It's been going on for weeks or months and you wonder if it's normal: Too many missed meals. Leaving the table as soon as possible after eating. Exercising excessively. Withdrawing from social situations, especially when food is involved. Large amounts of food disappearing from the house.
Lots of adolescents and teens have big appetites, or are on diets and want to lose weight. But could this be an eating disorder? You wonder if you're overreacting.
An estimated 30 million Americans — mostly adolescents, teens and young adults — will suffer from an eating disorder at some time in their lives, according to the National Eating Disorders Association.
If you suspect an eating disorder, NEDA has a free, anonymous online screening test that takes less than five minutes and provides guidance on what to do next (mybodyscreening.org).
Next week, Feb. 21-27, is NEDA's National Eating Disorders Awareness Week, aimed at helping others recognize eating disorders. The list includes anorexia, a form of starvation; bulimia, which involves overeating and vomiting or using laxatives or excessive exercise to lose weight; and binge-eating disorder or uncontrolled eating of large amounts of food.
NEDA also wants to increase awareness that eating disorders are real illnesses in need of prompt treatment and can be life threatening.
"The longer it continues and the older the person involved, the more difficult it is to treat," said Dr. Pauline Powers, a Tampa-based psychiatrist who has been treating eating disorders for 45 years. "If it hasn't been going on too long and they haven't lost too much weight, they can often be treated as an outpatient, which is less costly and may not interrupt school or work."
The Tampa Bay Times recently spoke with Powers, who also is medical director of the eating disorders program at Fairwinds Treatment Center in Clearwater, about what's new in the field, what puts people at risk and what parents should watch for. Here are excerpts from that conversation.
What's the current trend with eating disorders?
It's certainly gotten much more common. And more men are affected than ever before. For every 10 females with anorexia, there are three men with anorexia. And, overall, the rate of disordered eating is increasing faster in men than in women. We don't know why. I think that, as with women, men are just expected to be a certain size and shape that very few people can be.
What do you think about the new "curvy" Barbie doll which debuted earlier this month?
I've always thought the dolls contributed to anorexia. Maybe this (new doll) will help? I doubt it.
You have concerns about Vyvanse, a drug approved last year for adults with binge-eating disorder. Why?
I'm concerned because it's an amphetamine, and the chances of addiction increase with amphetamines. Plus, amphetamines are associated with weight loss and I'm not sure that's a good idea in someone with an eating disorder. The drug initially was approved for attention deficit disorder and now will be used for binge eating. The idea is that it will help with cognition, recognizing that you are overeating so you can stop.
What's new in research?
We're beginning to understand why eating disorders are so difficult to give up. It has to do with the parts of the brain that are affected — once they're activated, it's hard to turn them off. A similar thing happens with drug abuse. Knowing more about that process can help us figure out what we can do about it.
What's new in treatment?
Treatment now includes the whole family. Parents are included in the treatment team. We teach them how to take control of feeding the patient. Later, patients take it over, but we have the parents come in and start feeding the patient. It's not as easy as it sounds. It wears parents out.
What's the success rate of treatment?
Recovery in teenagers is over 70 percent if they get appropriate treatment. That's much better than we ever thought it could be.
Any misconceptions about eating disorders that you'd like to correct?
That when the patient comes out of the hospital everything will be fine and life will resume as normal. It still takes three to five years to fully recover, that's after you have improved in the hospital. There's another misconception that parents are the cause. The truth is we don't know the cause and it isn't the parent's fault, unless you consider a genetic predisposition someone's fault. Eating disorders tend to run in families and 50 percent of risk is genetic.
Contact Irene Maher at [email protected]