Teens Who Overcome Obesity Likelier To Develop Eating Disorders

A new study from Pediatrics (via USA Today) shows that obese teens who lose the excess weight are significantly likelier to develop eating disorders later in life. That's no surprise — losing weight is tough, and the lines between dieting and disordered eating can easily become blurry.

But unlike adolescents who start off at a more normal size and then lose weight, formerly obese teens are much less likely to receive medical treatment, even for severe eating disorders. The study suggests that doctors applaud weight loss in obese patients where it would otherwise be a cause for concern, resulting in eating disorders going untreated for years. Psychiatrist Jennifer Hagman explains that it's a "new, high-risk population that is under-recognized" among medical professionals: "They come in with the same fear of fat, drive for thinness, and excessive exercise drive as kids who would typically have met an anorexia nervosa diagnosis. But because they are at or a even a little bit above their normal body weight, no one thinks about that."

The findings looked at two case studies of teens who had lost a dramatic amount of weight and developed eating disorders, showing clear physical symptoms of anorexia, from stress fractures to dizziness to hair loss, as well as psychological ones: "Fear of fat, drive for thinness, and excessive exercise drive," says Hagman. "But because they are at or a even a little bit above their normal body weight, no one thinks about [anorexia]." Those teens were diagnosed with rarer diseases, with doctors ignoring the obvious possibility that those patients instead could have eating disorders because of their weight histories. 

Leslie Slim, the clinical director of the eating disorders program at the Mayo Clinic, says that "when a child is obese and starts to lose weight, we think it's a really great thing and we applaud it and reinforce it and say it's so wonderful and now you're healthy," says Sim. But if that weight loss becomes problematic, those patients "are just not being identified because of their weight history."

Recent statistics show that 6% of youths suffer from eating disorders, which have the highest mortality rate of any mental illness; meanwhile, 55% of high school girls and 30% of boys reported "disordered eating symptoms" in 2011 — a scary figure.