Recognizing eating disorder can mean life or death

By Pamela Carlton, MD

Young people at risk if parents are not vigilant

“You can never be too rich or too thin.”  This was written on a refrigerator magnet in the kitchen of my childhood home.  We all know that obesity is a real problem in the United States.  We hear about it daily on TV, on the radio and in the newspaper.  However, what we need is not a battle against obesity.  We do not need a diet that cuts out fats and carbs in a frantic push towards thinness.  What we need is to learn moderation and how to have a healthy, realistic relationship with our bodies and food.  The truth is, there are medical risks at either extreme of the weight spectrum, but there’s a lot of room in the middle.

As a physician who treats teens and young adults with eating disorders, I constantly see the consequences of our society’s obsession with the “thin ideal” and the fear of fat.  I care for children, some as young as twelve years-old, who have weakened hearts and brittle bones because they are not eating, over exercising and/or vomiting in an attempt to “not get fat.” There is no one reason why a child develops an eating disorder but one of the factors can be living in a society that demonizes fat and emphasizes unrealistic body images.  With a balanced diet and appropriate physical activity, people can be healthy at a great variety of weights.  We need to shift our focus from weight and body size to physical health and body satisfaction.

Our children learn by emulating what they see and hear.  If we send them healthy messages at home, hopefully, we can counter some of the dangerous messages they are bombarded with in the media.  There are three simple things that we can focus on.

Everybody’s body is different

It’s commonplace in our society to freely comment on body size.  Comments such as; “I hate how fat I am.” and “Wow, you look great. Have you lost weight?” reinforce that it’s good to be thinner and bad to be heavier.  Instead of making comments such as these, we should teach our children that bodies come in all shapes and sizes and we must appreciate and celebrate this diversity.

There is a place for all foods in a healthy diet

A balanced diet that includes all of the basic food groups is essential for good health.  However, because of various fad diets our society has managed to demonize fats, sugars and carbohydrates, labeling them as “bad foods.”  However, eliminating these foods from our diets would cause serious nutritional deficiencies and medical complications.  I am not saying that having doughnuts at every meal is healthy.  I am, however, promoting a healthy balance.  None of the food groups are bad.  We need them all in our diet in reasonable amounts in order to be healthy. And we need to explain this to our children.

Exercise is FUN

While part of a healthy lifestyle is being physically active, today’s focus on exercise seems to only be about losing weight.    When we say, “I have to go to the gym to get rid of these last 5 pounds,” we are sending a message that exercise is something to be dreaded.  Instead, physical activity should be promoted as a fun integral part of a healthy lifestyle.  Getting out and doing active things as a family can accomplish this.  Go ice-skating, hike or just splash around in the pool with your kids.  Try different activities until you find a few that your family enjoys.

Recognize the signs

By taking the focus off of body size and instead focusing on a balanced diet that includes all food groups, and appropriate physical activity you will increase the chance of your children developing a healthy body image and a healthy relationship with food.  However, even with the healthiest messages at home, people sometimes develop eating disorders.  Some of the warning signs that might indicate that your child is struggling with an eating disorder are:

• Large changes in weight
• Preoccupation with weight, food, calories, fat grams and/or dieting
• Preference to eat alone or excuses to avoid family meals
• Development of food rituals such as limiting food choices, eating very slowly or cutting foods into small pieces
• Cutting out whole food groups such as meat, carbs, fat, etc.
• Rigid exercise regimen despite weather, fatigue, illness or injury
• Loss of menses, dizziness and fatigue
• Social isolation, depression and moodiness

If you are concerned that your child might have an eating disorder it is crucial to get help immediately.  Eating disorders are life-threatening illnesses and the sooner one gets treatment the better the chance that they will recover.  Call your child’s doctor and explain that you are concerned that your child may have an eating disorder.  If the doctor is comfortable treating eating disorders he or she can evaluate your child and help you to establish a treatment team if needed.  If your child’s doctor is not experienced in treating children and teens with eating disorders, he or she can refer you to a specialist.

Over the years I have thought about that saying, “You can never be too rich or too thin.” And I realize, I’m not sure if you can be too rich, but I know that you can definitely be too thin.

By Pamela Carlton, MD

Co-Founder of The Healthy Teen Project

Director of The Carlton Clinic for Eating Related Disorders

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