For Megan Burkland, coping with stress two years ago overwhelmed her.
"I was diagnosed as an anorexic in my sophomore year of high school," Burkland said.
Her mother had become alarmed as Megan ate less and less, and exercised relentlessly.
"It was a very quick process. She lost her weight within about a four month period," said Shawn Burkland.
"I didn't think I had a problem. I thought I was ok and I didn't need help," recalled Megan.
But reality was starkly different during that time.
"She was 81 pounds. She had lost 29 pounds," said her mother, Shawn.
Pediatrician Dr. Cora Breuner led Megan's recovery team at Seattle Children's. She said many things trigger eating disorders, including a culture that values thinness, and more.
"If you have a family member with an eating disorder, there is a possibility that your child might have an eating disorder as well. Or if you have some significant emotional discord in the family such as a divorce or death in the family," Dr. Breuner said.
Now a study published in the Archives of General Psychiatry shows the scope of the problem. The national study of 13 to 18 year olds revealed anorexia, bulimia, or binge eating affect over half a million 'tweens and teens. The disorders strike more boys and Hispanic kids than previously thought. Most of the children are not getting mental health treatment specifically for their eating disorders.
"The advice for parents is education. Knowledge is power. The more parents know about this, know warning signs, know about who to access and how to access it is extremely important," said Dr. Breuner.
She said red flag warning signs a child may have an eating disorder include irritability, not wanting to eat with the family, new interest in exercising, and withdrawing from friends.
For months after she was diagnosed Megan needed someone to sit with her for every meal. Typical for anorexics, she resisted fiercely.
"Fighting at the table. She wasn't going to finish her food. Screaming and yelling, we were torturing her, and making her fat," recalled Shawn Burkland.
"I wasn't happy at all. I just remember I had a lot of anger," said Megan.
It took her doctor, a nutritionist, therapist, family and friends to help her recover. Now Megan hopes her story helps others. She had this message for other girls and boys who may be experiencing an eating disorder.
"Ask someone for help, because eating disorders are one of those diseases where you can't do it yourself," Megan urged.
The researchers who conducted the study found teens with eating disorders also faced anxiety, depression and thoughts of suicide. Those are even more important reasons for families to seek treatment.