Eating Disorders

About half a percent of 15-19-year-olds have anorexia nervosa. Bulimia nervosa, it’s around 1-5%. But if you do surveys of self-induced vomiting in women, between 10 and 15% of women, depending on the sample, have had self-induced vomiting. Wrestlers, if you ask them – male wrestlers, not female wrestlers – you will find that a fair number of them will have self-induced vomiting to make weight. They’ve gotten around that by making the wrestlers weight mid-season and then right at competition. If there’s too much of a change in weight they won’t allow them to compete.

So anorexia. That’s refusal to maintain body weight over minimal weight for age and height; 15% below expected, or failure to make expected weight gain during a period of growth leading to body weight below 15%. But that’s complicated. I’ll show you in a minute. Intense fear of gaining weight. You’ve all dealt with anorexics. They are horrified of gaining weight, well most of us are too, but … the thing that you need to realize is that with young women in puberty and men in puberty, the two largest increasing groups of eating disorders are people of minority status and males. You see here, here’s the normal growth. Remember the familiar … you can see normal height up here, and this is what the expected weight increase should be. She goes up here and she maintains weight, so if you just went by maintaining stable weight you’d say she’s doing fine. But if you compare what her weight is to what it should be, she’s losing ground and at this point she becomes about 84% of ideal body weight. Body weight and shape are disturbed. You look in a mirror and your hips are too big. You can see your ileac crest and that’s considered to be fat because it’s something that pokes out. There is usually amenorrhea.

Two types of anorectics; those that restrict, which means that during anorexia nervosa they don’t binge or purge. One of the problems in looking at weight loss for teenagers is you are using the growth chart. You cannot use a growth chart. I’ve included in here the weight in kilograms for a 17-year-old.

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