Among the boys in the study, those most at risk worried that their bodies were puny — too small, too skinny or insufficiently muscular, prompting them to consume unbalanced diets, exercise obsessively and take supplements or steroids that are a hazard to their health. When overly fixated on building their bodies, they can become socially withdrawn and depressed and develop a disorder called muscle dysmorphia that can lead to heart failure, resulting from insufficient calories and overexertion.
A missed diagnosis is likely when a young person’s relatives or doctors have preconceived notions about how someone with an eating disorder looks or behaves. For example, Dr. Nagata said, a teenage girl or young woman who is anorexic can fall under the medical radar because her weight is normal or even overweight.
Although diagnosis of an eating disorder like anorexia or bulimia was twice as common among the young adults whose weight was normal or underweight, the fact that these disorders also exist in heavier young adults is often overlooked, Dr. Nagata said.
“Almost half of those with anorexia nervosa are at or above normal weight,” he said. “Young people with atypical anorexia have the same body image distortions and severe psychological distress as those with regular anorexia. They’re at high medical risk and just as likely to be hospitalized for complications caused by their distorted eating behaviors.”
Dr. Nagata’s colleague and co-author of the study, Dr. Kirsten Bibbins-Domingo, an internist at the university, said in an interview, “Physicians who care for young adults should think about patterns of eating that are harmful, and not just among very thin women. Young adults with abnormal eating habits too often fall between the cracks because physicians think of them as healthy. However, abnormal eating patterns are not uncommon in adolescence and young adulthood, and that’s when patterns of behavior related to later health and disease are established and solidified.”
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated July 27, 2020
Should I refinance my mortgage?
- It could be a good idea, because mortgage rates have never been lower. Refinancing requests have pushed mortgage applications to some of the highest levels since 2008, so be prepared to get in line. But defaults are also up, so if you’re thinking about buying a home, be aware that some lenders have tightened their standards.
What is school going to look like in September?
- It is unlikely that many schools will return to a normal schedule this fall, requiring the grind of online learning, makeshift child care and stunted workdays to continue. California’s two largest public school districts — Los Angeles and San Diego — said on July 13, that instruction will be remote-only in the fall, citing concerns that surging coronavirus infections in their areas pose too dire a risk for students and teachers. Together, the two districts enroll some 825,000 students. They are the largest in the country so far to abandon plans for even a partial physical return to classrooms when they reopen in August. For other districts, the solution won’t be an all-or-nothing approach. Many systems, including the nation’s largest, New York City, are devising hybrid plans that involve spending some days in classrooms and other days online. There’s no national policy on this yet, so check with your municipal school system regularly to see what is happening in your community.
Is the coronavirus airborne?
- The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
What are the symptoms of coronavirus?
Does asymptomatic transmission of Covid-19 happen?
- So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
The problem of disordered eating behaviors among teens and young adults is often encouraged or compounded by participation in certain competitive sports and other activities that overemphasize a particular body weight and physique. Among these are gymnastics, wrestling, dance, figure skating, weight lifting and bodybuilding.
Social media, with its heavy focus on appearance, has fostered the problem as well, Dr. Nagata said. Even toys, like Barbie dolls and action figures, have made a contribution. “A study of male action figures found that they have become bigger, more muscular and more extreme in their appearance over a 30-year period,” he said.