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Eating Disorders
My painfully underweight teenage daughter refuses regular meals, obsessed with being "thin".
Your daughter, a victim of society's obsession with thinness, needs counseling immediately.
I am terribly worried about my teenage daughter's irregular diet and obsession
with her weight. I've already taken her twice to the emergency room for malnutrition.
Emaciated, she still refuses to eat with her family, resolved to lose even more weight.
If she does get a small amount of food down, she forces herself to throw it up with a finger
down her throat, or by spitting it into the garbage undigested. Her grades in school are failing.
We just don't know how to help her anymore.
Modern mass media distorts teenagers' perception of what constitutes beauty and a normal body
image, by constantly thrusting unrealistically thin models before them as the norm. Wanting to
"fit in", everyone has to aspire to look like a movie star. Any deviation is a source of
embarrassment and feelings of inferiority. In order to lose weight rapidly, they often resort to
potentially harmful over-the-counter diet drugs, and even illegal amphetamines, to suppress appetite.
Your daughter seems to be suffering from an eating disorder, typically one that will call upon all
her reserves, and your support, to overcome. She is not alone. Eating disorders affect more women
than men 9:1, with an average age of onset of 13-18. It is a complicated illness that has spread
rapidly throughout the modern world of industrialized nations. Eating disorders are classified
largely into two kinds.
Anorexia nervosa is defined by an underweight of less than 85% of normal and, in the case of women,
is often accompanied by medical problems, such as irregular periods or the absence of menstruation
(amenorrhea), as well as life-threatening complications requiring hospital intervention and forced
treatment.
In bulimia nervosa, patients attempt to control weight by taking abnormal amounts of laxatives, or
by frequent vomiting. They are obsessed by the notion that they are overweight, and that every
morsel of food they ingest will add to their imagined, excessive body fat, and so they starve themselves.
At other times, they give in to impulsive behavior and gorge themselves, only to wind up cutting their
wrists the following day out of shame and self-loathing.
By way of example, one of my patients, Francis, 17, exhibited symptoms of an eating disorder similar to
your daughter's. However, her illness progressed to the point that she had attempted suicide on
several occasions. In treating her, I learned that she had been fat in grade school, suffering the
torment of the other children. Her parents contributed to her self-consciousness by constantly
observing her weight problem, and embarrassing her in front of other children and adults, refusing
in her behalf the cake offered her at birthday parties. Consequently, she came to think of food as
"the enemy"
Most cases of eating disorder require a concerted effort and multiple counseling approaches. Your
daughter will need individual therapy to get at the psychological root of her problem, while family
counseling will help the rest of the family to cope. Forced IV feeding is a last resort. Naturally,
she will need all of the family's continued love and support. She is in the grips of a demon-and has
lost control.
Nutritional counseling will help her understand what her body requirements are and the best way to
get them. Sometime, extended treatment in a facility with other eating disorder patients, where she
can receive group and individual therapy, regular meals, and feel the support and acceptance of
others like herself, is the best way to break the stranglehold of her obsession, and put her back on
the road to leading a normal, healthy life.
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