Eating disorders now rank as the number one mental health problem among American teens. Making matters worse, a new study indicates that teens involved in extreme dieting — that is, using vomiting and diet pills to lose weight — are more likely to smoke, drink, use marijuana and attempt suicide. The same study also showed that 19 percent of all teens are involved in extreme dieting and that it’s on the rise among both boys and girls.

A number of factors contribute to such eating disorders, including anger, anxiety, a need for control, low self esteem and poor body image. But much of it relates to stress and the desire to fit in. Teens today tend to be overwhelmed by the pressures of school and extracurricular activities — much more so than in previous generations. Compounding the problem are airbrushed super models, highly sexualized media and dual-career parents who are challenged to find the time they want and need with their children.

Teens often turn to extreme dieting and other eating disorders because it gives them a sense of control. Typically these teens have pent-up feelings they aren’t expressing verbally and are looking for a way to cope.

Signs that a child may have a problem include rapid weight loss, especially if her activity level has not changed, mood swings and a change in peer group. Also look for signs of depression, such as a sudden lack of interest in things she used to enjoy, changes in sleep or loss of energy.

Of course, if you notice any of these signs, it’s important to act promptly. Begin by asking your child about what’s happening at school and in his relationships and let him know you’re watching. Get others involved, too, such as the school counselor, the family physician and a trusted psychotherapist.

The key is helping children find other ways to regain control in their lives and express their emotions. Setting limits on activities, providing a space for them to connect with parents and ensuring opportunities for open communication are all important. But perhaps the most important step parents can take, both in prevention and cure, is affirming children — for both their outer and inner beauty.

As published in the March 23, 2003 Edition of the La Crosse Tribune.