Anorexia is one of the most dangerous mental health disorders, and it’s a condition that has been steadily creeping down into younger and younger age groups in recent decades. It’s no longer rare to encounter 8- or 9-year-old girls who are already anorexic or beginning to start down this path.
What is Anorexia?
Anorexia is when a person intentionally restricts their food intake to a dangerously unhealthy degree. This is usually accompanied by a ritualization of food. For example, an anorexic might go all day eating just a couple of baby carrots, then rather ceremoniously partake of a candy bar late at night. Or they may go all day not eating at all and then rather ritualistically peel and slowly eat an orange before they go to bed.
There are varying degrees of anorexia. Mild sufferers may only reduce their calorie intake by a few hundred to a thousand or so calories below what is normal and healthy; enough to adversely affect their health but not so much that they’ve essentially stopped eating altogether. In its more extreme form, however, anorexics can restrict themselves to the point of all-out starvation, trying to subsist on anywhere from 25-100 calories per day when they should be consuming 2,000. For instance, one aspiring pop star described living off a single ice cube of frozen juice per day while trying to drop 15 pounds.
The degree of severity often depends on how early you catch it. Anorexia tends to progress and become more severe the longer it goes on. Like a surfer who becomes more skilled the more she practices, anorexics often turn food restriction into a challenge to see how much they can push themselves. What started out as skipping breakfast progresses to skipping lunch as well and then into more advanced stages of anorexia where a person attempts to go all day with little or no food.
Understanding Anorexia: Beyond the Stereotypes
Anorexia is commonly assumed to be a product of a distorted body image. The typical stereotype is that of a skinny, rail-thin girl who nonetheless looks in the mirror and sees herself as fat. (This is referred to as body dysmorphia.) But anorexia isn’t always about a distorted body image or even about one’s looks. Just as commonly it is something psychological – a behavior driven by a need for control or a sense of empowerment, or a means of getting attention. It may serve as a form of self-punishment that eases shame, or be a tool that drowns out stress and/or painful memories. This is why people who have other stress or trauma in their lives are at greater risk of falling into anorexia.
In many cases both factors are at play: A person restricts their calories because they desire to look good and don’t want to be fat, but they then discover that doing so gives them a psychological boost. Anorexia may start out as a means of losing weight or trying to look good and then take on more of a psychological dimension as the disorder progresses. Once the anorexic has shed the desired weight, they find it hard to stop the habit because of all the ways this behavior is yoked to their overall psychology.
Why Do Children Become Anorexic?
Most preteen children who become anorexic do so because of body image concerns. Often there is a specific trigger that sets them down this path, such as teasing at school or ideas implanted from other sources. It may arise because family members inadvertently give a child a complex about her weight or looks. Occasionally you’ll encounter a preteen girl whose anorexia has mostly psychological origins, but these cases are a lot rarer, and usually reserved to kids who come from unstable homes or chaotic backgrounds.
Among teens with anorexia, psychological factors play a much more prominent role. Dieting or body image concerns are still an important part of the equation, but it’s more of an even 50/50 split, wherein the behavior is driven by psychological needs as much as it is a desire to be thin. Teens are dealing with a lot more angst, turmoil, uncertainty and self-doubt in their lives. Anorexia can serve as a tonic for these ills.
Treatment for Anorexia
Anorexia is as much a symptom of broader psychological issues as it is a cause, and therefore treating anorexia generally involves a regimen of psychotherapy while promoting overall mental health. There are also plenty of things families and therapists should be doing to undermine the ideas that feed the disorder. You can find detailed information on treating anorexia in our book, Understanding & Overcoming Eating Disorders.
Signs & Symptoms of Anorexia
So how can you tell if someone you love is suffering from anorexia? There are a few warning signs and symptoms parents should be on the lookout for:
Physical signs & symptoms of anorexia
- Rapid weight loss
- Thinning hair
- Irregular periods or loss of menstruation in a an adolescent girl
- Stunted growth or delayed maturation in a prepubescent child
- Low energy
- Suffering from fatigue or confusion
- Shivering or complaining about being cold
- Pale or discolored looking skin
Behavioral changes linked to anorexia:
- Becoming more secretive about eating
- Ritualizing or obsessing over food
- Clipping pictures of food or recipes for unknown reasons
- Expressing an interest in dieting or concerns about being overweight, especially when a child is already thin
- Making up excuses to avoid eating, such as saying they aren’t hungry, saying they already ate, or claiming to feel sick
- Withdrawing from social situations that involve food
- Becoming more reclusive and avoiding friends or family
- Suddenly wearing baggy or heavier clothing, even on hot days, either because they feel cold all the time or to disguise their weight loss from others.
What to do if you suspect your child is anorexic:
1. Schedule a well-child appointment with your pediatrician, letting them know ahead of time about your concerns, so that they can do a checkup and see where your child is at.
2. Start closely monitoring their food intake, recording exactly what you see them eat and any attempts they make to avoid eating.
3. You can call your child’s school and check with their teachers to see if they’ve noticed any changes. Also ask them to keep an eye out for you and make sure you son or daughter isn’t giving away their lunch at school and is actually eating.
4. You can also confront your child directly, just be sure to do so in a loving manner and understand that there’s a high probability your daughter may lie or give evasive, dishonest answers. Before you take this step, I would strongly encourage you to purchase and read the book Understanding & Overcoming Eating Disorders, so that you know a lot more about the nature of anorexia going into it.