For many of us, eating is one of life’s simple pleasures. We often celebrate with food. In our hectic lives, we may use mealtimes to reconnect and talk. For most people, the consumption of food is not only a necessity of life, but also an enjoyable part of our daily lives.

For some, however, food represents an obsession, a manifestation of the fear of being fat. As adolescents develop and mature physically through puberty, their height and weight increase. Some adolescents mistake this natural process for unwanted weight gain. Those who react to this shift in body mass by severely limiting their food intake may have anorexia nervosa.

Sometimes referred to as the starvation sickness or the dieter’s disease, anorexia nervosa is a life-threatening, emotional disorder resulting in a distorted body image – even though anorexics may appear to everyone else as skeletal, the image of themselves they see reflected in the mirror is grossly overweight. In order to be diagnosed as anorexic, an individual must weight less than 85% of his or her expected height-weight ratio along with exhibiting an excessive or obsessive fear of gaining weight and a distorted body image. Diagnosis in females also includes amenorrhea – the absence of a monthly menstrual cycle.

Anorexia is diagnosed in about 1% of the adolescent female population and typically affects girls and young adult women between the ages of 12 and 18; however, cases involving males have been cited. Males who are athletes in sports where weight is a factor in performance, like wrestlers, dancers, or body builders, are more likely to develop the disorder. Anorexia is more common among Caucasian adolescent females than African Americans, most likely due to body type preferences which differ among ethnic groups. According to researchers, teenage Caucasian girls who have perfectionistic tendencies and controlling, overly protective parents are at the highest risk for developing the disorder.

Anorexia often begins as an innocent diet to shed a few pounds. Skipping desserts and snacks quickly shifts bypassing meals altogether or while seated at the table, pushing food around on the plate in order to give the appearance of eating. Although she may not be partaking in food, thoughts of food preoccupy many anorexics to the point of assuming kitchen chores, preparing meals for others, baking treats for friends, or collecting recipes. Eventually, many anorexics report feeling no hunger, but persist in their preoccupation with and guilt surrounding food.

There are many health issues that are associated with anorexia: slow heartbeat, low blood pressure, cardiac arrest, dehydration, electrolyte imbalances, and constipation. Because they have little to no body fat, anorexics are often cold and typically overdress, even in warm weather. In an attempt to maintain body heat, an anorexic’s body will eventual grow a fine silky covering of hair. In later stages of the condition, the kidneys may malfunction due to a potassium deficiency along with impaired mental performance/perception related to malnutrition.

If your daughter loses five or ten pounds and seems to be eating a healthy diet, you probably shouldn’t worry. However, if she has recently become secretive about her eating or obsessive in talking about food, if she expresses pervasive guilt about eating, or loses more than 10% of her body weight, seek advice from a professional. Anorexia is a complicated disorder. Its treatment should address both the physical symptoms and emotional causes. Medical treatment addresses the physiological functioning of the anorexic and attempts to bring her weight back to a more acceptable range. Behavioral therapy attempts to modify behaviors associated with eating and weight gain. Family therapy is often employed as well in an attempt to identify the root issues of the disorder and improve familial functioning associated with the anorexic’s emotional conflicts.