Eating Disorders in Teens: Myths, Facts and What To Do

No one will doubt that the teenage years can be a tough time. Hormones raging. Acne popping. That feeling that everyone else knows what they’re doing while you’re flailing around in that time between childhood and grown-up life.

It’s stressful. And raising a teenager can feel equally daunting.

Among your (probably many) concerns? Whether your teen’s relationship with food is a healthy one. Especially in an age of social media where societal pressures to conform to a certain body image have triggered more and more headlines about eating disorders in teens.

What’s a parent/caregiver/guardian/coach/teacher/loved one to do?

Psychologist and weight management specialist Leslie Heinberg, PhD, shares advice.

Teens and eating disorders

The American Academy of Child & Adolescent Psychiatry estimates that as many as 10 in 100 young women (that’s 10%) have an eating disorder. That’s an alarming statistic, especially when you consider just how dangerous eating disorders can be.

But before we get to all that, let’s consider some context before jumping to conclusions about whether the teen in your life could have an eating disorder.

If you take Hollywood’s word for it, popular, rich, white teen girls are the ones who develop eating disorders. And while they certainly can be at risk, they’re far from alone. And newer research is changing perceptions about who lives with an eating disorder.

“Historically, the focus on eating disorders came from studies of anorexia and bulimia that focused on young, white women,” Dr. Heinberg points out. “But eating disorders affect people across ages, sexes, racial and ethnic backgrounds, economic means and social status.

“There are groups that were largely ignored and weren’t screened. People weren’t asking those questions because we thought, Oh, this is something for thin, young, white girls. But now we know that’s not the case at all.”

In other words, anyone can develop an eating disorder. And the teen years can be a trigger for some people. So, the more you know about what to look for and what to do, the better.

What causes eating disorders in teens?

As with so many physical and mental health conditions, there’s no one reason people develop eating disorders. But Dr. Heinberg says that there are a few reasons why teens can be particularly vulnerable:

• Physical changes. Adolescence and puberty change the way kids’ bodies look — and how their minds work, too. And those changes can start a domino effect of insecurity and mental health conditions that can affect their relationship with food.
• Social pressures. Teenagehood can be chock-full of unrealistic expectations of what’s “normal.” From social media and movies to their teammates and friends, teens can be inundated with messages encouraging unhealthy fad diets and pressures to look a certain way. Those messages can take hold and normalize eating disorders.
• Newfound independence. Teenagers often start to take more agency in their lives, including freedom around food. As adults become less responsible for packing their lunches or putting dinner on the table, teens can start to fall into risky eating behaviors. And parents may be less aware of what they’re doing.

Taken together, it can create a perfect storm for teenagers to develop eating disorders.

Signs of eating disorders in teens

The signs of eating disorders can vary. There are five different eating disorders recognized in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR) — the reference book healthcare professionals use to diagnose eating disorders and other mental health conditions. They are:

• Anorexia nervosa
• Bulimia nervosa
• Binge eating disorder
• Avoidant/restrictive food intake disorder (ARFID)
• Other specified feeding and eating disorders (OSF)

Each eating disorder has its own set of symptoms and criteria for diagnosis. But in general, Dr. Heinberg suggests watching your teen for signs of an eating disorder, like:

• Not gaining weight or losing weight
• Exercising excessively
• Eating large amounts of food in one sitting
• Hiding food
• Withdrawing from friends and family, including not having meals with others
• Using the bathroom often after eating (that could be a sign of purging behavior, where a person will induce vomiting or use laxatives or other medications to eliminate food from their bodies)

Treating teen eating disorders

Treating an eating disorder takes time, patience and concentrated efforts focused on recovery.

And proper treatment is important. Eating disorders can affect your teen’s health, including their mental and emotional well-being and their physical health. Eating disorders can also cause malnutrition, which can affect your teen’s entire body, from their heart to their digestive system, immune system and more. In the most serious cases, eating disorders can be life-threatening.

Working with a qualified healthcare professional is your best route for a successful recovery. And for teens and other young people, expect the whole family to take part in their journey.

“The best eating disorder treatment for children and adolescents are family-based interventions in which their parents and guardians help them with their eating,” Dr. Heinberg elaborates. “And that should be done under the guidance of a qualified healthcare professional who can support both the teen and the adults in their lives, teach them about their condition and monitor their recovery.”

If you notice signs of an eating disorder or your teen engaging in potentially unhealthy eating behaviors, Dr. Heinberg recommends seeking help fast.

“If there are concerns, don’t wait,” she urges. “Talk to a pediatrician. Get them assessed. It’s much easier to turn around disordered eating or an eating disorder early on. An eating disorder that has really taken hold can become more difficult to treat.”