�I just turned 16 years old and I thought I was fat. All my friends used to call me lard, big butt, and fatty,� says Candice, 17, of Danbury, CT. 

Candice wasn�t actually fat. In fact, she was 5�3� and 103 pounds. But she had a distorted body image. That, along with the harsh words of her peers, led to something worse than bad feelings. 

�I decided to only chew gum and drink water. Weeks went by and everybody started noticing that my jeans were getting really big, that I was pale, and that I would always refuse to eat. I quickly lost five pounds, and it looked so bad �cause I weighed 98 pounds,� says Candice.

Candice had developed what doctors call disordered eating behaviors. These are unhealthy eating habits (including strict dieting, and bingeing or purging) that don�t occur as frequently or severely enough to meet the full definition of an eating disorder. But disordered eating can be the stage before an eating disorder like anorexia or bulimia. 

�Teens who develop disordered eating habits eat and exercise in ways that jeopardize their health, happiness, and safety. They do this because of their negative attitudes about food, weight, and their bodies,� says Holly Hoff, director of programs for the National Eating Disorders Association, in Seattle, WA.

Girls Hardest Hit

Like anorexia or bulimia, disordered eating is much more prevalent in teen girls, but it does affect guys. Actual numbers on disordered eating among teens are hard to find. But five to 10 million girls and women, and one million boys and men, suffer from eating disorders and borderline conditions.

Other surveys show the prevalence of disordered eating behaviors. In the 1999 Youth Risk Behavior Survey, 42 percent of both male and female students were trying to lose weight during the 30 days prior the survey. Forty percent had eaten less food, fewer calories, or foods low in fat, to avoid gaining weight. 

Warning Signs

Disordered eating behaviors are easy to recognize. They include one or more of the following: 

• Skipping meals                         
• Restricting food choices to a few �acceptable� items                         
• Focusing excessively on avoiding certain foods, particularly foods that contain fat                         
• Binge eating, especially snack foods and sweets                         
• Self-induced vomiting                         
• Taking laxatives, diuretics (water pills), or diet pills*

Tired and Sad

For months, Sarah, 17, of Miami, FL, restricted her diet to carrots, peppers, broccoli, and water.

�I got really thin. I started to lose some hair. I started to become anemic, and I became very sick.�

Alison, 16, of Miami, just ate Fritos and drank Coke to try and lose weight. 

�I felt really sluggish,� she says.

One New Jersey teen (who asked to remain anonymous) drank water most of the day, to try and feel full. She also ate small dinners in front of her parents, so she wouldn�t alarm them.
Her disordered eating didn�t last long. 

�I stopped after a while, because I hated feeling weak and tired all the time,� she says.

Teens with disordered eating behaviors often go back and forth between normal eating and disordered eating. Depending on the teen, the behavior may or may not lead to a diagnosed eating disorder.

While engaging in disordered eating, many teens experience fatigue, stress, unhappiness or depression, or difficulty concentrating, according to Hoff. 

What�s more, disordered eating behaviors can actually do the opposite of what teens hope.

�If a person is restricting food intake, metabolism slows down, which slows down how the body is burning food. It offsets what the person is trying to do,� says Hoff.

Candice experienced depression, a common side effect of disordered eating behaviors.

�I lost all my closest friends, �cause I never wanted to do anything.  All I wanted to do was go home and go to sleep. I went from being an �A� student to a �D� student. I could never pay attention, �cause I was too tired, and if I did anything I felt like I was gonna pass out,� she says.

Staying Healthy

There is help for teens with disordered eating behaviors. They should first talk with a counselor, nutritionist, or trusted adult about their behavior and why it started. 

�Teens need to understand how their eating and exercise habits got out of control. They need to be encouraged to have a healthier balance of eating and exercise,� says Hoff.

They also need to learn that their worth goes beyond how they look.

�Teens need to feel appreciated for their skills, talents, and personality, rather than appearance. They need to surround themselves with people who make them feel good. And avoid people who tease,� says Hoff.

Friends and family can help teens stop this unhealthy behavior.

�My best friend came to the hospital to see me, and when she saw me, she started to cry. She kept saying to me, �You need to stop �cause, just think, if you die, what will all your family, friends, and the world do without you?� As soon as she said that, I started eating,� says Candice. 

Editors� Note: For more information, call the Eating Disorders Information and Referral Help Line at (800) 931-2237, or click here.

SEX, ETC. national correspondents Kristen Alea, 16, of Miami, FL, and Acacia Stevens, 16, of Edison, NJ, contributed to this story.

*Source: The BodyWise handbook, by the Office on Women's Health, U.S. Department of Health and Human Services.

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