Eating Disorders among Teens and Adolescents

Understanding Teen Eating Disorders and Ways to prevent them

Eating disorders often take root during the early years of adolescence.  This is a time when young people become more aware of the social demands for a physical ‘ideal,’ and many may feel they fall short.  The teen years are a fertile ground for an eating disorder to develop, as various elements of this phase of life—stress, insecurity, societal pressures, athletic competition—may contribute to the teen’s eventual disordered eating patterns.

Eating disorders, such as anorexia, bulimia, and binge-eating disorder are serious health conditions that should not be ignored.  The exact cause of eating disorders is often a mystery, with complex factors at the root of the condition making it challenging to identify the origin.  The societal emphasis on being a certain size and shape can so color a young person’s sense of self that is can lead to disordered eating habits in the quest to meet that expectation.

In addition, personality traits like perfectionism, certain genetic or biological factors, or mental health disorders such as anxiety and depression are also possible risk factors for an eating disorder.  Also, a general sense of having no control over one’s life is a common trait among teens suffering with an eating disorder.

Does my Teen have an Eating Disorder?

Because there are different eating disorders with different symptoms, it isn’t easy to identify whether or not a child may be developing disordered eating patterns.  However, there are some common behaviors that may indicate an adolescent is struggling with an ED, such as:

  • Persistent worry about being “fat” and obsession with losing weight
  • Skipping meals
  • Obsession with celebrities’ physiques and wanting to emulate them
  • Eating in secret
  • Irregular menstrual cycles
  • Visiting the bathroom immediately after each meal
  • Excessive exercise
  • Using laxatives and/or diuretics
  • Eating large amounts of high fat or sugary foods
  • Expressing disgust at their eating habits
  • Eating more food at a meal than is considered the norm

These red flags should be addressed as possible symptoms of a serious problem and, if the behaviors persist, steps should be taken to get professional help for the teen.

How can Teen Eating Disorders be prevented?

If your teen is displaying some of the thoughts and behaviors that may precede the development of an eating disorder, open communication is key.  Because a young person’s self-worth is often tied up with their body image, talking about their concerns at an early stage is helpful in directing them to healthier thinking.

Some areas that can help promote a more balanced approach to ______ include:

  • Set a healthy example. Kids look to their parents for direction and emulate them to a large degree.  If parents are obsessing about weight and dieting, or constantly complaining about their shape or size it can set disordered thoughts in motion in an impressionable young teen.
  • Discuss media influence. Young people are not yet aware of how powerful an influence the media is on our thoughts and behaviors, and are more vulnerable to the messaging.  Teach your teen that celebrities’ photos are often photo-shopped and not natural.  Point out stars that are famous and talented who have curves and some extra pounds on their frames.  Explain how cultural preferences for the desired shape is ever changing and that one should not be a slave to them.
  •  Build self-esteem. Teens often are insecure about their changing bodies, so help them feel good about themselves by pointing out their special qualities and skills that have nothing to do with physical appearance.  By praising their accomplishments at school, in sports, and their areas of interest you will foster a healthy sense of self in your teen.
  •  Discuss the dangers of dieting. If your teenager is engaging in fad diets or fasting they could be compromising their health.  Teach them about the dangers of robbing the body of important nutrients and about the body’s nutritional needs while it is still growing.
  •  Discuss the consequences of emotional eating. A teen may attempt to work out their emotional issues through food.  Teach your teen that strict controls over diet or over-consumption of ‘comfort foods’ is not a healthy way to cope with negative emotions or stress.  Encourage open communication with your adolescent, or direct them to a counselor, pastor, or another family member to discuss the problems they may be experiencing.
  •  Discuss the negative impact of social media. While bullying is not new, teens tormented about their appearance on a social media platform is a relatively new phenomenon–one which can have devastating consequences.  A young teen being skewered publicly for their size or shape on a social media app may take drastic measures in response.  If your teen is being bullied online they need support.

 Treatment for a Teen with an Eating Disorder

When a teen begins to use food as a tool for managing emotional pain it is time to reach out for professional assistance.  Each teen suffering with an eating disorder has a unique set of factors that led to their condition; therefore the approach to treating them must be individualized in order to be effective.

At Casa Serena, our dedicated professionals treat each young person with the compassion they deserve, focusing on the individual, not the diagnosis.  Call us today (925) 682-8252 and let our expert and caring staff put your teen on the path to a full recovery, and a new, healthy beginning.

Sources for this page:

Athletes with Eating Disorders

How the Demands in Athletic Competition Fuel Disordered Eating

Athletes with Eating Disorders

It’s easy to grasp how an athlete may develop an eating disorder.  Competition among athletes is fierce, and the pressure to meet the perceived physical appearance standards or weight requirements of a sport can be unrelenting.  In fact, according to a 2004 study from Norway, athletes are far more likely to develop an ED than the general public.  The study found that 14% of the 1,620 athletes evaluated had an active ED, versus 5% of the general population.  In addition, the study showed a higher incident of ED in female athletes, with a prevalence among athletes in leanness-dependent and weight-dependent sports.

Although eating disorders do occur in every sport, athletes who participate in what are referred to as “lean sports” tend to be more susceptible to acquiring an eating disorder.  Those sports include gymnastics, wrestling, cycling, running, ballet, diving, rowing, jockeying, and martial arts.  These particular sports tend to have a weight-class requirement, such as wrestling, or a standard that promotes low body weight for peak performance, such as cycling.

Why do Athletes Develop Eating Disorders?

Along with the stringent demands involved in being a competitive athlete that may drive some toward disordered eating habits to accommodate the physical standard for the sport, personality traits also factor in.  “The traits found in those with anorexia are also often found in high-performing athletes,” states Dr. James Greenblatt, chief medical officer at Walden Behavioral Care in Waltham, Massachusetts.  Greenblatt continues, “These traits include high self-expectations, perfectionism, competitiveness, hyperactivity, preoccupation with weight and dieting, and a tendency toward depression.”

Disordered eating among athletes, as in the general population, is caused by complex factors, including psychological, behavioral, environmental, and genetics.  In sports, some participants may go to unhealthy lengths to control their weight, influenced by such factors as:

  • Demands for peak performance, including speed and agility
  • Aesthetic demands, such as grace and beauty in dance or gymnastics
  • Pressure from coaches, judges, peers, and teammates to have a certain body size and shape and who emphasize only performance and success
  • Form-fitting athletic attire
  • Training for a sport from a young age
  • Public weigh ins
  • Media images of top athletes that present a stereotypical body image for a sport

The Consequences of ED among Athletes

These pressures can cause an athlete to go to any means necessary to shed pounds in a short period of time.  Binging and purging or starving oneself of important calories and nutrients becomes a de facto method to achieving the weight or physical appearance required by their sport. By engaging in such unhealthy dietary practices, the athlete may become more prone to injury, having the net result of a shortened career.

In female athletes, the lack of appropriate nutrition can cause detrimental health effects, referred to as the Female Athlete Triad.  This includes disordered eating, amenorrhea, and osteoporosis.  The process begins with the disordered eating, which can result in a female athlete ceasing to menstruate (amenorrhea), which in turn may cause calcium and bone loss that can lead to stress fractures of the bones (osteoporosis).  Male athletes battling an ED may have an increased incidence of co-morbid depression and substance abuse.

How Can Eating Disorders be prevented in the Sports Community?

Those with key roles in the athletic community have a responsibility to be proactive about addressing the dangers and prevalence of eating disorders.  Many turn a blind eye, considering disordered eating as part and parcel of participation in competitive sports.  In some instances, the coaches themselves are to blame for triggering an ED by belittling comments toward their athletes about body size and shape, or by public weigh-ins where peers can humiliate a fellow athlete.

Those in power positions, like a coach, have the opportunity to address the ED and to influence the athlete back to healthy eating habits.  Effective coaches exhibit responsible eating habits themselves, and emphasize health and wellbeing over the destructive success-at-all-costs mantra.  In doing so they provide positive examples to their young athletes that promote healthy lifestyles in addition to athletic performance.

We Can Help

At Casa Serena our expert treatment specialists are available to treat athletes who are battling an eating disorder.  These compassionate professionals are trained in treating the specific issues related to participating in competitive sports, helping the athlete to reclaim a balanced and healthy approach toward the demands of their sport.  Call today for a discreet consultation at (925) 682-8252.

Sources for this page:

Calling Binge Eating what it is…a Real Disorder

Understanding the Very Real Dangers of BED

When people hear the terms ‘anorexia’ or ‘bulimia,’ most understand these words to represent complex mental health disorders that result in disordered eating.  For decades now, public awareness of the serious emotional issues that underlie anorexia and bulimia have helped people understand the validity of these dangerous psychiatric conditions.  However, upon hearing the term ‘binge eating disorder,’ many may wrongly associate it with simply a lack of self-control or a character flaw rather than as a bona fide disorder.

On the contrary, binge eating disorder, or BED, was recently added to the revised Diagnostic and Statistical Manual (DSM 5), recognizing it as a valid, diagnosable illness.  By adding BED to the DSM it gives health professionals specific diagnostic criteria that will aid clinicians in identifying and assessing the disorder, leading to effective treatment decisions for those struggling with BED.

What is Binge Eating Disorder?

Because the word “binge” has been used loosely to describe compulsive behaviors such as binge-watching a TV series, or “binging out” on ice cream after a break-up, there is a tendency to dismiss a binge eating disorder as just a reckless overindulgence in food that has resulted in weight gain; just as binge-watching on Netflix results in lost productivity.  It is a misnomer though, as BED usually has co-occurring mental health conditions that drive the disordered eating, which can result in dire health and psychological outcomes.  These comorbid mental health conditions include:

  • Anxiety
  • Bi-polar disorder
  • Depression
  • Substance abuse

Binge eating disorders affect about 2.8 million adults, according to a 2007 national survey by Biological Psychiatry.  Of those who suffer from BED, 5.2% will die from health complications that resulted from the disorder.  Shockingly, BED is more prevalent in adults in the U.S. than both anorexia and bulimia combined.

Those who suffer from BED use food to manage emotions they do not want to experience.  These unwanted emotions include anger, boredom, guilt, stress, sadness, or a sense of being out of control.  Someone with a BED will attempt to offset these emotions with the pleasure they anticipate they’ll feel by consuming vast quantities of comfort food on a recurrent basis.

BED is also accompanied by a fixation on body image, leading to compensatory behaviors after over-indulging in the food, such as vomiting (although purging is not a common trait in BED), using diuretics or laxatives, or over-exercise.  Despite the serious psychological and sociological issues that underlie BED, the disorder is often misdiagnosed as simply an issue with weight.

Diagnostic Criteria for BED

The DSM-5, published in 2013, lists the diagnostic criteria for binge eating disorder as such:

 Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:

  • Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances
  • Eating much more rapidly than normal
  • The binge eating episodes are associated with three (or more) of the following:
  • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
  • Eating until feeling uncomfortably full
  • Eating large amounts of food when not feeling physically hungry
  • Eating alone because of feeling embarrassed by how much one is eating
  • Feeling disgusted with oneself, depressed, or very guilty afterward
  • Marked distress regarding binge eating is present
  • The binge eating occurs, on average, at least once a week for 3 months
  • The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa

 Signs and Symptoms of BED

Although there are a multitude of variations of BED, there are certain signs and symptoms that someone may be suffering from this serious disorder.   By being aware of these signs, the chance for successful treatment of the disorder is made possible.  Some behaviors are displayed that may be predispositions for developing an eventual BED, but not necessarily.  Regardless, awareness is key in helping a loved one with a mental health condition such as BED.

Emotional characteristics of BED

  • Depression, social isolation, and moodiness
  • Feelings of anger, shame, anxiety and worthlessness preceding the binge
  • Negative or distorted body image
  • Rigid thinking
  • Perfectionist tendencies
  • Need to be in control
  • Conflict avoidance

Behavioral characteristics of BED

  • Eating secretly, hiding, stealing, or hoarding food
  • Disappearance of large amounts of food, empty wrappers or containers indicating large quantities of food consumed
  • Periods of impulsive or continuous eating beyond the point of feeling full, but does not purge. Eating fast, or eating large amounts of food when not hungry
  • Creating rituals allowing for binge sessions
  • Extreme rigidity with food, with periodic dieting/fasting

Effects of BED

A binge eating disorder can put someone at risk for developing several serious health conditions, including heart disease, type 2 diabetes, or high blood pressure, mostly due to obesity or radical weight fluctuations.  Because of the comorbid psychiatric conditions, a BED can also lead to a substance abuse disorder, which in itself can lead to death.

In addition to the physical effects, a BED can cause the sufferer to become disengaged from their normal responsibilities, eventually becoming unable to keep up with their obligations.  A BED can also affect relationships, due to the secretive behaviors and shame that may cause the sufferer to withdraw from loved ones.

Because BED is often a misunderstood condition, it is important to seek help from a provider who is an expert in the field of treating eating disorders.  At Casa Serena, our specialized professionals use evidence-based treatment methods in a caring and supportive environment to effectively treat BED.   Allow our compassionate staff to restore you or your loved one to good health and renewed quality of life.  Call us today (925) 682-8252!

Sources for this page:


Males Battle Eating Disorders, Too

The Eating Disorder Landscape is Not Only Populated by Females

While eating disorders may be more prevalent among females, plenty of males are also struggling with these dangerous disorders. In fact, the National Eating Disorders Association reports that while 20 million females are affected by eating disorders at some point in their lives, 10 million men will be as well; a statistic that is not widely known.

Among those suffering from anorexia nervosa or bulimia nervosa, approximately 25% are male. The percentage of males with binge eating disorders is higher, at 36%. The impetus behind what drives men and women to develop disordered eating habits is complex. Generally, factors that can result in an eating disorder may include biological, psychological, and interpersonal aspects.

Anorexia nervosa may result from risk factors such as childhood eating conflicts, struggles around meals, premature birth, feelings of inadequacy, and lack of control. With bulimia and binge eating disorders, a desire to live up to a media-driven portrayal of the perfect body shape and weight often drives obsessive behaviors and a preoccupation with thinness—“thin-ideal internalization.” Although the motive—attaining the “perfect” body—may be the same between the genders, there are distinct differences as to their specific concerns about their bodies.

Male vs. Female Eating Disorder Profiles

Young males are prone to the same insecurities related to their body size and shape as young women are. Males look to muscular celebrities as the ideal of manliness, just as girls seek to emulate stick thin supermodels. Beginning in 2010, men’s fashions became much more fitted, with ads featuring thin and sinewy male models plastered on billboards, magazine covers, and across social media. In recent years, an media focus on buff, pumped up male celebrities touting their six-pack abs has resulted in subconscious messaging for young men to try to attain a similar physique.

Where males may be less concerned with their weight than women, they are concerned with body image. Approximately 43% of men now report being dissatisfied with their bodies, a dramatic increase over the past few decades. Masculinity is often defined in our culture by how lean and muscular a man’s physique is. Males, therefore, may go to extremes to achieve the ideal body, turning to body building supplements, excessive exercise, steroid use, and disordered eating.

When the desire to achieve a muscular build becomes obsessive, it may lead to muscle dysmorphia. Muscle dysmorphia occurs mostly in males, thinking that their already fit bodies are still inadequate, seeing themselves as weaker and smaller than they actually are. This distorted thinking leads them to become consumed with weight lifting and hyper-vigilant about their diets to an unhealthy extent.

Social Media Fuels Eating Disorders

In the past, even just a decade ago, male teens and adults did not have the daily barrage of exposure to images of celebrities, models, and social pressures that has come with the advent of social media. Now, with men accessing multiple social media platforms on any given day, they are exposed to the hurtful comments and slurs directed towards both famous and everyday people about their looks or physiques. Again, this messaging sinks in, causing a sense of inadequacy and insecurity about their own bodies. It is as common nowadays for men to be sexually objectified as women, exacerbating the pressures they feel to fit the ideal image of what is perceived to be desirable.

Even among one’s peer group, many of those Instagram and Facebook photos have been doctored with Photoshop editing tools (even a “thinify” feature) and flattering filters, offering up a fraudulent image that subsequently becomes someone’s unattainable goal. Both females and males participate in the practice of photo editing their selfies and pics, in a quest to portray themselves in their best light, even if it isn’t authentic. So this becomes an unending dysfunctional pattern across social media, setting in motion the unrealistic images which can lead to negative self-talk, consumption of supplements or diet aids, and disordered eating habits.

Symptoms of a Male Eating Disorder

There are definite signs that point to an eating disorder. They include:

  • You exercise excessively. If you miss a workout you experience anxiety and guilt
  • You are compulsive about caloric intake, as well as sugar and fat content in foods
  • You use body building supplements or weight loss pills
  • You alternate between overeating and fasting
  • You engage in ritualistic eating behaviors, hiding food, eating alone
  • You feel depressed
  • You devote so much time to working out that you neglect family and responsibilities
  • You may experience muscle dysmorphia
  • You become isolated and withdrawn
  • You work out even with injuries

We Can Help

Because of the stigma attached to eating disorders, and combined with the erroneous notion that eating disorders are female-only issues, young men may not seek help for this serious medical condition. If you or your loved one is displaying the symptoms of an eating disorder, it is time for professional help. At Casa Serena our compassionate professionals can provide an assessment and customized treatment plan tailored just for you. Call us today (925) 682-8252!


Treating Eating Disorders with Psych Meds

Treatment for an eating disorder commonly includes a multi-disciplinary approach with the psychotherapist and psychiatrist as the primary treatment providers. In addition, a licensed dietician and a primary care physician make up the rest of the team involved in the care of the patient.   Depending on the type of eating disorder diagnosed, use of specific pharmacotherapy can also be effective.

To date, there has not been much success in treating anorexia nervosa with psychotropic drugs to cure the physical aspects of the disease. Indeed, food is still the best medicine for regaining physical wellbeing for anorectics. However, some SSRIs have shown promise in treating the underlying mental health conditions that accompany the eating disorder, once a healthy weight has been attained.

There has been much more success treating patients with psych meds who present with bulimia nervosa or a binge eating disorder. It has been found that bulimics respond well to antidepressants, even if they are not suffering from depression.

 Drug Treatment for Anorexia Nervosa

The most challenging eating disorder to treat is anorexia. Psychotherapy remains the primary tool used to stabilize and treat this eating disorder, as there are typically serious mental health issues that accompany the disordered eating. To date, there has been little evidence that medication is effective in treating anorexia, but when mood disorders such as depression or obsessive-compulsive disorder accompany the disorder, Fluoxetine (Prozac) has helped the anorectic patient manage these.

Side effects of these selective serotonin uptake inhibitors (SSRIs) are generally mild and tolerated well for most patients. Side effects can include:

  • Drowsiness
  • Decreased interest in sex
  • Nausea
  • Diarrhea
  • Weight gain
  • Agitation

If the patient does not tolerate the SSRI, then their psychiatrist may prescribe olanzapine (Zyprexa), a psychotropic drug used primarily to treat schizophrenia. In a patient who has anorexia nervosa, olanzapine can help them gain weight and modify their obsessive thinking. Side effects of olanzapine include:

  • Dizziness
  • Weakness
  • Drowsiness
  • Lightheadedness
  • Dyskinesia (movement disorder)

In addition, anti-anxiety medications can be effective in reducing the anxiety the patient may experience before eating.

Drug Treatment for Bulimia Nervosa

 Patients diagnosed with bulimia nervosa tend to respond well to fluoxetine in reducing the binge eating and purging. This is the only antidepressant that is approved by the U.S. Food and Drug Administration to treat bulimia nervosa.

In addition to fluoxetine, another group of antidepressant drugs called tricyclics (Norpramin, Tofranil, and Elavil) have been prescribed with some success. They have similar side effects as the antidepressants, but also have more risk of overdose and drug interactions.

Several placebo-controlled trials have shown topiramate (Topamax) to be effective in controlling binge and purge behaviors. Side effects include taste perversion, difficulty concentrating, and a sensation of pins and needles or skin crawling.

Studies with lithium demonstrated it is ineffective in treating bulimia.

Drug Treatment for Binge Eating Disorder

In treating binge eating disorders, the most effective drug has been topiramate , a medication usually associated with treating epileptic seizures and migraine headaches, as well as bipolar disorder. Side effects are listed above.

SSRIs (Prozac and Zoloft) and appetite suppressants (such as Meridia) have also been effective in treating the binge-eating behaviors. Appetite suppressants can help suppress hunger, which helps in weight loss, but they can have serious side effects. Common side effects of Meridia include dangerous changes in blood pressure, headache, dry mouth, and sleep disturbance.

Get Help Now

Casa Serena offers a safe and supportive environment to treat Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorders. Casa Serena incorporates yoga and mindfulness, expressive arts therapy, family education, body image support group, and many more effective program components. Our caring, professional staff can help you reclaim your power and gently guide your or your loved one to a full, healthy recovery. Call (925) 682-8252


Eating Disorders Treated with EMDR

The Treatment Benefits of Eye Movement Desensitization and Reprocessing

Behind each person’s eating disorder is a unique set of causes. There is no one single reason why an otherwise healthy individual might develop disordered eating habits. Causes range from taking extreme measures to fit in to a perceived societal ideal of physical beauty to trauma to obsessive-compulsive disorder. Often an eating disorder involves a co-occurring condition, such as a substance use disorder or mental health disorder, such as anxiety or depression. No matter the root cause of the eating disorder, treating the individual in order to attain not only a healthy weight, but also a healthy mind is the ultimate goal.

What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a therapeutic treatment technique to manage a variety of disorders, including eating disorders. It was developed in 1987 by psychologist, Francine Shapiro, when she noticed a link between eye movement and cognition, and the resulting effect it had on negative emotions.

EMDR involves a trained therapist initially working with the patient to identify memories or thoughts that are causing emotional pain and distress that may be contributing to a dangerous eating disorder. Once the source of the pain or trauma is determined, the therapist uses horizontal hand movements, sometimes in conjunction with tones played through the patient’s headphones, to provoke a series of eye movements while the patient thinks about the distressing core issue.

The goal of EMDR is to trigger the brain to replicate the process that happens during sleep, where the brain processes the day’s events through images and rapid eye movement (REM phase). The thesis of EMDR is that certain circumstances or events that were causing stress or discord often become softened over night, as the brain’s natural processes help resolve the issue. Often the next morning the troubling event or issue has lost much of its potency.

How Does EMDR Help Eating Disorders?

During the course of the EMDR therapeutic session, memories and emotions can rise to the surface. As the sessions progress, connections can be made between the emotions experienced as a result of reliving the traumatic or distressing memories, and the subsequent anxiety that is contributing to disordered eating.

Revelations that result from EMDR, such things as a controlling parent, parents getting divorced, physical or emotional abuse, or loss and grief, can aid mental health professionals in treating eating disorders by getting to the root cause. That cause becomes the target for the patient’s focus during the sessions, allowing for a change in their behavioral response to it.

Eventually, the intense reaction the patient once had to the trigger becomes less pronounced, and the patient is less motivated to engage in their disordered eating patterns. The process of EMDR, having brought about the revelation of what the underlying issue is, begins to resolve the painful memories, diminishing the patient’s need to continue anorexic or bulimic behaviors.

Help for Eating Disorders

There is help available for those suffering from a debilitating eating disorder. At Casa Serena, our supportive and compassionate professionals can help you in your process of developing life-long skills for healing. It takes courage to ask for help, and we honor that courage and believe in your ability to make positive changes in your life needed to let go of an eating disorder.  Call our Admissions Team today to learn more at (925) 682-8252.

Sources for this page: