Diagnosing an Eating Disorder in an Overweight Teen

Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.

By Dr. Mark Warren

The DSM V has brought formal recognition to a significant issue in those with eating disorders that have been previously excluded. The disorder “atypical anorexia” describes an individual who meet the criteria for anorexia, however despite significant weight loss the individual’s weight is within or above the normal range.

With the current focus on childhood obesity, this awareness is particularly important as children and teens who are overweight may be directed to lose weight for their health. While weight loss may be good advice for some, for others who are biologically predisposed to developing an eating disorder weight loss may lead to the psychological and physical manifestations of this illness. A recent article in the Huffington Post summarized an article from the Journal of Pediatrics – It notes that adolescents with higher weights may be ignored or overlooked due to our focus on weight. Pediatric eating disorders do not receive the same attention that pediatric obesity receives. It is estimated that at least 6% of children have an eating disorder and that close to half of high school females and a third of high school males engage in disordered eating behaviors including fasting, diet pills, and laxative abuse. As many as one-third of children and adolescents with an eating disorder may be of normal or above normal weight and suffer the same medical consequences, psychological pain, obsessions, behaviors, and loss of quality of life that underweight individuals suffer from. Going forward it is crucial for all of us that we do not define anorexia and underweight as the same thing. Body mass index is not always a measure that can be used to determine if an eating disorder is present. Questions related to disordered eating and weight management behaviors should be asked and taken seriously regardless of weight.

Contributions by Sarah Emerman

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