Focus on the Family

Recognizing and Confronting Adolescent Eating Disorders

How can I know if my daughter is anorexic or bulimic? She's lost a great deal of weight over the past few months, and she's become extremely thin. What should I do if I find out she has a serious eating disorder?

Let’s begin with a couple of definitions.

Anorexia nervosa is a condition of self-imposed starvation that eventually leads to a body weight at least fifteen percent below the expected level for an individual’s age and height. It affects as many as one in one hundred girls and young women, and it is characterized by an extreme fear of – or antagonism to – gaining weight and a strikingly distorted body image. As more weight is lost, the fear of gaining weight intensifies rather than diminishes. Not surprisingly, this leads to a number of medical consequences, including the interruption of the woman’s monthly cycle, loss of bone density, decrease in body temperature, reduced capacity of the stomach, dry skin, thinning of scalp hair and the development of a fine hair growth on the body called lanugo. Anorexia nervosa is a serious condition with lethal risks: at least five percent (some sources say as high as twenty percent) of anorexics die from starvation, cardiac arrest or suicide.

Bulimia nervosa is characterized by a behavior known as bingeing and purging. During a binge, an individual quickly consumes an enormous amount of food, often without even chewing or tasting it. The resulting physical and emotional discomfort will provoke a purge, usually involving self-induced vomiting. The bingeing and purging cycles may occur a few times a week or, in severe cases, several times daily. Bulimia is more common than anorexia, affecting an estimated one to three percent of women in Western countries at some time in life. Among the serious medical consequences of bulimia are the decay of teeth and inflammation of the throat and salivary glands due to repeated exposure to stomach acid; severe constipation; and potentially dangerous disturbances in heart rhythm due to loss the of potassium from vomiting. Less common, but equally serious problems include bleeding and even rupture of the esophagus or stomach, and choking or pneumonia resulting from food aspirated into airways.

While each case is unique, there are a number of contributing factors that may be considered underlying causes of anorexia and bulimia. Personality traits such as perfectionism, obsessive-compulsive tendencies and a desire for total control are typical of young females with eating disorders. Biochemical issues, particularly imbalances of chemical messengers in the brain known as neurotransmitters, may also play a key role. Cultural factors are also important: in developed countries, advertisements, films, videos and TV consistently associate thinness with the ideas of bodily perfection and personal success. And over the past several years, a number of websites have emerged – so-called ” pro-Ana” or ” pro-mia” sites – that actively promote anorexia and bulimia as ‘positive lifestyles” rather than eating disorders.

Because eating disorders can put health and even life in serious jeopardy, they should be taken very seriously. In order to be effective, treatment must address a variety of issues and will often require a team approach. A thorough medical examination is extremely important, and counseling, involving the entire family, will be needed on a long-term basis. If you need help finding a qualified Christian therapist, call us. Focus on the Family’s Counseling department can provide you with referrals. Our staff will also be more than happy to discuss your situation with you over the phone.

In the meantime, you can help your teenage daughter in the following ways:

  • Beware of perfectionism, especially in regard to your child’s weight or physical appearance. She must understand that her worth and your acceptance of her are not based on physical beauty or perfect performance, but are, in fact, unconditional.
  • Beware of demands on an adolescent to “make weight” for an athletic team, slim down for a cheerleading or dance team or in some other way subject the body to stringent dietary restrictions for any reason.
  • Help your daughter understand that body shape and build have a strong genetic basis and that few women are capable of attaining cover-girl status, even with intense effort.
  • Eliminate from your own and your family’s conversations jokes or demeaning comments about the appearance of others.
  • Point out to your children how advertising and other media present misleading images of beauty and body image.
  • Be a good role model in your own eating and exercise habits, and be careful about openly criticizing your own body appearance.
  • Focus on relationships and building emotional intimacy in your family rather than on food-related issues.


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