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Eating disorders in Colorado teens, young adults rose during pandemic
Gazette - 10/5/2022
Oct. 4—As the pandemic enveloped the globe in 2020, Emma Warford used her newly acquired free time to laser in on a destructive hobby — scrutinizing her caloric intake.
Over the course of the next year that obsession, coupled with stressful activities, such as taking advanced placement and college classes, having a job and extracurricular hobbies, landed her in the pediatrician's office. She was deemed severely underweight, diagnosed with anorexia and placed in outpatient treatment, where she saw a dietician and therapist weekly.
Several factors coalesced to create a perfect disordered eating storm.
"Being at home and also I am definitely a perfectionist," said Warford, 17, who attends Rock Canyon High School in Highlands Ranch. "I have OCD (obsessive compulsive disorder) that contributes a little bit. I've never had coping skills. I was never taught how to prioritize mental health."
Warford wasn't the only one. The pandemic, with its double whammy of isolation and fear of getting sick, changed the way many people related to their bodies and contributed to a rise in eating disorders for kids and young adults. According to a recent study, in 2020 those disorders increased by 15.3% in children and adults 30 and younger. It's a serious statistic about an issue more dangerous than many might believe.
Even if someone isn't losing a massive amount of weight, the consequences can be harsh. Depriving the body of nutrition can cause a wealth of physical problems, such as impaired memory, the ability to learn and even death. Malnourishment can lead to increased rigid and obsessive thinking. And this, added to a potentially fraught time of life, when teens and younger people are already perseverating on their bodies and image, can be detrimental.
"People think we die more by depression," said Jenna Glover, child psychologist and director of psychology training at Children's Hospital Colorado, "but because of the complications that come with an eating disorder, like cardiac arrest, malnutrition and death by suicide, it's a very serious disorder."
About eight months into the pandemic 17-year-old Colorado Springs student Shelten stopped playing football due to fears of getting COVID-19. After he stepped away, his mind began to play tricks on him and lured him into a tricky relationship with food.
"I worried I wouldn't stay fit physically and mentally," he said. "I thought if I changed the way I ate it would do that, but it didn't help. It made it worse. I just ate things that didn't have a lot of calories or small portions."
People restrict their eating for a few reasons, Glover said. In Western culture, with its emphasis on beauty ideals — muscular men and thin women — body image is a looming factor. Social media hasn't necessarily made it worse, she said, but it has provided more opportunities for comparison.
An eating disorder also can grow out of trauma. Restricting what someone eats can give a sense of control or help change their body in such a way that others won't be interested in it. There's also orthorexia, an obsession with healthy living.
"We talk about being on the paleo diet," Glover used as an example about the diet that promotes eating the same foods eaten by humans during the Paleolithic era. "We elevate what wellness looks like and take it to the extreme. It can become an obsession, when it's not healthy anymore and it's the extreme."
After being diagnosed, Warford's health continued to decline. After an EKG revealed her heart rate was plummeting last year, she was rushed to the hospital where she stayed for a few weeks until she got medically stable. She went home, but wound up requiring residential care. A facility in Washington took her in when the waiting list for such a place in Colorado was too long. Warford spent four months recovering before coming home and resuming her junior year.
"I'm doing well," she said. "Physically I'm 100% better. There are still some mental aspects I'm working on because the physical comes first. I still see a therapist and dietitian occasionally. A lot of it I do by myself, navigating and trying new things, like being more comfortable around food and accepting myself as I come."
After being admitted to the hospital on Christmas two years ago, Shelten, who also learned he had OCD after getting sick, spent the next five months in recovery, four of which were at an eating disorders center. After returning home in the summer of 2021, he's faring well, spending time at football practice and working two jobs.
"I'm doing amazing," he said. "I still have some problems with my emotions, but I'm getting helped by doctors. I have medicine to help with that."
Warford and Shelten are lucky. In the majority of cases, it takes an average of seven years from when a child develops an eating disorder until they're diagnosed, Glover said. It can live under the surface for a long time before anybody else notices.
The good news is recovery is possible. If it's caught early in teens, they can be treated on an outpatient basis. Others, who have lived with disordered eating for a long time and are malnourished, might need intensive programming and possibly residential treatment.
"You can't just refeed someone immediately. It will cause damage," Glover said. "After a course of treatment it's a lifelong maintenance of recovery for some, but they can recover and live their lives without an obsession of food and body image."
While there might be a few kids who tell their parents they're struggling with disordered eating, they're the exception. Kids either refuse to believe they have an issue or they use it as a coping strategy, Glover said.
"It makes them feel better temporarily," she said. "Or they know it's a problem, but they don't want anyone to take it away from them. They're highly secretive about it — this is helping me and I don't want to change it or I'm highly ashamed and I don't want anyone to know."
Signs to watch for include significant changes in eating habits; suddenly caring about calories; refusing certain foods or eating at a restaurant if they don't know the calorie count; sudden interest in grocery store outings or what the family is eating; excessive amounts of time looking in the mirror or their phone; checking body parts, such as wrist size; negative comments about their body; over-exercising; and withdrawing from mealtimes or in general.
"One thing wouldn't be concerning, but multiple things warrant a conversation with your child and pediatrician," Glover said. "If a parent suspects or has a child who is diagnosed and suffering with an eating disorder, they should also get their own support. This is a chronic medical condition, the same as if a kid had cancer."
Warford did try to tell her mom a few times something was wrong, but it took a while to register.
"I had no idea. An eating disorder is hard," said Chris Hendrickson, Warford's mother. "How can you not eat? ... You want to say just eat, what's the problem? But you're not addressing what's going on in their head. Something is going on that is so strong and turning off their eating cues."
Though the increase in eating disorders is holding steady, doctors are still seeing more mental health problems in kids and young adults.
"They've lost time with friends and learning opportunities," Glover said. "There's more stress to get back into everyday life. If chronic stressors exist for a long time, it takes a long time for kids to get back to normal, even though their daily schedule looks like normal."
She advises parents to develop healthy language and habits around food, such as talking about food in a nonjudgmental way.
So often in society foods are deemed good or bad, or people make comments like, "I was bad today so I can't eat dinner tonight."
"We don't want to model that for our children," she said. "Food is medicine for bodies and energy. There is no good or bad food. It's just food. And don't make negative comments about your body. Talk about your body in a way that is neutral and positive: I love my legs, they take me everywhere."
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