Obese teenagers who lose weight are at risk of developing eating disorders such as anorexia nervosa and bulimia nervosa, Mayo Clinic researchers imply in a recent Pediatrics article. Eating disorders among these patients are also not being adequately detected because the weight loss is seen as positive by providers and family members.

In the article, Mayo Clinic researchers argue that formerly overweight adolescents tend to have more medical complications from eating disorders and it takes longer to diagnose them than kids who are in a normal weight range. This is problematic because early intervention is the key to a good prognosis, says Leslie Sim, Ph.D., an eating disorders expert in the Mayo Clinic Children’s Center and lead author of the study.

Although not widely known, individuals with a weight history in the overweight (BMI-for-age greater than or equal to the 85th percentile but less than the 95th percentile, as defined by CDC growth chart) or obese (BMI-for-age greater than or equal to the 95th percentile, as defined by the CDC growth chart) range, represent a substantial portion of adolescents presenting for eating disorder treatment, says Dr. Sim.

“Given research that suggests early intervention promotes best chance of recovery, it is imperative that these children and adolescents’ eating disorder symptoms are identified and intervention is offered before the disease progresses,” says Dr. Sim.

This report analyzes two examples of eating disorders that developed in the process of obese adolescents’ efforts to reduce their weight. Both cases illustrate specific challenges in the identification of eating disorder behaviors in adolescents with this weight history and the corresponding delay such teenagers experience accessing appropriate treatment.

At least 6 percent of adolescents suffer from eating disorders, and more than 55 percent of high school females and 30 percent of males report disordered eating symptoms including engaging in one or more maladaptive behaviors (fasting, diet pills, vomiting, laxatives, binge eating) to induce weight loss.

Eating disorders are associated with high relapse rates and significant impairment to daily life, along with a host of medical side effects that can be life-threatening, says Dr. Sim.

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The article is published online September 9 in the journal Pediatrics. Dr. Sim’s co-authors include Mayo Clinic researchers Jocelyn Lebow, Ph.D., and Marcie Billings, M.D.

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