The co-directors of Mass General’s Eating Disorders Clinical and Research Program share information about eating disorders and how parents can help their children.

How common are eating disorders?

Eating disorders affect millions of people. Rates are particularly high among females between the ages of 12 and 35. Estimates indicate that approximately 0.5 to 3.7 percent of females have anorexia in their lifetime, while 1.1 to 4.2 percent of females experience bulimia and 2-5 percent of men and women have binge eating disorder, which is the most common of all eating disorders.

How can I talk to my child about a possible eating disorder?

Approach your child in a calm, empathic and non-judgmental manner. Tell him or her that you’ve noticed a change in weight, exercise patterns or attitudes toward food, and that you’re concerned.

While adolescents can resist limits … they typically feel reassured that their parents are involved and concerned.

It is important for your child to hear that you are interested in understanding what is going on rather than trying to blame him or her. Encourage your child to respond to your concerns. Ask what he or she would like you to do. If your child doesn’t know how you can be helpful, offer to speak to the child’s pediatrician, or to set up an evaluation with a mental health professional.

If your child resists help, or says that there is nothing to worry about, tell him or her that you are still worried, and would like a professional’s advice. While adolescents can resist limits, they need them, and despite their protests, they typically feel reassured that their parents are involved and concerned. If you become concerned about your child’s safety, due to low weight, threats of self-harm or threats of harm to others, seek emergency care immediately.

The hallmark feature of anorexia nervosa is significantly low body weight, followed by an intense fear of gaining weight, and difficulty appreciating the health consequences of being underweight.

Do eating disorders cause medical problems?

Eating disorders are the psychiatric illnesses with the highest rates of medical complications, including death. Because they can be associated with severe physical problems, patients should be closely followed by a primary care physician or a medical specialist. Some complications are minor and bothersome, while others can be life threatening.

  • Eating disorders can commonly be associated with weakness, inability to tolerate cold temperatures and hair loss due to malnutrition and low body weight.
  • About 90% of young women with anorexia suffer from bone loss, putting them at increased risk for fractures. When body weight is very low, patients sometimes grow downy hair, called lanugo, on their body. This happens because there is not enough body fat present to insulate the body; it typically goes away as weight normalizes.
Individuals with bulimia nervosa are not underweight. Instead, bulimia nervosa is characterized by binge eating followed by inappropriate compensatory behaviors, including self-induced vomiting, laxative or diuretic abuse, fasting, or excessive exercise.
  • Many women with eating disorders experience changes in their menstrual periods. Their periods may become irregular, or may disappear completely. Pregnancy can still occur, even when periods are irregular or absent, so it is important to continue to use protection if pregnancy is not desired. As nutritional status improves, periods often become more regular.
  • Patients with eating disorders commonly report stomachaches or constipation because of dehydration and the lack of bulk in the diet. Symptoms often resolve as the body gets used to more food and can also be treated by increasing fluid and fiber intake to a healthier range.

What causes an eating disorder?

People with binge eating disorder frequently go on eating binges, but do not use inappropriate compensatory behaviors. Binge eating is not just having an extra helping of dessert on a holiday or other special occasion. Instead, binge eating involves eating an unusually large amount of food in a discrete period of time and feeling as though it is hard to control the eating behavior.

There is no easy answer. If your child struggles with an eating disorder, please do not blame yourself. Eating disorders were once thought to be found only in high-achieving, affluent, Caucasian teenagers with demanding families. Adolescent girls were thought to starve themselves to prevent the body changes and social expectations associated with becoming a woman. Now, we believe that eating disorders are related to a combination of biological, psychological and social factors. They affect men and women of every age, socioeconomic, ethnic and cultural group.

There is no easy answer. If your child struggles with an eating disorder, please do not blame yourself.

How are eating disorders treated?

In our program, we offer a variety of outpatient treatments for those with feeding and eating disorders. The treatments we offer have been shown to be most effective in large-scale studies. After a comprehensive assessment, we will recommend the treatment best matched to individual needs.

Treatments options include cognitive behavioral therapy, family-based treatment, guided self-help, group sessions and medication. We also collaborate with Harvard Medical School affiliates to offer higher levels of care for patients unable to beat their eating disorder through outpatient support alone.

There are many opportunities to support the Eating Disorders Program. For more information, please contact us.

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Kamryn T. Eddy, PhD, is a co-director of the Eating Disorders Clinical and Research Program at Mass General, and an associate professor of Psychology at Harvard Medical School. Dr. Eddy’s clinical specialty areas are assessment, family-based treatment, and cognitive behavioral therapy for children, adolescents and young adults with eating disorders.

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Jennifer J. Thomas, PhD, is a co-director of the Eating Disorders Clinical and Research Program at Mass General, and an associate professor of Psychology at Harvard Medical School. She specializes in cognitive-behavioral therapy for eating disorders. Her recently released book Almost Anorexic: Is My or My Loved One’s Relationship with Food a Problem? describes many forms of eating disorders not fully captured by current psychiatric definitions.