Digestive Health

04 May 2012

Eating disorders FAQ

It’s a balancing trick: the signs that every mother of a pre-teen girl should watch for and how to not become paranoid about eating disorders.

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Is this an eating disorder?

After several decades of information and research on eating disorders, it feels like we should know enough to recognise the symptoms and manage the issues by now.  But the spectres of bulimia and anorexia come back to haunt every new generation of teens – the Eating Disorders Expert tackles two key questions:

Q: Should I worry about my 13-year-old?
My step daughter is aged 13 and in grade 8 this year. She has "suddenly" stopped taking food to school, she doesn’t eat anything in the morning - not even coffee - BUT at least she eats at night.

However, the portions at night are extremely small. She is eating out of a baby plate and she'll dish up meat and veggies, but no potato, rice, mash etc. She is not overweight or underweight, she's very nicely built though very small. To me she's 100% right in weight – it’s just the portions that worry me.

Her brother has noticed and started teasing her.  Last night he dished up for her (as a joke) and put 1 single piece of macaroni which upset her immensely. I then told him to STOP this immediately and thatI never want to see or hear him making jokes or commenting on her portions as it will only make things worse.

Am I over-reacting? Should I talk to her or just leave it? How do I raise the issue without making it worse?

Expert: You should certainly sit up and take notice of the message your step-daughter is putting out here. It’s obvious that she has suddenly become extremely restrictive in her eating and trying desperately to lose weight. She is also making it very visible, unlike many early sufferers who are secretive and manipulative in their restrictive eating.

I suggest that you and your husband sit down with her (not during a meal time) and confront her with your concern about the inadequate diet she is following. Her troubles could be about anything, so listen to her. However, it is urgently required that she resume normal eating before she becomes underweight. A dietician should be able to advise you and your step-daughter on some healthy changes that are required. Do not ignore these dangerous signs.

Q: Dangerous use of laxatives
Please, I would like to know:  when does laxative abuse become dangerous? What can I do to stop? This is my third time down this road, but it was different before when I used them for a much shorter time and my body was able to bounce back quickly. This time I’ve used higher doses for a much longer period, and now I don’t know how to stop. I really need some advice, PLEASE.

Expert: You should never be taking laxatives for the purpose of losing weight. In fact, I do not condone the use of any medication or substance for the purpose of losing weight, as we ultimately need to be able to listen to our appetite and practice moderate and healthy eating habits. Laxatives should, in my opinion, only be prescribed by knowledgeable medical professionals, as most laxative use is unnecessary.

Furthermore, laxative abuse is extremely dangerous. Your body becomes dehydrated and depleted of essential minerals (sodium and potassium), which make up the "battery fluid" that keeps the pump of the heart working. Excessive laxative abuse can cause a heart attack. I suggest you consult a registered dietician for guidance. If you have an eating disorder, then some therapy might also be helpful.

Send your questions about eating disorders and obesity to the Expert.

See the Weight Loss centre for healthy eating options and balanced weight-loss plans.

(Joanne Hart, Health24, January 2012)

 

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Digestive Health Expert

Dr. Estelle Wilken is a Senior Specialist in Internal Medicine and Gastroenterology at Tygerberg Hospital. She obtained her MBChB in 1976, her MMed (Int) in 1991 and her gastroenterology registration in 1995.

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