Teen eating disorders

Bulimia Nervosa
Of the women between the ages of fourteen and twenty-five, an estimated I per cent have bulimia nervosa. This disorder is characterized by cycles of binge eating followed by purging or other inappropriate compensatory behaviour to rid the body of calories. Because young girls don't know about or can't execute the methods of purging, this disorder doesn't usually begin until the mid-teens.

For a bulimic, a binge is eating boxes of cookies or litres of ice cream in a short period or time. Methods of purging themselves include selfinduced vomiting or using diuretics, diet pills, or laxatives. Teenagers with bulimia use stimulant laxatives such as Correctol or Ex-Lax most frequently because these cause diarrhea soon after eating. This leads to the loss of fluid, which may give a false sensation that she has lost weight. The abdominal pain, which is a common side effect, serves to make the teen's emotional pain real. The misuse of laxatives has serious complications, including dehydration and electrolyte imbalance. Many anorexics also suffer constipation from a combination of inadequate intake of food bulk and excessive vomiting, as well as the laxative habit, and may go days without having a bowel movement. Seek medical advice for your teen as soon as you become aware of the problem.

To induce vomiting, some teens use syrup of ipecac, an over-the-counter drug intended to induce vomiting in someone who has accidentally swallowed a poison. If used repeatedly, the drug becomes toxic to the muscles and can destroy heart tissue irreversibly, weakening the heart. If your child is using ipecac, she needs immediate medical attention. Unlike anorexics, bulimics know they have a problem. However, they don't want to admit to what they consider shameful and disgusting behaviour.

The British Columbia Ministry of Health includes the following as signs of bulimia:

• She eats large amounts of food, but shows little weight gain.

• She becomes excessively sensitive, secretive, and irritable about food and eating.

• She goes to the bathroom after meals and vomits In secret.

• She has a chronic sore throat and hoarse voice.

• She leaves evidence of vomiting or laxative abuse.

How to Help

Parents may feel helpless watching a child struggle with an eating disorder. Because of their worry, they may vacillate between being too involved or not involved enough. In an attempt to gain control of the situation, some parents revert to parenting techniques they used when their teen was a young child. Trying to force or tempt a child into eating may perpetuate the eating disorder. You may simply want to have your daughter spend more time at home so that you can make sure she's eating regular meals and nutritious food. But if you no longer allow your teen to hang out with her friends or go to the mall, her symptoms may escalate. Support her by letting her continue to spend time with her friends, to do the things other teens her age are doing.

You can help best by maintaining good communication with her, by showing your interest in her activities and her feelings. She needs to know that she's not alone and that you care about her. Talk about things other than food and weight. Let her know that you're concerned about her health and seek help from your family doctor or from an eating disorder clinic that can offera multidisciplinary approach.

Your role is that of a parent or a concerned friend, not a therapist. If your child refuses help, negotiate with her, but don't demand. Offer to go with her to the doctor's. Promise a shopping trip after the appointment. Say "I know you don't think you have an eating disorder, but unless a doctor confirms that, we'll never know for sure." If she's adamant about not seeing a doctor, maybe she'll talk with a school counsellor or a therapist who can help her recognize that she does need medical help. The National Eating Disorder Information Centre in Toronto keeps a national registry of therapists and programs.