Expert: Ginger M. - 10/1/2008

Question
Hi. I am a 15 year old male who is 6"2' and 130 Pounds. I am worried that I might be anorexic. About a month ago I started to feel very weak and tired. I eat food, just probably not enough. I don't usually eat my lunch at school, and if I do, I feel sick after. I am very consious about my body and I would hate to become fat.. In the last week or two, I am beginning to become more and more tired and nauseated. I forget alot of the things I learn in school and have been getting behind in all of my subjects. All of my friends say that I am way to skinny but I don't know. I can see my hip bones and my ribs without sucking in and my legs and arms are pretty thin too. I get weird random bruises on my arms and along my spine for no reason. My stomach is bacially always sore and I sometimes vomit at school or at home. I also get lightheaded very easily. I am very worried that I am anorexic but I don't know what to do. What would you suggest? Thanks so much..

Answer
Hi There,

Thanks for your question, and I'm sorry you are going through stress about this. I'll try and answer as best as I can, and give you some information.

Doctors and nutritionists generally use the Body Mass Index (BMI) to calculate the best weight for your height. A BMI of over 25 is considered overweight, and a BMI of under 18.5 is considered underweight. If you are under- or overweight, you are at an increased risk for all kinds of health problems. At 6'2" and 130 pounds, your BMI is 16.7, which is severely underweight. There could be all kinds of reasons for this apart from an eating disorder like anorexia (thyroid problem, etc.), so my big question is, how do you feel about your size? You say you would hate to become fat- do you recognize that you are absolutely not fat right now? What is your normal food intake in the run of a day?

To be diagnosed as anorexic, a person must be more than just underweight. Eating disorders are a mental illness and a person diagnosed with them must have a number of symptoms. The DSM-IV is the manual used by doctors to diagnose mental illnesses- it has the criteria that a person must have in order to be diagnosed. Here's what the DSM-IV says for anorexia (at the bottom, you can click to see the criteria for bulimia and eating disorder-not-otherwise-specified):

http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry/eat...

You can see that most of the criteria are psychological, and because you are lightheaded and tired doesn't mean you are anorexic ...but if you are feeling this way because you are consistently refusing/unable to take in enough food, then it could be. All the things you describe- feeling weak, tired and lightheaded, sore tummy, memory problems at school, random bruises, etc. - are all symptoms of malnourishment or undernourishment. When you vomit at home and school, are you doing it on purpose to try and lose weight or avoid gaining weight, or does it happen because you are sick to your stomach?

Whatever is going on, you should go to a doctor ASAP. He or she will likely give you some blood tests to check your nutrient levels and to check for other health problems. Tell him/her that you are worried about having an eating disorder. You're very smart- if you are at risk for developing anorexia, you can get the right help now to stop the situation from becoming more dangerous. I'm sure you already know that eating disorders are very serious, and can lead to all kinds of physical health problems, even death. Plus, you already know how a lack of food makes you feel really bad! I've been there, and it's not fun- I know what it's like to not be able to concentrate in school and forget the things you've learned, and I know how it feels to be so tired, you could fall asleep at your desk at any second!

In the meantime, I would suggest you try increasing the amount of calories you are eating, if you can. Here is the link for the Dietary Guidelines for Americans:

http://www.health.gov/dietaryguidelines/dga2005/document/default.htm

Can you try to use it as a guideline for what you eat each day? It might help to write down what you're eating, and try to match your servings with the dietary guidelines. If you find you aren't able to eat enough food, maybe you could try some nutritional shakes like Boost or Ensure (you can get them at drugstores and grocery stores)- they come in flavours like vanilla, chocolate and strawberry, are easy to drink, and are packed full of vitamins. You can also get them in pudding form. An important thing to remember is that in your case, at your height and weight, putting on some pounds doesn't mean you're getting fat- it means you are gaining *health*. It means you are likely to feel a lot better and concentrate better in school.

I would also suggest researching eating disorders as much as possible. There are a lot of great books and websites that can give you information on what they are and how they affect people's lives. A website I really find good (and I recommend it to a lot of people, because it describes eating disorders so well and has so much great information on them, for people suffering, as well as their families and friends) is

www.somethingfishy.org

There are some websites out there that describe anorexia as a "lifestyle choice": ignore them! They are generally written by people who are suffering from an eating disorder and haven't been able to get the help they need. Eating disorders aren't a lifestyle choice, any more than cancer is. They are very serious *diseases* that can take over a person's life- but they can also be overcome with the right help. I'm proof of it!

I'm proud of you for wanting to find out more and get help with this. It's an important step, whether or not you have anorexia or another eating disorder! Please let me know how you're doing, and if you have any other questions at all, I'm here.

Ginger