National Eating Disorders Awareness and Screening Week takes place Feb. 25 – March 3. Karen Sadler, MD, of the MassGeneral Hospital for Children Department of Medicine and Division of Adolescent and Young Adult Medicine, sheds some light on eating disorders, their symptoms and treatment options.
What are some types of eating disorders and how common are they?
Anorexia, bulimia and other specified feeding or eating disorders (OSFED) are the most prevalent eating disorders in the United States. Together, they affect up to 5 percent of the population. While their exact cause is unknown, they are considered “perfect storm” illnesses, when a combination of environment, mindset and childhood development lead to unhealthy and dangerous behaviors.
Binge eating disorder, more common in females, is characterized by episodes of extreme overeating. Those affected consume far more than what would be considered appropriate in a normal meal. This brings about feelings of guilt, anxiety and depression.
Avoidant/restrictive food intake disorder (ARFID) falls in the opposite extreme. People with ARFID limit their food intake – as the act of eating causes tremendous stress and anxiety – leading to significant weight loss and malnutrition. ARFID is usually seen in younger children and can be triggered by a traumatic event such as food poisoning or choking.
What are the signs parents should watch for?
Given how common and serious eating disorders are, all parents should know signs of disordered eating. These can include a child refusing to eat in a social setting, picking at – rather than eating – food, running to the bathroom after meals, or limiting quantity of food or food groups altogether.
Any sort of weight loss should be done slowly in a supervised setting. Children and teenagers are still growing and maturing, so their energy and nutrient needs are different than adults. Rapid weight loss can deprive a teen of what he or she needs for proper development.
Who is most likely to develop an eating disorder?
Eating disorders are stereotypically thought to affect white, mid-to-late teenagers who excel academically, athletically and socially. However, the landscape is changing. Children are now presenting with these disorders at a younger age and males are being affected at an increasing rate. Some of this is due to over-exercising or over-focusing on calories and energy output through apps and wearable devices. Activities like modeling, running, wrestling and dance are traditionally considered more high risk because of their emphasis on looks and body proportions.
What are the treatment options?
Treatment is based on the severity of the disorder. Outpatient physician monitoring with consultations from a nutritionist and therapist helps many patients, but other individuals need hospitalization until they are stable enough to participate in a specialized eating disorder program. These programs address not only the physical impacts of an eating disorder, but the psychological and emotional impacts as well.
The long-term effects of having an eating disorder are still being assessed. Studies are ongoing, for instance, on bone health and anorexia through the MGH Neuroendocrine Unit.