(HealthDay News) – Obese adolescents are at risk of eating disorders, which can go unrecognized due to their higher weight status, according to a case report published online Sept. 9 in Pediatrics.

Leslie A. Sim, PhD, from the Mayo Clinic College of Medicine in Rochester, MN, and colleagues present two examples of eating disorders that developed in the context of obese teenagers trying to reduce their weight.

The first case involved a 14-year-old boy who presented to an eating disorder evaluation with a two-year history of significant weight loss in the context of a history of obesity. Weight loss efforts started with healthy eating and exercise but developed into severe restriction. He exhibited physical and emotional sequelae of low weight. There was no discussion of concerns regarding weight loss during 13 medical encounters that took place when he was losing weight, and no mention of an eating disorder in medical documentation, despite his having lost over half his body weight. The second case involved an 18-year-old girl who was experiencing physical sequelae of low weight and poor nutrition status. After one-year of weight loss at age 15, she presented with secondary amenorrhea, dizziness, and orthostatic intolerance. In spite of these symptoms and her mother’s repeated concerns about her restrictive eating and minimal fat intake, health care providers did not consider an eating disorder because her body mass index was appropriate.

“It is essential that eating disorder symptoms are on every practitioner’s radar, regardless of the patient’s weight,” the authors write. “Disordered behaviors must be identified as early as possible, and patients referred for appropriate intervention.”

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