DEAR MAYO CLINIC: My 15-year-old daughter, who is overweight, wants to lose weight badly. She has recently lost about 20 pounds, but I'm becoming worried about how she's doing it. She often skips meals, and she exercises for several hours every day. I want to support her in her effort to lose weight, but should I intervene and encourage her to do it in a healthier way?
ANSWER: You are wise be concerned about your daughter's weight-loss methods. Getting to and staying at a healthy weight is important. But her current habits may not be good for her in the long run, and they could be symptoms of another serious medical problem: an eating disorder.
The key, though, is to confirm that the choices your daughter makes as she loses weight truly are healthy. Just because she's losing weight does not necessarily mean she's getting healthier. In some cases, the weight loss could point to an eating disorder. It's important to note that among teens who are overweight and then lose weight, eating disorders often go undetected in the early stages. This group also tends to have more medical complications due to eating disorders than teens in a normal weight range.
More than 55 percent of high school girls and 30 percent of high school boys engage in unhealthy eating behaviors to lose weight, including fasting, taking diet pills, vomiting and using laxatives. About 6 percent of teens develop an eating disorder, such as anorexia nervosa or bulimia nervosa. Teens with a history of being overweight or obese represent a substantial portion of individuals who require medical care due to an eating disorder.
An eating disorder can cause significant medical and psychological problems, no matter what a person's weight when the disorder begins. These may include lack of menstruation, bone loss, digestive problems, kidney damage, heart problems, depression and suicidal thoughts or behaviors, among others. It's critical that eating disorders be identified and treated as soon as possible. Research shows that the longer an eating disorder continues, the harder it may be to successfully treat it. If it is caught early, however, teens often can make a full recovery.
As you decide whether to intervene with your daughter, it may be useful to keep in mind that significant weight loss is not easy for anyone to achieve. It's particularly uncommon and difficult for teens whose bodies are still developing and growing. Any considerable weight loss in a teen needs attention.
I would encourage you to talk with your daughter about her eating and exercise habits. Make an appointment for her to see her health care provider, as well. At the appointment, the provider should review your daughter's medical history, discuss her recent weight loss and screen her for an eating disorder. If there is evidence of an eating disorder, treatment should be started right away. If not, her health care provider can give your daughter ideas for maintaining a healthy weight in a way that nurtures her body. -- Leslie Sim, Ph.D., Child and Adolescent Psychology, Mayo Clinic, Rochester, Minn.
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