This web site was partially supported by the Health Resources and Services Administration, Maternal and Child Health Bureau through grant number 6T76-MC00011
SITE MAP
| Home Page |
| Adolescent
Nutrition and Eating Disorders
Chapter 1 Eating Disorders During Adolescence Chapter 2 Anorexia Nervosa In Adolescence Chapter 3 Onset of Anorexia Nervosa during Adolescence Chapter 4 Initial Stage of Anorexia Nervosa in Adolescence Chapter 5 Crisis Stage Anorexia Nervosa in Adolescence Chapter 6 Long-Term Recovery Stage Anorexia Nervosa in Adolescence Chapter 7 Bulimia Nervosa in Adolescence Nutritional Care Summarized - Table Selected References & External Links List of Reviewers |
| N.W. Regional Web Symposium |
| Presentations |
| MPH Student Research |
| Biographical Information |
Eating
Disorders during Adolescence: Nutritional Problems and Interventions
Jane Mitchell Rees, PhD, RD, CD
Departments of Health Services and Pediatrics
Maternal Child Health and Adolescent Medicine
University of Washington, Seattle, WA 98195
Chapter 2 Anorexia Nervosa In Adolescence
Anorexia Nervosa: Symptoms
The term anorexia nervosa is actually a misnomer. Affected adolescents ignore and even lose their hunger sensations. The motivation to be thin apparently keeps these adolescents from eating. Since an early description (in 1689), a combination of symptoms has come to be regarded as characteristic of anorexia nervosa, although certain of these symptoms may be seen in other disorders. The unique combination of symptoms in anorexia nervosa has been defined by the American Psychiatric Association (APA) [See APA web site] .A description appears below, including considerations suggested by adolescent eating disorder specialists (in brackets and capital letters), making it applicable to most adolescents.
- Refusal to maintain body weight at or above minimal normal weight for age and height
- Loss or failure to gain weight with maintenance weight 15% below expected [FOR AGE APPROPRIATE DEVELOPMENTAL STAGE]
- Fear of gaining weight or becoming fat, although underweight [OR APPARENTLY NORMAL WEIGHT WITHOUT SUFFICIENT BODY FAT STORES FOR AGE APPROPRIATE DEVELOPMENT STAGE]
- Disturbed experience or evaluation of body weight, size, or shape
- Feeling fat [OR THAT BODY PARTS ARE FAT], although underweight [OR AT UNHEALTHY WEIGHT FOR AGE APPROPRIATE DEVELOPMENT STAGE]
- Absence of three consecutive menstrual* cycles not relying on estrogen in post-menarcheal females [OR FAILURE TO ACHIEVE MENARCHE* AND ESTABLISH MENSES* AT AN APPROPRIATE AGE]
* In all cases females are considered amenorrheic when menses do not occur unless induced by estrogen replacement.
"A relentless pursuit of thinness" and "a misuse of the eating function
in efforts to solve or camouflage problems that otherwise would appear
insolvable" underlies these symptoms as pointed out by Hilde Bruch in her
classic description in 1973 (Eating Disorders. New York, Basic Books).
In summary, the adolescent with a severe eating disorder suffers from arrested
physical and psychological growth and development. (Because most patients
are females, the feminine pronoun will be used in this discussion.)
[top] [Table of Contents]
Anorexia Nervosa: Overall prevalence
Although recent precise figures are not available, as many as 1% of American teenaged females, 15 - 19 years of age, are said to suffer from anorexia nervosa. The majority of persons with anorexia nervosa are adolescents, although the disease affects young adults and other age groups. The disorder is supported by a cultural paradox: food is abundant and used lavishly for purposes other than survival and on the other hand slimness is highly valued. These cultural values are strong internal messages for many in the modern world. The impact is great on a young adolescent who has not developed autonomy.[top] [Table of Contents]
Anorexia Nervosa: Prevalence in females
About 1% of average high school aged girls in the US and England are thought to be affected. It must be recognized, however, that accurate data are difficult to obtain because of the secretive nature of the disorder and the fact that many do not seek treatment.[top] [Table of Contents]
Anorexia Nervosa: Prevalence in males
The disorder is not common among males, with only about 5% to 10% of diagnosed cases being males less than 14 years. Of cases diagnosed in older adolescents, 19% to 30% are in males. Males with anorexia nervosa seem to have the same sort of disorder as females. The traditional lack of value on extreme slimness in males adolescents probably puts them at a somewhat lower risk for the disorder. Celebrities with excessively thin and/or muscular bodies are beginning to influence the ideals of young males, however. Obsessive muscle building and exercise to the point of harming their bodies, may be the equivalent of anorexia nervosa in vulnerable males.[top] [Table of Contents]
Disclaimer
This Web Site is a reference for health care professionals, students and educators; it is not intended to provide advice or treatment to people with eating disorders. If you have an eating disorder or disturbed eating patterns, consult a qualified physician who specializes in eating disorders.