Did you know that the eating disorder anorexia nervosa has the highest death rate of all mental health conditions? Eating disorders impact sufferers’ physical health and quality of life, their ability to function in daily life, and their relationships with family and friends. Sadly, many teens (and even tweens) battle eating disorders. We explore this important topic.
Eating disorders and social media
The spotlight has recently turned onto the role of social media with calls to clamp down on images and posts glamorising eating disorders. The South African Society of Psychiatrists (SASOP) says media stereotypes of beauty and “ideal” body types had long been implicated in contributing to eating disorders, especially in those already vulnerable or at-risk.
SASOP member Prof Christopher Paul Szabo, a leading expert on eating disorders, says there is a “real vs ideal” disconnect between average body sizes and types in real life versus the often-unattainable ideals portrayed in the media and by social media users. “This potentially creates incorrect perceptions that being underweight, meaning below healthy norms, is desirable and contributes to the unhealthy attitudes and behaviours around weight, food, dieting and body image that are central to eating disorders.”
Potential signs your child may have an eating disorder
Prof Szabo says that dieting should be added to the list of risky behaviours for teenagers, along with the more usual concerns of unprotected sex and abuse of drugs and alcohol, especially when there was no clear health reason for dieting. Eating disorders are broadly defined as an unhealthy preoccupation with eating, food, weight, exercise, or body image, together with behaviours such as restriction of intake, excessive exercise, binge eating, or purging, that impacts on quality of life and the ability to function in daily life.
Eating disorders and pre teens
While eating disorders are most prevalent in teenage and young adult women, there is increasing concern about pre-teens, with the physical changes of puberty such as increased body fat and girls maturing at younger ages interacting with social pressures for ‘thinness’ and dieting, creating the risk of an eating disorder developing.
Eating disorders do not discriminate
Prof Szabo, who is head of the Department of Psychiatry at the University of the Witwatersrand and Head of Clinical Department at Charlotte Maxeke Johannesburg Academic Hospital, says his research since the early 1990s has found that eating disorders affect both black and white young women. He found there were similar behaviours and attitudes irrespective of race, and these weren’t limited to urban or “Western” settings.
This mirrored the findings in other African countries and other societies undergoing social and political change. He says it is important for families, schools, and medical professionals to be aware that eating disorders are possible in all cultures, socio-economic groups, and races, so that the symptoms are not dismissed or misdiagnosed, and sufferers can get help.
Eating disorders don’t just affect girls
The stereotype of eating disorders being limited to females is also changing. Teenage boys and young men are increasingly at risk due to the pressure to achieve a perceived ideal male body type, usually involving exercise to lose weight and build muscle.
What causes eating disorders?
Prof Szabo says the causes of eating disorders are complex and the treatment is specific to each individual. While body image concerns were central, Prof Szabo says that “Eating disorders are also powerful indicators of distress that goes beyond food and body issues alone. Every sufferer has an individual story.” He says the causes are best understood as an interaction between the individual and their environment.
Three possible causes of eating disorders:
- The quest for perfection: Perfectionism is a personality trait associated with eating disorders but not exclusively so, says Prof Szabo. Combined with a preoccupation with diet and exercise regimens, perfectionism should be an early warning signal.
- Family pressure: The role of parents and family in the development of eating disorders is highly controversial, but Prof Szabo said no specific causal relationship have been identified. However, he says families should pay as much attention to healthy father-daughter relationships as to the relationship between mother and daughter. Unrealistic expectations of high achievement or perfection from either parent are associated with feelings of guilt and shame that could potentially lead to expression in an eating disorder.
- Stress and abuse: Further possible precipitants of eating disorders can often be linked to stresses such as changes in family circumstances, abusive situations (either directly or witnessing abuse), or pressure to perform in school or sport, leading to feelings of a lack of control or disrupting the sufferer’s sense of self-esteem and self-worth. The area of eating and body becomes the one place where the sufferer feels in control over their emotions and circumstances.
The warning signs
Prof Szabo says concerns around weight – especially when a person’s perception of being overweight didn’t match their actual weight – and history or preoccupation with dieting, and their weight and eating habits dominating conversation are all warning signals of an eating disorder.
How are eating disorders treated?
Prof Szabo says treatment should include the help of a specialist in eating disorders, as sufferers tended to resist treatment. However, the family physician is often the starting point.
- Eating disorders are treated with a combination of psychotherapy, usually also involving therapy sessions for parents and family, as well as nutrition or dietary counselling.
- Medication may be prescribed to treat related symptoms such as sleeping problems, anxiety, or mood disorders.
- Treatment for anorexia may also include hospitalisation, with a focus on nutrition counselling and weight restoration, which has also been proven to aid in an improvement in overall psychological and emotional health.
- Hospitalisation may be a requirement in certain instances for bulimia nervosa.
