Recognizing Signs & Symptoms of Anorexia in Teenagers

Anorexia nervosa -- known more familiarly as anorexia -- is an eating disorder. Eating disorders like anorexia may affect as many as 10 percent of young women in the United States, according to the American Academy of Child & Adolescent Psychiatry. Boys can also develop anorexia, but it is much less common. Teenagers who have anorexia could literally starve themselves to death, and the condition requires medical treatment as early as possible.

Distorted Body Image

Although any teen might be concerned about her weight, an anorexic teen has a distorted body image that makes her convinced she is fat, even when she is actually of normal weight or even underweight. In the early stages of anorexia, the teen’s behavior may simply seem like normal dieting behavior. Anorexia may develop slowly, over months or years, which can make it more difficult to see the signs. The disease often progresses, however, as weight loss continues to the point of emaciation and other symptoms develop.

Early Stages

In the early stages of anorexia, most signs and symptoms are subtle and related to the teen’s behavior 1. She may refuse to eat or deny that she is hungry, even when she has not eaten all day. Some teens skip meals or make excuses for not eating at mealtime. The teen often becomes obsessed with her body size, shape or weight. She may begin to limit her food intake to “safe” foods -- usually foods that are low in fat and calories. When she eats, she may cut her food into tiny pieces or chew it and then spit it out. Some teens weigh their food, while others cook elaborate meals for other people, then refuse to eat the meal they have prepared.

Weight Loss and Obsessive Behaviors

As anorexia progresses, a teen usually loses weight. If she has been overweight, the weight loss may bring compliments from others, which can reinforce the behavior. She might exercise obsessively to increase her weight loss, all the while complaining about being fat. She may develop obsessive behaviors, such as weighing herself multiple times a day or examining her body in the mirror to find what she perceives as flaws. An anorexic teen may begin to wear baggy or layered clothing to hide her weight loss from parents and friends. Some teens may also show signs of emotional problems, such as a flat mood or lack of emotion.

Advanced Stages

In the advanced stages of the disease, an anorexic teen may become skeletally thin, while still continuing to talk about being fat. She might complain of fatigue or suffer episodes of dizziness or fainting. Physical symptoms include brittle nails, thin hair that breaks easily, dry skin, constipation and the cessation of menstrual periods. Some anorexic teens develop an irregular heartbeat. Lab work often indicates abnormal blood counts, elevated liver enzymes and dehydration. She may also have low levels of serotonin, a chemical in the brain that affects emotions.

Other Problems

Anorexia is a complex disease that may be accompanied by other medical problems. Adolescents with anorexia are more likely to suffer from alcoholism than their peer group, according to Timberline Knolls (an Illinois residential treatment center for eating disorders), and to suffer from depression, anxiety disorders or obsessive compulsive disorder 1. Teens with anorexia may also abuse over-the-counter energy boosters, dietary supplements and prescription medications. Some teens binge and purge, as well as restricting their food intake. If you have concerns about your teen’s eating habits or think she might have anorexia, talk to your family doctor or pediatrician immediately; the American Academy of Child and Adolescent Psychiatry states that anorexia can be life-threatening.