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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 |
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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 3 Onset of Anorexia Nervosa during Adolescence
The physical manifestation of anorexia nervosa may be sudden, although
unrecognized underlying characteristics may have been present prior to
manifestation of an identifiable disorder. Intervention strategies
should simultaneously address the psychological and physical issues of
the adolescent.
Onset: Progressive development
From the family's point of view, the teenager with anorexia nervosa has traditionally been a "model child". She fits into the family and meets her parents' high expectations, working extremely hard at school and being satisfied only with excellent grades. Suddenly she displays a compulsive attitude about her weight and food consumption. The family erupts in crisis as response to her extreme eating behavior.[top] [Table of Contents]
Onset: Psychological characteristics
The teenager with anorexia nervosa is troubled about her life. She finds it difficult to mature psycho-socially and clings to the rigid patterns of childhood. She is unable to sustain peer friendships and isolates herself. Life appears to be out of her control. She is conflicted about living as her parents direct, is hurt by their critical comments and begins to realize that she must assert herself but finds that difficult. She feels too fat and thinks she has to be slim to be a worthy person. She takes an uncompromising stand about her eating and exercise habits. Increasingly preoccupied and angry when her family interferes, she denies her illness.[top] [Table of Contents]
Onset: Distorted perceptions
A range of distorted perceptions has been noted, often related to body size and shape, hunger, satiety, physical endurance and the need for rest. Distorted perceptions characteristic of anorexia nervosa may be exacerbated during episodes of crisis level starvation and will vary from time to time as well as adolescent to adolescent. Anorexia nervosa should not be ruled out on the basis of lack of specific distortions if other symptoms are present.[top] [Table of Contents]
Onset: Motivation
The adolescent with anorexia nervosa has been described as wishing to stave off adulthood. The question is whether she tries to avoid maturation or whether maturation eludes her.[top] [Table of Contents]
Onset: Family characteristics
Many families of adolescents with anorexia nervosa list no problems until the manifestation of the disorder. They need assistance from family specialists on the health care team to deal with the unexpected crisis of an eating disorder. As treatment progresses they require guidance while developing a family system to support their adolescent as she learns to regain her health.[top] [Table of Contents]