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180 6.2 Nutrition for Adolescents
Bulimia nervosa
Bulimia nervosa is characterized by:
●● binge eating of abnormally large amounts of
food along with a feeling of lack of control
●● compensatory behaviour after the binge,
including vomiting, use of laxatives, fasting or
excessive exercise.
Eating disorder not otherwise
specified
Eating disorder not otherwise specified is a broad
diagnostic category of abnormal eating
behaviours including binge eating disorder and
the female athlete triad. These include aspects of
anorexia and bulimia but do not meet the
diagnostic criteria.
In binge eating disorders, binge eating is not
followed by the compensatory behaviours.
The female athlete triad is a syndrome of
sportswomen with three characteristics:
●● low energy intake which may be a result of trying
to lose weight for sports performance reasons,
body image reasons or not understanding the
energy and nutrient requirements of lifestyle and
training regime
●● menstrual dysfunction
●● low bone mineral density which can result in
bone fractures during athletic training or
performance.
The long-term energy and nutrient depletion of
eating disorders and the resulting malnutrition can
have lasting effects on growth, sexual development
and bone density. In the short term, dental erosion
caused by self-induced frequent vomiting increases
dental erosion.
If an eating disorder is suspected in a child then ensuring that young people:
the family should be alerted and encouraged to
seek professional help from a specialized treatment
centre with a multidisciplinary team. Early
treatment results in the most positive outcomes.
When the eating disorder develops into a chronic
condition, even with treatment there may be
frequent relapses throughout life. In about 10 per
cent of cases it causes death.
Alcohol
Alcohol intakes tend to increase during the teenage
years, reaching a peak at about the age of 19. In
adolescence, alcohol intake is often limited to one
or two days per week and intoxication and value for
money are the key aims. In the NDNS rolling
survey 4 per cent of boys aged 13–15 years and 8 per
cent of boys aged 13–15 years were drinking alcohol
once or twice a week. UK adolescents have one of
the highest levels in Europe of alcohol use, binge
drinking and getting drunk.
High alcohol intakes are a cause for concern for
both health and social reasons. Teenagers have less
ability to metabolize alcohol than fully mature
adults and are more susceptible to its adverse
effects. Under the influence of alcohol they are
more likely to have unsafe sex because they are less
likely to use contraception, and also more likely to
have sex they later regret.
Regular heavy alcohol consumption and binge
drinking:
●● are associated with physical problems, antisocial
behaviour, violence, accidents, suicide, injuries
and road traffic accidents and criminal offences
●● affect school performance
●● can exacerbate existing mental health problems
●● may have adverse effects on health in later life.
In 2000, nearly 14 per cent of 16–19 year olds
experienced dependence on alcohol (British
Medical Association 2003). From a nutritional
point of view, regular alcohol consumption can
displace more nutrient-dense foods from the diet
and, since alcohol has a high energy density but
little impact on appetite, regular drinking can
easily lead to over-consumption of energy.
If health advice on alcohol is over-negative it
may be ignored. Emphasis is better placed on
●● are aware of safe drinking limits
●● know how to assess the alcoholic strength of
products, particularly some of the ‘designer
drinks’ or special brews of lagers which may
have a deceptively high alcohol content.