems like they can grow a foot taller overnight. With mass communication and media exposure, teens are more aware and connected than ever, which means that they are more vulnerable to influences than ever. Since adolescence is such a crucial time of development, both physically and mentally, it is important to consider the relationship between adolescence and eating disorders.
Are teens particularly vulnerable to developing an eating disorder? Why?
What is the role of social media in the development of eating disorders?
Are teens with eating disorders at an even greater health risk than adults who develop eating disorders?
Are teens with eating disorders more difficult to treat than adults?
All these important questions will be answered, as well as the question of how to proceed if you think a loved one may be a teenager with an eating disorder.
Why teens are vulnerable to eating disorders
Adolescence is characterized by rapid physical, mental, emotional and social change. Concretely, adolescence ranges from 10-19 years of age, but age is not a great benchmark for everything that happens during this time, since people develop at different times. Everyone understands a growth spurt, but the adolescent body is also acquiring more muscle mass, and redistributing body mass differently. Biological females often undergo change before biological males, and females often acquire more body fat and water weight, as the body prepares to bear children.
Because the change is so sudden and drastic, young people may feel uncomfortable in their bodies, and become hyper aware of this. They may not even recognize themselves. An individual might obsess over their new body and its perceived flaws. In fact, early adolescence is the peak time of body dysmorphia onset, which is largely associated with the onset of an eating disorder. Eating disorders and body dysmorphia are often co-occurring, as a person tries to “fix” what they think is “wrong” in unhealthy ways.
On a neurological level, the adolescent brain has significant neural plasticity: the brain, at this time, is still malleable, and easy to influence. The limbic system, which is responsible for functions such as pleasure seeking and reward processing, is still developing. The prefrontal cortex, which manages executive functions such as decision making and impulse control, develops even later than the limbic system.
Adolescent development: body and self
Studies have shown that eating disorders literally change the neurobiology of the brain, causing food to be perceived as more or less rewarding. Losing or gaining weight changes how active the reward pathway is concerning food and exercise. Praise or criticism about someone’s body or diet, especially in adolescence, when the body is changing and social perception is very important, also has the power to change how a teen perceives themselves and their eating habits. Teens who develop disordered eating habits can have those maladaptive behaviors ingrained in their vulnerable minds. And because the prefrontal cortex is not yet fully developed, they don’t have the brain processing power to realize the harm of their actions.
Adolescence is the period when people are developing a sense of self. Self perception can be heavily influenced by what others think of us. Instances of bullying, abuse and trauma, which is linked to eating disorders, contribute to how we see ourselves. The social rewards of losing weight or being “on a diet” also influence self image. Teens may go to great lengths to change how they are perceived, by themselves and by others.
Many children and teens who develop eating disorders have not developed, or have lost, any sense of identity. Often, teens with eating disorders feel as though they don’t know who they are, since they’ve always been “the one with the eating disorder.” It’s hard to shake this perceived identity, especially if they don’t think they have any other defining qualities.
Adolescence is also a volatile time in terms of external change: they may move, go to a new school, be separated from their parents or friends, have sexual encounters, among other things. In an effort to control change, many teens turn to what they can control: their bodies. This perceived sense of control is comforting - until the eating disorder gets out of control.
And, of course, they are the first generation to be exposed to and affected by social media at a young, impressionable age. Constant exposure to “fitspo,” “health food,” and unrealistic bodies all affect how teens think of and understand the role of food, exercise and body image. There is also a “perfection filter” when it comes to social media: only the best parts of people are posted, which often entails the excessive use of filters, posing and curation of only “perfect” content. This creates a warped, almost dystopian sense of what people look like, and what they should look like.
It’s not all bad though! Read about the positive influences of social media on recovery here!
Are teens with eating disorders at a greater physical health risk than adults?
Eating disorders are damaging, potentially deadly, at any age. However, as adolescence is a time of physical growth, eating disorders may slow or stop certain biological developments. This is because teenagers are still in a crucial time of development: their bodies can be affected, but the mind is still adaptable, which also makes early intervention and treatment more effective for teens.
There are several physical complications of eating disorders, such as:
Dehydration
Bradycardia or tachycardia (abnormally slow or fast heart action)
Hypertension
Mineral or metabolic abnormalities, such as potassium depletion and decreased metabolism
Low blood sugar
Gastroparesis (the inability to correctly process food in the stomach)
Bone density as well as hormonal and menstrual cycle developments are particularly affected by the onset of eating disorders at a young age. Hormonal and menstrual changes may make reproduction unlikely or impossible later on. Linear growth (height) is also stunted, as the growth spurt characteristic of puberty may never occur.
Perhaps most alarming is that teens often believe they are invincible: they are too young to have a heart attack or permanent digestion problems. The teenage body will learn to adapt to inadequate nutrition and hydration, making them less aware of symptoms and making it easy to engage in behaviors. But teenagers are not invincible: they can certainly suffer acute, prolonged, and potentially irreversible physical health complications.
Are eating disorders in teens harder to treat?
The good news is: teens with eating disorders, who are treated early, have a much higher likelihood of making a full recovery. Behaviors have not yet been fully ingrained within their minds and bodies, meaning that it will be easier to facilitate change.
The key, however, is early intervention. This means helping a teen get treatment early. Therapy, nutritional intervention, and psychological treatment for co-occurring disorders, such as anxiety, may all be necessary for recovery. Helping teens in their recovery also means both being aware of and open about eating problems, and setting a good example within the home. Taking over cooking, having family meals, potentially engaging in therapy, and supporting teens through emotional difficulties also improve the chances of making a full recovery.
Unfortunately, there may come a time when outpatient treatment is impossible. Hospitalization may be necessary, and while it is preferable that teenagers willingly seek help, there may be a time going to the hospital is non-negotiable. Young patients who are malnourished may not recognize that they are a danger to themselves, and can’t see that medical intervention is necessary. If involuntary hospitalization is necessary, be sure to remain an open line of communication and compassion, in order to improve motivation and maintain a relationship with them.
It is hard to see someone so young suffer so much. However, this does not mean that they will be sick forever. In fact, if they receive help quickly, they are much more likely to make a full recovery, which is entirely possible for everyone!
If you or a loved one is suffering from an eating disorder, take the first step today and talk to someone about recovery or start by learning about the eating disorder recovery programs we offer.