Two of the more disturbing and potentially dangerous behaviors found among teenagers are the gorging-purging pattern of bulimia or the starvation pattern of anorexia nervosa. No doubt the incredible pressure to be thin, felt in particular by young girls, is partly the culprit for the rise of eating disorders.

Both of these problems are found predominantly among girls. A recent study found that one million teenagers are affected by some symptoms of bulimia or anorexia.

Anorexia is estimated to affect as many as one out of every 100 females aged 12 to 18. Anorexia and bulimia often are triggered by disturbing life situations: puberty, ridicule over weight, first sexual contact, death of a loved one, separation from family due to college or some other reason, or other trauma.

The two disorders may intermingle in an individual. Bulimia symptoms are found in 40 to 50 percent of individuals suffering with anorexia.

Anorexia

Anorexia is by far the more dangerous of the two disorders. About 18 percent of anorexics die from self-inflicted starvation.

Anorexia most commonly begins in adolescence, but it can show up in a child as young as eight years old. Often the problem is jump-started by an innocent comment: “You’re looking a little chubby, dear.”

Although anorexia often involves a pattern of excessive dieting over a long period of time, it may be a single, limited episode—a child may lose a significant amount of weight within a few months but then recover, begin eating more normally, and not repeat the self-destructive behavior.

Symptoms of anorexia include:

• Extreme weight loss
• Unusually high desire to please parents or others
• Dry, pale skin; brittle hair
• Cessation of menstruation in females
• Anemia
• Refusal to maintain a weight higher than the minimal normal weight for a given age and height.
• Intense fear of gaining weight or becoming fat, even though underweight
• Denial and defensiveness about the problem
  

Bulimia

Bulimia occurs about twice as often as anorexia. This eating disorder often begins in conjunction with a diet and starts in adolescence or the early twenties. A binge incident normally lasts less than two hours during which as many as 3,400 calories of soft, sweet foods are easily consumed (ice cream is often a favorite). To lose the weight, a bulimic then turns to some method of purging.

Much health damage can result from a persistent binge-purge cycle because of the upsetting of the body’s balance of nutrients. Problems can include fatigue, seizures, muscle cramps, and decreased bone density. Repeated vomiting can harm the esophagus and stomach, make the gums recede, and erode tooth enamel.

Symptoms of bulimia include:

• Preoccupation with body shape and weight
• Recurrent episodes of binge eating (rapid consumption of a large amount of food in a short period of time)
• Regularly engaging in either self-induced vomiting, use of laxatives or diuretics, strict dieting or excessive fasting, or vigorous exercise in order to prevent weight gain
• Persistent over-concern with body size and weight
• Low self-esteem
• Depression (may not be a symptom of bulimia, but often occurs with it)

What should you do if you suspect either anorexic or bulimic tendencies in your child?

Of the two disorders, anorexia is more difficult to confront and treat because the child will vigorously deny the problem. If you feel your child is obsessed with dieting and is looking overly thin, talk to your pediatrician immediately.

In the more extreme cases, where the child is suffering from starvation, hospitalization and intravenous feeding may be required until the immediate crisis passes. Extensive evaluation and counseling may be required, including the possibility of treatment at a residential care facility.