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Normal-Weight Teens can Suffer from Eating Disorders

Update Date: Aug 27, 2014 02:32 PM EDT

When it comes to eating disorders, people often picture a super skinny girl. Even though disorders such as anorexia nervosa and bulimia nervosa can make people really thin, being thin is not always a clear indicator of a disorder. According to a new study, normal weight teens can also suffer from eating disorders.

"Emaciated bodies are the typical image portrayed in the media of patients with restricting eating disorders such as anorexia nervosa," said lead researcher Melissa Whitelaw, a clinical specialist dietitian at The Royal Children's Hospital in Melbourne, Australia reported by WebMD. "This paper highlights that it is not so much about the weight but the weight loss that can lead to a serious eating disorder. The complications of malnutrition can occur at any weight."

Whitelaw and her colleagues recruited 99 teens between the ages of 12 and 19. The team diagnosed an eating disorder by using a different method known as the Eating Disorder Not Otherwise Specified (EDNOS-Wt). This diagnosis factors in typical symptoms of anorexia such as dramatic weight loss, distorted body image and fear of gaining weight with other symptoms not related to weight, such as depression and anxiety.

Overall, the researchers found that from 2005 to 2009, the rate of patients diagnosed with EDNOS-Wt increased from eight percent to 47 percent. The researchers compared the patients with EDNOS-Wt to patients diagnosed with anorexia. They found that both groups had very similar symptoms with one exception: they were all not rail-thin. When the team compared weight loss, they found that the anorexic group lost a medium of 28 pounds whereas the group with EDNOS-Wt lost a medium of 29 pounds.

The researchers also discovered that the side effects of an eating disorder were similar in both groups. 41 percent of anorexic patients and 39 percent of EDNOS-Wt patients had dangerously low levels of phosphate. 30 percent of anorexic patients and 38 percent of EDNOS-Wt patients needed to be treated with a food tube. Furthermore, the lowest pulse rates were 45 beats per minute (bpm) and 47 bpm for the anorexic group and the EDNOS-Wt group respectively.

"[Normal-weight patients with anorexia symptoms] were becoming medically unstable, despite the fact that they had what you would call a normal body weight," Whitelaw said.

Cynthia Bulik, director of the Center of Excellence for Eating Disorders at the University of North Carolina at Chapel Hill, added, "We are conditioned to think that the key feature of anorexia nervosa is low body mass index [BMI]. In fact, we miss a lot of eating disorders when focusing primarily on weight."

The researchers stressed the importance of looking for multiple signs of eating disorders as opposed to solely focusing on weight.

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