Is it OK for my Teenager to have a Low Heart Rate? The Physical Signs of Eating Disorders

Is it OK for my teenager to have a low heart rate? Why is my teen cold all the time? Is it normal for my child’s hair to fall out? Why is my child wearing a sweatshirt in the summer? Why is my child constipated?

Anorexia nervosa in childhood comes with many psychological, social and emotional consequences. Psychological illnesses in childhood are on the rise and should all be taken seriously and dealt with swiftly. When it comes to childhood eating disorders thought, we have to consider the component that other psychological illnesses don’t have- severe short and long term medical complications.

Eating disorders, specifically anorexia nervosa, have the highest risk of mortality of all mental illnesses due to their physical complications. Anorexia nervosa can greatly impact many body systems and often leads to hospitalization for malnutrition.

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In order to get proper treatment and early intervention for eating disorders, it is important to know what you are looking for. We will discuss physical signs and complications of an adolescent eating disorder. This is a starting point to help you gather information about your child’s health and bring your concerns to their pediatrician or eating disorder treatment team. You are your child’s best advocate and arming yourself with all the information you can, will help you to lead your child’s treatment team on the road to healing and recovery.

Unfortunately, our society holds some harmful myths about eating disorders. In the media, teens with eating disorders are often portrayed a frail, extremely thin and obviously ill. In reality, that is more often than not, not the case. Weight loss is a large part of the medical complications, but there are many others that can appear before extreme thinness is visible and can be a clue that something is not right. Weight loss and extreme thinness are surely warning signs to look out for and seek help and guidance from a professional- they just aren’t the only signs.

Physicals signs of an eating disorder in adolescents to watch out for:

1. Low Heart Rate- This is the number one sign I see being ignored or explained away by doctor’s and parents when it comes to eating disorders. I hear “well they are an athlete or a runner” or “they’ve always had a low heart rate” or “doesn’t that mean they are healthy?”. The answer- not when an eating disorder is present. Low heart rate is indicative that the body is not getting enough nutrition so the heart is compensating by slowing down to use less energy. This can become very dangerous, especially when sleeping and the Heart Rate lowers even further. If your child’s heart rate is low, please take them to be evaluated by an eating disorder professional and share your concerns about their eating habits. Be persistent, even if the doctor tells you it is nothing to worry about.

2. Loss of height- if your child has stunted growth or loss of height, this could be from an eating disorder. Not getting enough nutrition can stunt physical growth, including height, causing children to not reach their full height potential. Children should be growing and gaining weight every year. If this is not happening, you should explore this further with their pediatrician. If there is a loss of height, this could be due to osteoporosis (brittle bones). Osteoporosis is very common in older women, but not in young, developing females and should be a cause for concern. Bone density scans may be necessary to determine your child’s bone health.

3. Weight loss- This Is an obvious one, but not in the way you may be thinking. ANY weight loss during childhood and adolescents should be screened for an eating disorder. Children are growing and developing and should not be losing weight at their yearly follow ups. Even if your child is living in a larger body, weight loss should be investigated closely to determine if they were engaging in disordered eating behaviors to achieve weight loss. Many times, especially when children are higher on the growth curve, pediatricians and parents will celebrate and praise weight loss in children without even asking or checking for eating disorders. Please check on your child’s weight loss and have them evaluated by an eating disorder professional.

4. Always being cold or Hypothermia is a common sign on an eating disorder. If your body is losing weight, it does not have the extra layer of insulation to keep you warm. Often times, I see teenagers wearing big sweatshirts and sweatpants in the dead of summer and complaining they are freezing, If you notice your child is always cold, dressed inappropriately for the weather, constantly in a blanket, or frequently adjusting the thermostat, this could be a sign of an eating disorder.

5. Hair loss or changes in hair texture- Skin can become dry and flakey and hair can become brittle, break easily and fall out in clumps. If you see more hair in the hairbrush or bathroom than usual, or if your child is complaining of hair loss, it could be due to malnutrition from an eating disorder.

6. Dizziness or lightheadedness- these are common signs of malnutrition from an eating disorder. If your child has passed out or felt like they might pass out, been dizzy upon standing or seemed unstable this could be due to frequent low blood sugar and should be evaluated by a medical professional due to fall risks.

7. Constipation or complaints of stomach pain- so often I see client who have been to every GI doctor and specialist to figure out what was causing stomach pain and constipation and they have not been screened for an eating disorder. Eating disorders have huge impacts on the gastric system and can lead to discomfort and pain, which can be used by the eating disorder as another reason not to eat. If your child has been experiencing frequent constipation or new onset of stomach issues or complaints of discomfort, please have them evaluated for an eating disorder by a professional.

This list is just scratching the surface of medical complications brought on by eating disorders. Some are temporary and some can have long term consequences and lasting effects. Your child may have some, all or none of these and still have an eating disorder. They could also be related to other medical conditions- the important thing is to get them evaluated for an eating disorder if you are concerned. An assessment will not hurt, but it could save your child’s life.

All of this information is based on personal experience and from research by Lock & Le Grange. It is not meant to be medical advice.

An eating disorder evaluation is the first step on the journey to full recovery for your struggling child. Please schedule a free consultation call to see if an eating disorder assessment is recommended for your child.

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References

Lock, James, and Daniel Le Grange. Help Your Teenager Beat an Eating Disorder, Second Edition. Guilford Publications, 2015.

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