When Weight Loss Goes Awry

At 5 feet 5 and 110 pounds, Amelia Greenberg was about as overweight as an earthworm. But last summer, as friends started dieting, she decided to lose five to 10 pounds. Within a few months Amelia, now 15, was on the death march called anorexia nervosa. Daily meals shrank down to "a grape, a mushroom and a cracker." Her weight plummeted to 84 pounds, her heart rate to a terrifying 31. In a weak but determined voice from her bed at the Children's Hospital in Denver, Amelia--a straight-A student and cheerleader--says, "I would never want this to happen to anybody else."

Unfortunately, it is. While kids on one extreme are getting bigger, others are wasting away. Statistics say that 1 percent of adolescent girls and young women suffer from anorexia nervosa and 1 to 3 percent from the purging disorder bulimia nervosa--but those numbers are conservative. They don't take into account kids with serious borderline symptoms, or the two groups that experts say appear to be growing in number: boys and children as young as 7. "We're seeing many more kids, sicker kids... and younger kids," says Dr. David Kaplan, chief of adolescent medicine at Children's.

There's no simple explanation for why intelligent, often highly accomplished kids spiral into such destructive behavior. Obsessive-compulsive disorder, depression, low self-esteem and anxiety can all play a role. And then there's the "reduce fat in your diet" drumbeat, which can haunt children who already feel pressure--from gaunt models or each other--to be thin. One 57-pound 7-year-old anorexic told her doctors her thighs were too big; if she got down to 50, she said, other kids would "like her more." A 10-year-old, who dropped 10 pounds after refusing foods with any amount of fat, got so skinny her bathing suit had to be held up by pony-tail holders. "People think of this as a teenage problem," says the child's mother, "but it's happening to little girls." Boys, striving for that lean, muscular look, are also succumbing. About 10 percent of eating-disorder cases now occur in boys and men. As with girls, says Dr. David Herzog, president of the Harvard Eating Disorders Center, "there's often that same picture of obsession and perfectionism."

The health effects can be devastating. Potentially fatal heart arrhythmia is an immediate concern, and bone loss can lead to severe osteoporosis. Bulimia, which tends to strike older teens, can damage the stomach and esophagus. With medical treatment--including psychotherapy and, in some cases, certain antidepressants--patients can make full recoveries.

But it is never easy--especially when society's perception of beauty can be so skewed. The day before Amelia checked into the hospital, deathly ill, her classmates told her, "You look so good. I wish I was as skinny as you." May their wishes never come true.

When Weight Loss Goes Awry | News