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Teen Girls' Health

Slim Chances: The Risks of Being Too Thin

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By Jennifer Ashton, M.D., Ob-Gyn with Christine Larson
WebMD Feature by “The Body Scoop for Girls”

My patient Cindy had always been a star student, but when she turned thirteen, the stress of adolescence became too much for her. Her parents were splitting up, and Cindy’s mother was struggling with self-esteem issues. She constantly criticized both herself and Cindy for not looking their best. Meanwhile, Cindy was losing interest in her classes and getting in trouble at school for the first time. She felt she had no control over her life.

Cindy decided to take control by drastically restricting the amount of food she ate. From a healthy five feet four and 115 pounds, she dropped to 110, then 100, then 96 pounds. At fourteen her periods stopped. Six months later she had a seizure in history class, caused by a severe imbalance in her blood chemistry. Her doctors realized she had anorexia. She was admitted to the hospital for treatment. I started treating her a few years later, after her anorexia was largely under control and her body weight normal, thanks to lots of psychotherapy and hard work on her part. But she’ll probably struggle with her eating disorder for the rest of her life.

No one knows exactly what causes anorexia nervosa, bulimia, or other eating disorders. Genetics, stress, and social and psychological factors may all play a role. Still, lots of girls endure the divorce of their parents, struggles at school, and other forms of stress but never develop eating disorders.

What we do know is that teens with anorexia have a distorted body image. No matter how much weight they lose, they still see themselves as fat and disgusting. True, many teenagers feel frustrated and anxious about how they look sometimes, but girls with anorexia loathe their looks all the time. They literally want to make themselves disappear.

In severe anorexia the body starts to shut itself down. Periods stop or come irregularly, the body stops controlling its temperature well, and mental focus and concentration start to slip. In the worst cases girls with anorexia starve to death. In fact, anorexia has one of the highest death rates of all psychological disorders: As many as 15 percent of people with anorexia die from conditions related to the disease (including suicide).

Bulimia, another common eating disorder where girls go on eating binges then purge their food by vomiting or taking laxatives, shares some symptoms with anorexia. One thing they don’t share is significant weight loss: Bulimics often maintain a normal weight. Still, the body fails to get the nutrients it needs and may shut down certain functions.

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