By, Jacqueline A. Reilly, MS LMSW

For many, the teenage years are characterized by impulsivity, lack of future planning, and unpredictable emotional swings. Most eating disorders emerge during the adolescent years when a young woman is reaching developmental milestones, some of which encompasses significant brain changes. These changes in the brain can make a person more vulnerable to developing eating problems such as anorexia nervosa, bulimia and binge eating disorder.

One of the more pronounced aspects of adolescent brain functioning is the activity focused in the prefrontal cortex (Keating, 2004). This activity consists of myelinization and pruning which means that the nerves in that area of the brain where decision making, future planning, and control of risky behavior is exercised, is becoming more and more efficient. The intensity of activity and growth in that area, since the teenager is not yet done with this process for a number of years, correlates to unpredictable emotionality and stages of identity formation that are markedly different from that of, for example, a normal twenty five year old person. In short, teenagers have a difficult time seeing their connection to the future and are more likely to accept reasoning and behaviors that they might not have by the time they reach twenty years of age.

It is an old adage that teenagers are impressionable and now we have hard science supporting this.  Current science indicates that adolescence is also the last significant time of synaptic pruning thus, how the brain is used during adolescence may predict how the brain will function into adulthood. Eating disorders that develop during adolescence and that remain untreated may become chronic psychological fixtures in adulthood. This is why it is imperative that an adolescent who ventures down the path of an eating disorder receive early intervention and treatment in order to have the best long term outcome.

How does this help us understand eating disorders as they appear during adolescence? Girls in our culture are bombarded day in and day out with images of success associated with being thin. This image of success promises parental approval, peer acceptance and admiration for being a stellar student and a good athlete among others. If we do not embrace the developmental playing field that teens are embedded in, we cannot understand their vulnerability to the false cultural promise of happiness gained via weight loss. 

The developmental tasks for adolescents according to Eric Erickson (1968), concerns identify formation. James Marcia (1980) furthers this idea and lists four stages that can happen during adolescent identity formation. One stage, identity diffusion, includes apathy and an inability to commit to ideology or to chart a life course. This possible stage can indicate a plethora of psychological problems from defiant, self destructive behaviors to depression and risk taking (Adams, Gullotta, & Montemayor, 1992). Identity foreclosure includes alliance, rigidity, and conformity. In this stage teens can give their identity over to a strong parent, a peer group (Kroger, 2003), and even to the complicated preoccupying practices of an eating disorder. Identity moratorium occurs where, for various reasons, which may include abuse, a teen delays development and puts off the march toward adulthood with its associated independence from parents and engagement in peer relationships (Flum, 1994). Finally, identity achievement indicates that a healthy sense of self is developing where good decisions can be made, high self esteem cultivated and a capacity for intimacy attained (Kroger, 2003).

Teenagers are supposed to be awkward as they venture down the path of social, academic and among other things, athletic prowess. They gain competence by failing and learning from their mistakes and learning self forgiveness. The conditions of adolescent cognitive development which includes reasoning that might be quite different from that exercised by a full adult can set a teen up to be more vulnerable to eating disorders.  Eating disorders are complicated and their causes are as varied and unique as is the individual who is suffering with one. Paying attention to the cognitive developmental tasks at hand can help in the effort to better equip our teens against eating disorders.  
  
Marcia, J. E. (1980) Identity in adolescence.