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Eating disorders still a big problem among teens

Recent reports that young actress Mary-Kate Olsen was being treated for an eating disorder focused new attention on a problem that's been a concern for years: anorexia and bulimia among teenagers.

Eating disorders are "very common," says Christine Hartline, director of the Eating Disorder Referral and Information Center in Del Mar, Calif. As many as 10 million females and one million males suffer from an eating disorder in any given year. Many others exhibit unhealthy eating habits but do not meet full disorder criteria.

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Eating disorders "can affect all ages and both sexes," says Dr. Harry Brandt, director of the Center for Eating Disorders and head of psychiatry at St. Joseph Medical Center in Towson, but are found "primarily in high school- and college-age females." Most people who have eating disorders "begin when they're teenagers," says Hartline.

Why? Because, when we're teenagers, our bodies are changing constantly and we're focusing on those changes more than ever. "We don't necessarily like or understand" them, says Hartline. Also, we are "confronted with complex issues," says Brandt, ranging from college and separation from family to adulthood and adult sexuality.

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According to a 2004 study done in England, 75 percent of teenage girls think thin girls are more popular and more attractive. And, when they fail to look like the celebrities they admire, two-thirds say they feel depressed.

Children "as young as 7 or 8" are developing eating disorders; it's "related to family and social issues -- so many people are weight-conscious, and younger and younger kids are picking up on it," Hartline says. "It makes kids think 'everybody wants to change their bodies' and that they should want to, too."

On the other side of the spectrum, Brandt notes, "recently, older individuals have been developing eating disorders because of [our culture's] emphasis on the importance of youth." According to Anorexia Nervosa and Related Eating Disorders Inc., studies report that people as young as 6 and as old as 76 suffer from either bulimia or anorexia.

Still, "the trend tends primarily to be teenage," says Hartline. And, she says, teen eating disorders differ somewhat from the ones adults have. The core symptoms are the same, but with teens, there are more family issues. For them, an eating disorder can be a way to tell "controlling parents" or a "perfectionist family ... 'you can't control everything about me,' " says Hartline. And, teenagers don't necessarily want to get better, especially if a parent is the one making them get help.

Although treatments for eating disorders are highly dependent on the individual and there is "no single specific ... gold standard," according to Brandt, most therapy focuses on nutritional rehabilitation. Often, medication is prescribed. "Depression and anxiety disorders are very common" among people with eating disorders, says Brandt.

Treatment centers for teenagers differ from ones for adults, providing family counseling in addition to individual therapy. They also surround teens with a peer group their own age. But, "as long as a person goes into an eating disorder program, they're all effective," notes Hartline, regardless of whether they are specifically for teens or not.

Brandt, on the other hand, says that "even with the best treatment, only one-third of patients reach full recovery; of the remaining two-thirds, one does reasonably OK while the other is chronic and does horribly."

The most important thing for the medical field, says Brandt, is to understand why eating disorders occur, which may lead to ways to prevent them. St. Joseph Medical Center is taking part in a 10-year study with seven other centers in the United States, as well as ones in Canada, England and Germany, to look for a genetic cause for anorexia. It is based on a preliminary study done by the Price Foundation Collaborative Group, which pointed to a chromosomal abnormality that may predispose people to the disorders.

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So, where's the line between a healthy diet and an eating disorder? For that matter, is any weight-loss diet healthy? "Dieting with moderation is not a problem, and most people tend to do fine," says Hartline. But, she says, because we live in a "compulsive dieting society," people are "looking for a quick fix ... and expect it to help with all aspects of life, but it won't." It becomes a real problem when the dieting gets compulsive, with constant weighing of oneself and calorie counting.

The proper way to diet, according to Hartline, is to use a nutritionist and focus on both food and exercise. According to Brandt, no weight-loss diet is healthy. "Diets can create a lot of problems. I see that all the time."

"Friends are usually the first that know" that a teen has a problem, says Hartline. She advises them to "keep in mind it's really serious; ... by helping intervene you can make a huge difference. The main thing is to get help, and also to educate yourself."

Long-term effects of anorexia and bulimia can include osteoporosis, electrolyte disturbances, an irregular heartbeat, a ripped esophagus and "damage to just about any major organ," Brandt says. Eating disorders have the highest mortality rates of all psychological disorders: for anorexia, estimates range from 12 to 18 percent.

So, what will be the effect of the very slender Olsen going public with her eating disorder? It's hard to say. "It does help ... to have teens recognize that people don't just look like this -- a lot of celebrities have eating disorders, and it's important for people to know that their look doesn't happen naturally," says Hartline. In fact, Brandt notes, "celebrities are probably even more at risk because of their jobs."

And what about the people who will continue to see Olsen, 18, as a role model? "A lot of kids do look up to them, do want to look like Mary-Kate; young girls want to be like her and might be willing to develop a disorder to be like her," says Hartline. Pro-anorexic Web sites are now using Olsen as a role model as well. "It's a double-edged sword," says Hartline.

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Olsen fans are more optimistic. In their posts online, they support Mary-Kate. And, yet, their "poor MK" and "MK is beautiful and always will be!" comments are still surrounded by dozens titled "Am I Fat?" and one thread called "12 ways to look like MK!", which reminds girls that boys love Paris Hilton and Mary-Kate, "so they'll love you, if you're ready to drop some pounds!"

Warning signs of eating disorders

Preoccupation with food, weight or appearance

Making excuses during lunch for not eating

Dissatisfaction with weight loss despite excessive weight loss

Loss of menstrual period

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Frequent restroom visits, especially after meals

Excessive exercise

Always cold

Wearing layers of clothes to hide weight loss

Frequent weighing

Frequent overeating, especially when distressed

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Strict dieting after eating binges

Depressive moods

-- Center for Eating Disorders, St. Joseph Medical Center

More information

National Eating Disorder Association, 800-931-2237, www.nationaleatingdisorders. org

Center for Eating Disorders, St. Joseph Medical Center, Towson, 410-427-2100


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