Dying to be thin
Know how to help your anorexic teen.
A shockingly large number of teens, 10% of which are boys, suffer from an eating disorder called Anorexia Nervosa. Teenagers with anorexia have such a distorted body image that even when their bones are protruding from their bodies they still see themselves as fat.  

Anorexic teens will go to extreme lengths to keep themselves from gaining weight.  There are two types of anorexia: restrictive anorexia (starvation) and purging (this includes occasional binges, purging by vomiting or laxative abuse and excessive exercise).  Many times teens have both types and they are pulled into a cycle of starving and purging.

Anorexia usually begins with a desire to diet and lose weight. It may be triggered by an event such as the end of a relationship or the death of someone significant. As many as 60% of patients suffering from anorexia nervosa have been sexually abused.  The child feels they have no control over their feelings and so, instead, begin to control their food intake. Anorexia is like an addictive state and once the individual has started dieting and losing weight, it is very difficult for them to stop.

How to help your anorexic teen
Prevention is always better than cure and if you recognise your teen showing tendencies towards anorexia, the best time to help is to "nip it in the bud."  Although you can't "prevent" anorexia, you can certainly reduce the risk of your teen developing the disorder in the following ways:
•    Help your teen focus on their strengths and reinforce a positive self-image (not related to feelings about body image and weight)
•    Don't criticise your teen for being overweight. Roxy, a girl who suffered from anorexia as a teen, remembers her mother constantly monitoring her weight, even as a young child, and keeping tabs on everything she ate.  When she recovered from anorexia she retained the compulsive thinking and started doing drugs, including heroin and tik.  Now, a recovered addict, Roxy says that things may have been different if her mother was less obsessive of her weight when she was a younger because that is what triggered her addictive cycle.
•    Discourage your child from dieting and rather focus on healthy eating patterns.
•    Keep your eyes and ears open and try to spot suspicious behaviour or rigorous dieting as quickly as possible.
If you suspect your teen has anorexia, the first step to take is to get a medical diagnosis. It is, however, often difficult to diagnose, as anorexic teens often deny there is anything wrong and will try to disguise the disorder. The doctor should conduct blood and urine tests to rule out other potential causes of weight loss as well.

The next part of treatment is restoring the weight loss. Hospitalisation may be required if the child is severely emaciated and has lost more than 25% of his or her body weight. Antidepressant and anti-anxiety drugs have been found to be useful in some cases.  Psychotherapy is essential and often family therapy is suggested.  Treatment is most effective when it consists of a multidisciplinary approach including psychotherapy, nutritional advice and medical monitoring.

Future risks
Unfortunately, although many teens recover from anorexia, it is a difficult disease to overcome.  It is often resistant to treatment and you need to be aware that relapses are common.  About 50% get back to their normal weight, but even these "lucky" cases tent to continue to suffer from depression and anxiety and have difficulty with close interpersonal relationships.  There is also always the danger, like with Roxy, that these teens will "switch" to another addictive condition such as drug abuse.  It is imperative that even when your child has recovered, that you keep a close eye on them and be ready to step in when they need you.  Anorexia can be beaten, but only with persistence and a whole lot of love.

Michelle Minnaar has degrees in Psychology and Education and regularly conducts workshops for teens and parents on topics such as self-esteem, depression, eating disorders, drug abuse and learning problems.

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