Teen Eating Problems: A Live Chat with Kelly Brownell, PhD, Director of the Yale Center for Eating Disorders

Keeping the relationship your kids have with food healthy

WebMD Weight Loss Clinic - Live Events Transcript
Event Date: March 20, 2003

How can you keep your child from establishing an unhealthy relationship with food? And what are the best ways to avoid conditions like anorexia, bulimia, and compulsive eating? The Director of the Yale Center for Eating Disorders, Kelly Brownell, PhD, joined us to talk about it.

The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Member: How do you deal with a teen who wants to eat vegetarian?

Brownell: There is nothing wrong being vegetarian. A vegetarian must be very careful about eating a balanced diet, but it can certainly be done. If being vegetarian is a means of restricting intake, and may be signs of an eating disorder, then perhaps some professional help might be in order. So, the motivation of being vegetarian really is the key here.

Moderator: What are the signs of an eating disorder in teens?

Brownell: There are different eating disorders. It would probably take me too long to list the diagnostic criteria here, but there are some excellent web sites. One excellent site is nationaleatingdisorders.org. I must add, however, that a person may not meet a strict diagnosis, but still have problems that should be addressed. If a person has his or her behavior or his or her psychological well-being affected by desires to be thin and to restrict eating it makes sense to get professional help. The web site I mentioned is a very good place to start, to find both information on what an eating disorder looks like, and what might be done about it.

Member: Do eating disorders only affect teen girls or can boys get them, too?

Brownell: More and more we realize that boys can have eating disorders much the same as girls. In clinics like ours we will see eight or nine female clients to every male we see. This does not mean, though, that males do not get eating disorders. It is generally the case that males are less likely to seek help for problems of any kind, plus most media attention is on eating disorders in females. Thus, males may be unaware that their problem is an eating disorder or may be reluctant to speak about it. In our clinic and others, a good success has been found with males we encounter. Therefore, I encourage any males with such problems to learn more about eating disorders and if needed, to get professional help.

Member: I am a school nurse dealing with about three cases of anorexia, one bad enough to be sent to a hospital. She is returning next week. The kids have asked what to serve if they have a birthday party or special class event; the same thing they are having or make accommodations?

Brownell: There is no reason to treat this young woman differently than any other child. If her friends and the adults around her begin treating her as if she is her disorder, she loses her individuality and identity. In addition, there is not much that outside folks can do that would make the disorder worse or much better, other than to be generally supportive.

With that said, anorexia is a very serious disease. This is especially true for a person who has required time in the hospital. It is essential that follow-up care be provided, but I suspect the hospital program arranged this for the girl.

It can be helpful to watch for signs that the eating disorder is not over, or emerges at a later point. It is perfectly reasonable to keep parents informed about what you observe as a health professional.

Member: How can I as a school nurse encourage those girls that need to maintain a more healthy body weight achieve that without giving them notions that they are "fat"?

Brownell: You raise a very good point. In a high school or middle school, health professionals face this fine line where you want to encourage healthy eating but not exert undue pressure for people to be thin. We typically recommend that for the general student, eating and physical activity placed in the context of improving energy, vigor, and overall well-being and confidence, not weight loss.

For students who appear to be developing eating problems, it is important that they get help. Eating disorders can be serious, and can grow worse with time, so students and parents should be encouraged to pay attention. Particularly for the students who have anorexia, denial is strong. Students may ask you to keep their problems in confidence, but if you suspect that a student truly has an eating disorder, it is important to tell the parents, and perhaps to work with them in getting help for their child.

Member: Wrestling season just ended. I was appalled at the things the boys at our high school went through to make weight, whether they needed to go up or down. Isn't this harmful? Can't this lead to eating disorders?

Brownell: This is an interesting question. My colleagues and I have studied this issue, and typically find that the disturbing behavior that is promoted by the sport of wrestling tends not to be carried on beyond the wrestling season. Stated another way, boys appear to be drawn to wrestling for athletic reasons rather than as a means of dieting in a socially acceptable way.