Teens with Eating Disorders May Also Self-Injure
All eating disorders have an underlying psychological reason, usually stemming from a distorted body image. Physicians often concentrate on supporting the patient toward more healthful eating and treating causes such as depression, anxiety, and low self-esteem, but often they miss a more serious behavior. Teens with eating disorders are at a greater risk of self injuring, usually by cutting or burning.
Females with Bulimia or Binge-Eating Disorder Most at Risk
Researchers from the Stanford University School of Medicine reviewed medical records of about 1,400 patients between the ages of 10 and 21 who were diagnosed with an eating disorder at a clinic over a 14-month period. As with most patients diagnosed with eating disorders, about 90% were female with an average age of 15.4 years.
About 42% of these patients were never screened for self-injurious behaviors on admission to the eating disorders program at Lucile Packard Children’s Hospital at Stanford University, but of those who did, 41% admitted to cutting or burning themselves, according to lead study author Dr. Rebecka Peebles.
"It's generally held that these behaviors are fueled by an underlying level of (complex and intense) anxiety and they branch out in many different ways," said Dr. Richard Pesikoff, clinical professor of psychiatry at Baylor College of Medicine. "People do a variety of self-soothing behaviors like rocking, picking or cutting."
Cutting, says Dr. Pesikoff, produces endorphins that produce an anti-anxiety effect and physical relief from emotional pain. However, cutting and burning may also be forms of punishment and self-hatred.
Patients who binge-eat or have bulimia nervosa are more likely to self-injure than those with other eating disorders (such as anorexia), says Dr. Peebles. Also those with a history of abuse, either physical abuse or drug/substance abuse, also have higher incidences of such behaviors.
Dr. Peebles hopes the study will encourage more mental health practitioners to screen patients more closely for self-injuring behaviors. "Clinicians aren't routinely asking about [self-injurious behaviors]. But in clinical practice, kids are fairly open when you engage with them," she said.
Peebles R, et al "Self-injury in adolescents with eating disorders: correlates and provider bias" J Adolesc Health 2010.