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Dangerously Thin: Could You Recognize an Eating Disorder in Your Teen?

When Alyson looks at photos shot a few years back, she can see her bones sticking out. Back then, however, she saw herself differently.

"I'd look in the mirror and I'd see someone who was 200 pounds," says the 18-year-old Dutchess County resident.

Will You Recognize the Signs?

Many teens obsess about their looks
and weight. How do you know when
your child's weight-loss goals cross
the line? Consider seeking treatment
if your child is:

  • Skipping meals
  • Showing signs of rapid weight
  • Obsessed with eating, food,
    and weight control
  • Withdrawing from social
    activities, particularly parties
    involving food
  • Constantly weighing herself or
  • Restricting portions and/or
    avoiding whole categories
    of foods
  • Making excuses to go to the
    bathroom immediately after
  • Spending hours working out
    to burn off calories

Nothing to Lose
In early high school, the 5-foot-1-inch teen says she tried to lose a quarter of a pound a day and rejoiced when she dropped below 90 pounds. She would stay on a treadmill until she was sure she had burned the few calories she had eaten that day.

When Alyson continued to lose weight despite medical attention, she was referred to Marcia Nackenson, M.D., an adolescent medicine specialist at Maria Fareri Children's Hospital at Westchester Medical Center. Dr. Nackenson works with a team of physicians, nutritionists and mental health professionals to treat eating disorders.

Both Alyson and her mother credit Dr. Nackenson and her team for turning the teen's health around. "I felt like she cared so much," says Alyson. "I would put on this happy face for her but she would see right through it. We formed a bond and I could tell her anything."

Who's at Risk
Dr. Nackenson says there is truth to the perception that eating disorders disproportionately affect "good girls," teens who do well in school and rarely cause trouble. Eating disorders are more common in teenage girls than boys and occur in all demographic groups. Lately, Dr. Nackenson says, she is seeing more children in the "tween" years of 11 or 12.

Anorexia and bulimia affect between 1 and 2 percent of American teenagers, national statistics show. People with anorexia lose weight by severely restricting food and exercising excessively; bulimics eat in binges and purge. The disorders can cause bone loss, severe fatigue, heart failure and even death.

Psychological, social, genetic and family factors may all contribute to eating disorders. And today's media images don't help.

"Society pushes ultra-thin role models," Dr. Nackenson says. "Kids come in wanting to be size zero regardless of their height or build."

Getting Help
Treating eating disorders can be difficult. Patients referred to Maria Fareri Children's Hospital receive a comprehensive assessment. They are monitored intensely and typically receive medical treatment, nutritional counseling and mental health therapy, Dr. Nackenson says.

With Alyson, Dr. Nackenson didn't use scare tactics, but clearly spelled out what she was doing to her body, including jeopardizing her ability to have children later in life, her mother recalls. Slowly, Alyson began responding to the goals that Dr. Nackenson set for her.

Alyson is now doing much better. "I'm healthy and I will be able to have kids, and I won't die because my kidneys failed," she says.

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