Our expert talks through what you need to know about disordered eating — and how to help.
Battling an eating disorder can be a bewildering and terrifying experience, partly because there are a lot of misconceptions in the media and society around these illnesses. They’re not a “phase” your teen is moving through: They’re complex and nuanced mental illnesses with serious — potentially life-threatening — medical consequences.
Most eating disorders involve a problematic relationship with food, usually characterized by a persistent disturbance in eating behaviors and preoccupations with weight, distorted body image, and/or anxiety about certain foods.
According to the National Eating Disorder Association (NEDA), over 28 million Americans will battle an eating disorder during their lifetime. While eating disorders have historically been associated with young, white, heterosexual, cisgender women, they affect people of all races, ethnicities, and genders at similar rates. Misconceptions about eating disorders have real consequences, leading to fewer diagnosis and treatment options for people of color, men, and members of marginalized groups.
The good news is that they are treatable. If you’re worried your teen may be struggling with an eating disorder, it’s normal to feel confused and scared. While it takes courage to acknowledge there might be a problem, it’s a crucial step that might save your teen’s life. The more you know about eating disorders, the easier it’ll be to understand what they are going through and how to help them cope.
The 3 Main Types of Eating Disorders
There are different types of eating disorders, and most people who suffer from an eating disorder also suffer from anxiety and/or depression, making treatment more complex.
Learn more about the types of anxiety, the symptoms, and how to provide support for your teen.
The most common eating disorders include:
Anorexia Nervosa
People with anorexia severely limit their calories and the foods they eat. There are two subtypes of anorexia: restrictive anorexia, which foods or calories are restricted, and a binge-purge subtype. In this subtype, people restrict food and calories, but also have episodes of binging and purging.
Bulimia Nervosa
Bulimia includes episodes of binge-eating followed by self-induced vomiting, the use of laxatives, or over-exercising to compensate for binging.
Binge-Eating Disorder
Binge-eating disorder (BED) — the most common eating disorder among Americans — is characterized by eating large amounts of food in a short period of time, past the point of feeling full. Unlike with bulimia, there’s no purging with BED.
What Causes Eating Disorders in Teens?
There’s no one specific cause of eating disorders. But research has found the following are risk factors for developing an eating disorder:
- Genetic/biological factors, like having a relative with an eating or mental health disorder.
- Psychological factors, like perfectionism, poor body image and low self-esteem.
- Social/cultural factors, like living in a family or within a culture that stigmatizes weight gain, playing sports or activities that are weight-focused, and teasing or bullying around weight.
How Serious Are Eating Disorders?
Eating disorders have the highest death rate of any mental disorder. Anorexia, especially, has a high mortality rate, with the added risk of dying from starvation and an increased likelihood of suicide*.
The calorie restriction that characterizes anorexia robs the body of fuel, the depletion of necessary electrolytes is a common sign of bulimia. Both can signal the body to start breaking down, leading to severe health problems, such as:
- Risk of heart failure from dropping blood pressure
- Risk of kidney failure and anemia
- Damage to the stomach and esophagus and blocked intestines
- Seizures, fainting, dizziness
- Hormonal imbalances that can stop menstruation
- A delay in puberty
- Anxiety, depression, and other anxiety and mood disorders
- Severe dehydration
Signs and Symptoms of Eating Disorders in Teens
There’s not one checklist of symptoms that will tell you if your teen is struggling with an eating disorder, because these aren’t one-size-fits-all illnesses. Different disorders look different in different people.
And since these disorders are often accompanied by secretive behavior and feelings of shame and guilt, it can be hard to know exactly what’s going on with your teen’s eating patterns.
Even so, there are some signs to look for and pay attention to. Some can be seen in many disorders, and some are specific to certain disorders.
Someone battling an eating disorder might:
- Be preoccupied with weight, calories, dieting, body shape, body weight, and body image. Might maintain an excessive exercise regime.
- Avoid eating in front of others.
- Refuse certain foods and food groups.
- Develop rituals based around eating, like chewing for a specific period.
- Lose and gain weight rapidly, and possibly wear baggy clothing to hide their body.
- Struggle to stay warm, even when it’s hot outside. This can lead to growth of fine, downy hair on their arms and legs.
- Experience a number of physical symptoms like stomach pains, dental problems like cavities and tooth discoloration, irregular or absent periods
The National Eating Disorder Association’s site has a lengthy and detailed list of possible symptoms, including specific symptoms for each disorder.
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When to Seek Treatment for Teen Eating Disorders
If your teen is displaying symptoms like these, or you’re worried about a difference in their eating behaviors or patterns, encourage them to take NEDA’s Eating Disorder Screening Tool — a short questionnaire that will help you determine if it’s time to see a licensed therapist or psychologist. If it is, a counselor will evaluate their symptoms, eating habits, and gather information based on their history.
Treatment will depend on the disorder and the severity, but usually involves both psychological and nutritional counseling, along with medical and psychiatric monitoring. Since eating disorders can potentially put their life in danger, it’s vital to seek professional help immediately, so your teen can be diagnosed and begin treatment.
How to Support to Your Teen for Eating Disorders
Bringing up the issue of eating disorders with your teen might feel intimidating. But you can’t help them if you don’t know what’s going on — and they need to know they can count on you. Here’s a guide to broaching the topic.
Find a Private Place and Stay Present
Make sure you’re away from distractions and noisy surroundings. Keep your voice gentle, calm, and reassuring. Don’t interrupt: they need your undivided attention and unconditional love.
Focus on Behavior
Frame your concerns around their behavior rather than their appearance. Remarking on weight, weight loss, or how they look can backfire. Use “I” statements that avoid blame or judgment: “I noticed you haven’t eaten much at dinner lately. Is everything okay?”
Stay Calm
Many young people with eating disorders work hard to hide their behavior. When you confront them — no matter how gently — they may feel embarrassed, ashamed, or that their privacy has been violated. And they may lash out.
Stay centered, try not to become defensive, and don’t take their reaction personally. Even if it’s directed at you, it has nothing to do with you.
Eating Disorders: Make Time For Yourself
If your teen has an eating disorder, you might experience a whole range of emotions. Often, parents and caregivers feel guilty and blame themselves. They may feel like it’s their fault, or that they somehow caused their young person’s suffering.
But an eating disorder is an illness, and overthinking about what you could have done differently won’t help. The only thing that matters is supporting your teen as they move towards recovery.
To do that, you need to take care of yourself, too. Eating disorders can put an incredible strain on families.
Don’t minimize or dismiss that stress and its consequences. Take time to give yourself the same love and care that you’re giving your teen — grace, understanding, self-compassion and patience. Some ways to do that:
- Exercise regularly.
- Take walks in nature.
- Make time for activities you find fun and relaxing.
- Eat healthy meals.
- Get enough sleep.
- Confide in a trusted friend or a therapist.
- Join a support group with caregivers who are going through the same thing.
Additional Resources for Teen Eating Disorders
If you need help supporting someone with disordered eating, we at BLOOM have put together a list of resources to help your friend or family member.
National Eating Disorders Association (NEDA):
Online chat and support through texting are also available: 1 (800) 931-2237 | www.nationaleatingdisorders.org
The Alliance for Eating Disorders Awareness:
www.allianceforeatingdisorders.com
National Association of Anorexia Nervosa and Associated Disorders (ANAD):
Eating Disorder Helpline: 1 (888) 375-7767 | www.anad.org
Eating Disorder Anonymous:
www.Eatingdisordersanonymous.org
National Alliance on Mental Illness Helpline: 1 (800) 950-6264
Or in crisis text “NAMI” to 741741
SAMHSA’s National Helpline: 1 (800) 662-4357
This helpline is a free, confidential, 24/7, treatment referral and information service for individuals and families facing mental and/or substance disorders.
Teen Tribe:
www.Support.therapytribe.com/teen-support-group
This website provides peer-to-peer group support for teens who go through challenging times. This is a free service.
ADAA Directory:
www.Adaa.org/supportgroups
This website allows teens and family members to search support groups in their local area, as well as phone or online groups.
Suicide/Crisis Support Hotline: 1 (800) 273‑TALK (8255)
Or text the Crisis Text Line – “HELLO” to 741741
*If you or someone you know needs help, call the National Suicide Prevention Lifeline at 988. You can also reach a crisis counselor by messaging the Crisis Text Line at 741741.
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