Dear Dr. Garner,
My daughter is 18 years old, and I am concerned that she has an eating disorder. She is constantly preoccupied with her weight. She now weighs 89 pounds, and she is 5 feet 2 inches tall. Her teeth are also in poor condition, and her breath is unpleasant.
I don’t know what to call it, but she has a problem. Could you tell me what you think I should do?
Concerned Mother in Elmhurst
Dear Concerned Mother,
I am sorry for your anguish, and I can understand how concerned you must be about your daughter.
Eating disorder symptoms can vary widely. The main types of eating disorders are anorexia, bulimia and binge eating.
As I am sure you are aware, eating disorders can cause serious physical problems. Some of these can be life-threatening. I would like to outline what occurs in the different types of eating disorders, and then we can talk about some possibilities of treatment.
Anorexia: A person with anorexia is obsessed with food and being thin. He or she is willing to starve himself or herself almost to the point of death. The main symptoms include excessive exercise, preoccupation with food, trouble sleeping, refusal to eat and denial of hunger.
Bulimia: In bulimia, a person eats a lot of food and then vomits. One eats a large amount of food, and then in order to get rid of calories, vomits or does excessive exercise. The weight in someone with bulimia can be normal. The symptoms of bulimia include excessive exercise, forced vomiting, laxative use and abnormal bowel function. In addition, as in the case of your daughter, damaged teeth and gums may occur. Someone with bulimia is constantly dieting or fasting and may abuse alcohol as well.
Binge Eating: In binge-eating disorder, a person eats an excessive amount of food and then makes up for it by vomiting. The person may not eat when she is hungry. The person usually eats faster during the binge episode. The person frequently eats alone and feels depressed, disgusted or upset over the amount that he or she has eaten. Depression, hopelessness and fatigue are common.
Unfortunately, people with these eating disorders often refuse to see a doctor. It is important to discuss the situation with your daughter and at least have a referral to a psychologist, psychiatrist or a general doctor.
Signs of an Eating Disorder
There are some tipoffs that someone has an eating disorder:
• Skipping meals
• Making excuses for not eating
• Wearing baggy or layered clothing
• Use of dietary supplements or weight-loss products
• Using laxatives
The exact cause of eating disorders is not well known. It may be genetic, which makes a person more prone to develop it. It may be psychological or emotional. Our whole culture helps to breed eating disorders as the most popular people are often presented as extremely thin and that to be popular, it is necessary to be thin.
There are some risk factors for developing eating disorders, such as being female, young adult (teens to early 20s), having a family history of eating disorders, having a history of frequent dieting and finally, entering a new phase of life, such as going off to college or starting a job.
Serious complications including heart problems, risk of suicide, mental problems and kidney damage increase the longer someone has the problem.
It is important to speak with your child in a non-judgmental manner. Urge her to visit the doctor if only to get an overall checkup. Medication cannot cure an eating disorder; however, it can help control the urge to starve oneself, binge, purge or lose some of the excessive preoccupation with food and diet. Counseling must be combined with medication.
When the situation gets to the point where teeth and gums are being damaged and weight loss is excessive, professional help is necessary.
Waste no time in getting your daughter to see a health care provider so she can get on the road to wellness.[hr] Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.
