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Q. I think my 14-year-old daughter might have an eating disorder. She rarely eats much at all, and when she does it's usually junk food. She's very skinny, though she used to be heavier last year. When I try to get her to eat more, she says she's not hungry. All of her girlfriends are quite thin as well. What should I do?
A. There are many types of eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder.
People with anorexia nervosa literally starve themselves by dramatically restricting their food intake. Bulimia nervosa is characterized by recurrent periods of binge eating and then vomiting, using laxatives, or compulsively exercising. The binge eater eats enormous amounts of food, and then feels embarrassed and distressed by her inability to stop the binge.
Another syndrome for consideration is "disordered eating," which represents a mild change in eating habits in relation to a stressful event or illness. Disordered eating does not necessarily mean a person has any health problems. However, if not checked, it can lead to an actual eating disorder.
Beyond simply noticing your daughter's weight and eating habits, ask yourself these questions:
If you answer "yes" to most of these questions, your suspicions might be true. She certainly falls into the most likely age category. The onset of eating disorders peaks first at 14 years, which corresponds to the age when the most changes occur in a girl's body. Then they peak again at age 18, when young women face the transition to college and/or leave the family home.
Eating disorders, like other illnesses, are most successfully treated when diagnosed early. A physical examination is critical to either confirming or ruling out an eating disorder -- and possibly discovering and treating another illness.
If your daughter is diagnosed with an eating disorder, you'll need to place her in the hands of a doctor, therapist, and nutritionist. A support group might help as well. Hospitalization may even be necessary.
The best way to help your daughter is by recognizing how powerful an eating disorder is. It is an illness and she cannot help herself without professional assistance. It's important to be compassionate toward her as she is the one who is truly suffering.
Realize too that you, as the loving parent, may feel anger, frustration, and helplessness. You may need a therapist yourself.