Overweight Teens with Eating Disorders Overlooked by Doctors

A new study, released today, suggests that teens who are obese or severely overweight are at serious risk of developing an eating disorder as they lose weight. The research shows that it can even take up to an extra year to diagnose their eating disorders because their weight masks the disorder.

The report, authored by Leslie Simm, the clinical director of the eating disorders program at the Mayo Clinic, reviews two cases where teens with a history of obesity developed a pattern of restrictive eating following their weight loss. Amazingly, the researchers noticed that eating disorders could go unchecked for as long as two years, even though the patients were receiving regular medical check-ups.

Their eating disorder is known as “restrictive eating” or “anorexia nervosa”: when dieting they restrict what they eat too much when they’re losing weight, and have the classic anorexia symptoms, such as a serious fear of weight gain, without immediately appearing unhealthily thin.

The symptoms of these eating disorders are very worrying – and the list is long. Their symptoms included: a serious fear of weight gain, restrictive eating, stress fractures, concentration problems, irritability, bloating, chest pains, menstrual problems and hair loss.

The two patients, a 14 year old boy and an 18 year old girl, did not appear to do anything rash when they were dieting. They were sensibly eating less than 1,500 calories a day and exercising, and the researchers say that they did not binge or make themselves sick, but this did not stop them from developing a mental illness.

In fact, Kristen, the female patient, had even been taken to her doctor by her mother, and they were assured that she was still healthy since her body mass index was “appropriate”. Evidently, this was not the case as she was later diagnosed with anorexia which she had had for a long time.

“These case studies really represent a phenomenon we're seeing in our clinic more and more," study author Leslie Simm, told HuffPost. Not identifying the eating disorders early can be a real issue for the patients, as the best prognosis for recovery is to catch the disorder early. The patients have most of the symptoms of anorexia, but since they do not have the usual very thin appearance, doctors have not been diagnosing the illness early enough. This has raised questions about the formal criteria used to diagnose eating disorders, according to HuffPost.

It's a "new, high-risk population that is under-recognized," says Jennifer Hagman, medical director of the eating disorders program at Children's Hospital Colorado. Hagman was not involved in the report.

In fact, it seems that this is the group that doctors should be actively focussing on when they are looking for eating disorders, as Simm suggests that the number 1 risk factor for developing an eating disorder is trying to lose weight.