Adolescents between the age of 13 and 17 are particularly at risk for developing diseases such as anorexia nervosa, bulimia nervosa or binge eating disorder (BED), though in certain cases younger adolescents may develop disordered eating patterns as well. With each of these disorders, food is being used in an unhealthy manner to cope with painful emotions or challenging life situations.
Why do teenage girls develop eating disorders?
Eating disorders are rarely the result of one isolated event or situation. However, certain factors can contribute to the onset of anorexia, bulimia or BED in adolescent girls. These include:
Trauma — Trauma can occur in one significant event or repeatedly over a period of years. Sexual violation, the death of a loved one, physical abuse, parental divorce, emotional neglect or abuse, or even relocating to a new school district, can trigger and perpetuate an eating disorder.
Influence of American Media — The American culture is obsessed with thinness. This fanaticism is reflected in the media, including television, movies, magazines, billboards, etc. The subtle, yet pervasive, message is to be beautiful and popular you must be thin.
Bullying –This type of mean-spirited behavior is not new; however, what is new is the severity and horrific methods by which bullying is conducted these days. The advent of social media has taken bullying to a whole new level. The emotional pain and torment inflicted on young girls through such forums as Facebook and Instagram has resulted in widespread body dissatisfaction, lower self-esteem, problems with depression and more. These psychiatric conditions represent the ideal environment for an eating disorder to take hold.
Perfectionism — Many young girls are driven by perfectionism. They feel the need to be the perfect student, athlete or daughter. To be perfect, she must be thin. Unfortunately, many teens erroneously believe the thinner, the better.
Peer-Pressure — Most young people today perceive fat as a four-letter word. In an attempt to be popular, girls may feel the pressure to lose significant weight.
Athletic Achievement — Certain competitive sports may lead to the development of an eating disorder. This is especially true in judged sports such as gymnastics or ballet where participation is dependent on a specific body type or “look”. Advent of Puberty – This is a time of vast change for a young girl, physically, mentally and emotionally. She may develop an unhealthy relationship with food as a method to cope with such enormous change in her life.
Eating Disorder Treatment for Adolescent Girls
Anorexia, bulimia and BED manifest in different ways. Anorexia is defined by restrictive eating or starvation; bulimia is characterized by bingeing and purging, while BED is confined to bingeing. What these disorders share in common is food and the desire to have it do what it was never intended to do. Basically, food has two real functions: to provide nourishment and an element of enjoyment. When an eating disorder enters the equation, a teenage girl is now using food, or the refusal of food, not for nutrition or pleasure, but as a tool to right the emotional wrongs in her life. In effect, an eating disorder is a set of external behaviors designed to address internal strife.
At Timberline Knolls, we recognize there is no eating disorder blueprint; there is no cookie-cutter anorexic, bulimic or binge eater. That is why our program does not treat the disorder, we treat the individual; because every single adolescent that comes to us for care has her own experiences, unique personality, family history, personal goals, etc. She also has her own reasons for why an eating disorder entered her life. If we only addressed the behaviors–the restricting, the bingeing and purging, or the compulsive overeating — we would do her a disservice, because she would not get well; she would not have the opportunity to experience the abundant life that only recovery from an eating disorder can offer.
Why is eating disorder treatment at Timberline Knolls so successful?
Importantly, we treat all co-occurring disorders simultaneously. Our clinical staff is highly skilled at treating a wide range of addictions and disorders including:
- substance abuse and addiction
- mood and anxiety disorders
- trauma and post-traumatic-stress-disorder (PTSD)
- self-injury and other process addictions
The ability to treat co-occurring disorders is essential because nearly all of our residents admit with more than one diagnosis. Perhaps an adolescent has anorexia and severe anxiety; or another has BED and an addiction to alcohol. We treat all disorders and addictions concurrently, knowing this approach offers teenage girls the best chance for complete and sustained recovery.
This is one of the many benefits of residential treatment for eating disorders. There are times when a young girl may admit with a primary diagnosis of extreme depression or debilitating anxiety. During the intake process, or perhaps through psychological assessments, it becomes clear to our clinical staff that in addition to depression or anxiety, she is practicing eating disorder behaviors. Addressing this co-occurring disorder becomes an integral component of her treatment plan.
Possibly the most important aspect of residential treatment is time. Having an adolescent under our 24/7 care for a longer period than in an inpatient stay, gives our clinicians the time required to help her understand the many aspects of her disorder and take meaningful steps toward recovery. Similarly, the teen has the time she needs to restore a healthy body weight, to learn new coping skills and reconnect with her true identity. While at Timberline Knolls, she can fully focus on getting well, free from the distractions of everyday life, including friends, activities, and especially, her cell phone. The fact that Timberline Knolls is a female-only program is highly beneficial. In a sex-integrated environment, teenagers behave, talk and act differently.
Therapy at Timberline Knolls Residential Treatment Center is comprehensive, meaning we use every possible therapeutic approach to help our residents. The core curriculum includes individual sessions with a primary therapist, individual and group nutrition sessions, process and trauma groups, psycho-educational groups that address such topics as body image and stages of recovery, as well as a host of expressive therapy groups. These include art therapy, dance/movement therapy and yoga. The first two are required, while the last two are optional.
Our treatment approach incorporates a blend of the principles of recovery found in the 12 step program in tandem with the tools inherent to Dialectical Behavior Therapy (DBT). Our staff is trained in DBT; this means everyone on campus can help young residents learn and practice their new coping skills in all settings.
While in treatment, adolescents live in their own lodge, with others age 12 to 18. This lodge has its own dedicated treatment team of nurses, primary and family therapists, dietitians, internal medicine doctor and psychiatrist. This ensures that each teenage girl receives the individualized and age-appropriate care she needs.
During the school year, young residents attend TK Academy, which is located right on campus. The school is staffed by nine educators and a principal. Girls attend classes each morning, allowing them to learn in a safe and supportive environment. Our teachers work with each student’s home school to coordinate approved curriculum.
After years of treating eating disorders, we know that the individual who comes to Timberline Knolls is not the only one damaged by the disorder. All family members have been impacted, often in different ways. Parents are understandably frustrated and frightened, frequently at the end of their collective rope; while siblings have their own set of issues; often the children who are “not sick,” feel lonely, abandoned, or less important. They also need and deserve our help.
This is why our treatment includes family therapy. Throughout treatment, our family therapists interact with the family members, focusing on such topics as communication, conflict resolution, anger management and broken relationships. Our director of family therapy facilitates a weekly multi-family group to provide information and support to loved ones. Our eating disorder specialists also conduct family meal support training sessions, either in-person or via conference call.
What are the physical and medical consequences of teen eating disorders?
At the most basic level, an eating disorder is a form of self-abuse. As such, it will result in short and long-term medical and physical consequences. These differ according to the type of disordered behaviors the teenager embraces. However, it is critical to remember that, with early intervention, most of these negative health consequences can be avoided or negated. The longer anyone engages in eating-disorder behaviors, the higher the risk of permanent damage and/or death.
Anorexia is synonymous with self-starvation. A girl with anorexia restricts food intake to the degree that her body is not able to maintain its weight. Girls with the illness tend to weigh at least 15% below what would be considered normal body weight. Because the body, especially one that is developing, needs food to function, starving takes a significant toll on an adolescent’s health.
The short and long-term consequences of anorexia include:
- Anemia — This blood condition is common in anorexia, a result of poor nutrition, especially the lack of iron in the diet. Blood health returns once adequate nourishment is reintroduced.
- Dry Skin and Hair Loss — Dehydration causes the skin to dry out and become flaky. The teen’s scalp, starved for protein and nutrients, often becomes bald or patchy.
- Feeling Cold — Without protective fat stores to keep her warm, a girl with anorexia is usually cold and often has bluish fingertips. Her body temperature is rarely at a healthy 98 degrees.
- Slowness of Thought — The brain needs fuel to function. When deprived of needed calories, there is a commensurate retardation of the thought process. This is referred to as psycho-motor delay.
- Amenorrhea — If an adolescent engages in anorexia long enough, her menstrual cycle will discontinue. Her body shuts down its reproductive capacity, recognizing it could not possibly support another life.
- Infertility — Depriving the body of nutrition during the critical adolescent years can result in permanent infertility. Although menstruation often recommences once sufficient weight is gained, the ability to reproduce is not guaranteed.
- Heart Rhythm Abnormalities/Heart Attacks — Electrolyte abnormalities often trigger arrhythmias in the heart, signifying that this organ is undergoing stress. When a body is starving, it starts digesting its own muscle tissue in an effort to maintain life. The heart is highly vulnerable. In the case of extreme starvation, the heart simply stops functioning.
- Brain Shrinkage — Prolonged starvation can result in literal brain shrinkage. Additionally, studies indicate a girl can experience an actual drop in IQ and a decrease in higher level cognitive functioning.
- Osteopenia/Osteoporosis — These degenerative bone conditions result from lack of calcium and other dietary deficiencies. Bone loss is permanent if the anorexia goes on into adulthood without remission, leaving young women at severe risk of bone fractures and spinal curvature.
Girls with bulimia binge on large quantities of food, then purge. Both of these behaviors are extremely hard on the human body, since it was never meant to consume the volume of food associated with a binge or experience repeated acts of self-induced vomiting. Additionally, laxative abuse and excessive exercise often occur.
The short and long-term consequences of bulimia include:
- Injury to the teeth — Excessive vomiting increases the acidity of the mouth. This results in erosion of tooth enamel and dentin.
- Injury to the esophagus — Repeated vomiting causes acid and bile from the stomach to irritate and inflame the lining of the esophagus causing a condition known as esophagitis. Scarring may cause this passageway to become so narrow that food cannot go through. Vomiting can also cause tears in the lining of the esophagus, which could cause a life-threatening rupture.
- Severe kidney and heart complications — Fasting, vomiting and other forms of purging result in loss of fluid and crucial minerals from the body. Chronic dehydration and low potassium levels can lead to kidney failure. Frequent vomiting results in high alkali levels in the blood and body tissues. Severe alkalosis and potassium deficiency can lead to an irregular heart rate or sudden death.
- Injury to the stomach and intestines –Binge eating and frequent vomiting commonly causes gastritis, an inflammation of the stomach lining. Laxative abuse alters the body’s mineral balance, leads to dehydration, damages the lining of the digestive tract, and can burn out the colon. This damage often causes extreme constipation; in severe cases, the colon must be removed.
Binge Eating Disorder (BED)
BED is similar to bulimia in the food consumption aspect. Adolescents with BED eat inordinate amounts of food. But, unlike bulimia, they do not purge. This will result in weight gain, and if the behavior is prolonged, obesity.
The long-term consequences of BED include:
- High blood pressure
- High cholesterol levels
- Type II Diabetes
- Gallbladder disease
If your daughter or loved one has an eating disorder, please consult a professional for help. Our licensed counselors are always available for a free, confidential assessment.