Anorexia Nervosa: When Thin Isn't Enough
Anorexia nervosa may develop at any age, but it most often begins during the teen years. Anorexia nervosa often begins when a teenager successfully follows a diet or when a teen decides to “buff up.” Many times the teenager is at a normal weight when they begin to diet. The teen reaches the chosen goal, but still feels they are not thin enough. Even though the individual may now be extremely thin, they feel fat. So the teen resolves to diet even more.
Anorexia nervosa affects girls more often than boys, but there has been an increase in the number of males suffering from anorexia. Guys face similar societal pressures to be strong/buff and also have trouble with self-esteem issues that contribute to the drive for thinness and development of eating disorders.
Family members may not realize what's happening until the person with anorexia becomes dangerously underweight. By this time, they may not be eating anything at all or may still be eating some food, while severely restricting their fat intake. Exercise may continue relentlessly, for hours each day, as the teen adheres to a rigorous schedule that burns up even more unwanted calories. No matter what friends and family might say, the person with anorexia refuses to give up his or her extreme diet. Without professional intervention, the individual will continue to get thinner until their health and life are in serious danger.
The typical person with anorexia is a perfectionist and an overachiever, excelling in school and involved with lots of activities. Sometimes, the preoccupation with weight starts in response to a stressful event, such as changes with or loss of friends or problems in the family. It may begin as a way to stave off general pressures such as growing up, “fitting in” socially, doing well in school, or keeping things happy in the family.
“Anorexia nervosa” literally means loss of appetite due to nervousness. But the name is misleading. Except in advanced phases of the illness, the person with anorexia nervosa is always hungry. A person with anorexia exercises enormous control to restrict their eating, even in the face of severe physical hunger.
Bulimia Nervosa: Binge–Purge Syndrome
Bulimia nervosa is a disorder that involves eating large amounts of food and then getting rid of it by vomiting or through the use of laxatives, diuretics, or diet pills. Some people with bulimia also purge after a binge by fasting for days or by exercising for hours.
Like anorexia, bulimia often begins with a diet. But the dieter soon feels deprived and panicky. They turn to food for comfort. Overeating helps the person stuff down their feelings of anxiety, depression, anger, or loneliness.
The binge is followed by feelings of guilt about their loss of control and fear of getting fat. Bingeing is usually followed by desperate attempts to get rid of the food just eaten, but purging leaves the teen with bulimia still hungry. The vicious binge/purge cycle begins again. This becomes a routine that is difficult to interrupt.
At first, overeating and then purging seems like a perfect way to satisfy food cravings without paying the price. But it soon turns into a shameful obsession. People with bulimia, afraid that others will think their habit disgusting, become furtive and fearful of discovery. They may spend more and more time alone, sometimes going through the binge/purge cycle several times a day.
People with bulimia often maintain close to normal weights. They often go through their binges and purges in private, so the condition may be hard to detect.
The typical person with bulimia is especially concerned with how others see them. They may be emotionally insecure and lack confidence. The individual feels that they live behind a façade: competent and attractive on the outside, but inept and disgusting underneath. Dieting begins as a way to feel better about oneself and to win approval from others.
Bulimia tends to begin in the teen years and often continues into adulthood.
People with bulimia aren’t always physically hungry. They have learned to use food to cope with stress and emotional difficulties. Erratic eating patterns develop in response to using food as a coping tool, which leads to the inability to respond to hunger and satiety in an appropriate manner.
For more information about The Children's Hospital Eating Disorders Treatment Program, please call
(720) 777-6452. If you would like to discuss concerns about your child, please have the following information available:
- Child’s current weight, height and weight history
- Past and current eating patterns
- Other symptoms or behaviors you are concerned about
- Routine exercise habits
- Current care providers (MD, therapist, nutritionist, etc.)