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'Crisis of eating disorders'

Family nurse practitioner explains symptoms, treatment of increasingly common youth problem 



A growing number of adolescents struggle with eating disorders, which are now the third most common chronic health condition in children and adolescents, behind asthma and obesity. 

“We are seeing an enormous increase,” said family nurse practitioner Davia Moss, who specializes in adolescent medicine at Upstate. 

“The pandemic, combined with social media, combined with our diet culture, has sort of been a perfect storm to create this crisis of eating disorders,” she explained. 

Here’s more information, excerpted from a podcast interview with Moss, available here


How does this begin?

“I hear this a lot from my patients. They will say they were just trying to get healthier, and then somewhere along the line things became out of control. 

“I also have a number of patients who were told when they were young that they were so skinny. And the minute they hit adolescence — which is very normal — all of a sudden they stopped hearing that, and that was the trigger. That was all they needed to go down the path of an eating disorder.” 


Are fad diets to blame?

“There’s no reason for any adolescent to be on a ‘diet.’ Their brains are not capable of balance, so it often can get very quickly out of control. 

“The other tricky part is, they often get a lot of positive feedback when their body starts to change. And for an adolescent, they really thrive off that. That’s when things can get very out of control quickly.” 


What are the symptoms?

Significant changes in a child can be a red flag. Is their attention concentration changing? Have they fainted? How is their fatigue level? Are they suddenly wanting to exercise more? Are they isolating themselves more? Eating disorders thrive on isolation. 

What medical problems may arise? 

  • Electrolyte imbalances 
  • Constipation 
  • Heartburn or reflux 
  • Menstrual irregularities 
  • Cold intolerance 
  • Brittle hair/nails 
  • Tooth erosion or cavities 
  • Anxiety 
  • Decreased bone density 
  • Fertility difficulties 


Why do some people end up hospitalized?

“The patients who are hospitalized are often the ones that are restricting to a very, very significant under-500-calories-a-day and over-exercising. They can have long-term cardiac and gastrointestinal sequelae (consequences). We have patients who abuse laxatives, which can actually impact the ability of your GI (gastrointestinal, or digestive) tract to even function correctly for the rest of your life.” 


Image of a sad-looking teen girl sitting by herself on the floor of an empty room

Symptoms explain condition type 

These are four of the most common types of eating disorders: 

Someone with anorexia nervosa has restrictive patterns of eating and significant body image concerns. 

Those with bulimia nervosa have a pattern of binge eating and intentional vomiting. 

A person with a binge eating disorder feels out of control with regard to food. 

Someone who restricts his or her eating of certain foods because they create sensory difficulties, but who has no body image concerns, may have avoidant/ restrictive food intake disorder, or ARFID. 

The American Psychiatric Association says eating disorders are characterized by severe and persistent disturbances in eating behaviors and associated distressing thoughts and emotions. They can seriously affect physical, psychological and social function. 

This story appears in the 2024 Upstate Health magazine, Issue 1