Clinically reviewed by Angie Clark, DNP, APRN, PMHNP-BC, Amy Roethler, RDN, LD, and Kallie Osmundson, MA, LPCC, treatment team for PrairieCare’s Healthy Eating and Living (HEaL) program in Rochester, Minnesota.
Teen eating disorders are a very common and serious mental health issue that often requires professional support. Parents and caring professionals need to learn how to recognize the behavioral, physical, and psychological symptoms of eating disorders in adolescents to prevent long-term health complications.
Read on to learn about the signs of an eating disorder, how to talk with someone you care for, and why treatment is so crucial for recovery. Plus, hear from our experts who lead our Healthy Eating and Living (HEaL) program in Rochester.
What Is an Eating Disorder?
An eating disorder is a serious mental health disorder that affects around 20 million women and 10 million men in the United States, according to the National Eating Disorders Association (NEDA). People with eating disorders have unhealthy relationships with food, weight, and their appearance.
Additionally, teens with eating disorders often have an unrealistic view of their body weight, size, and shape—what’s known as body dysmorphia. Because they can no longer conceptualize what a normal body weight looks like, they begin to implement overly restrictive diets and obsess about calories and food intake.
Eating disorders are complex and often occur alongside other mental health conditions, such as depression, anxiety, and obsessive-compulsive disorder (OCD). And they can be deadly if left untreated. At least one person loses the battle to the disease every hour, and research confirms that anorexia nervosa has the highest mortality rate of any psychiatric disorder. People with anorexia nervosa are at severe risk of dying from health complications caused by starvation. Moreover, they are at high risk of attempting suicide.
In addition to diagnosable eating disorders, a large percentage of teens worldwide struggle with disordered eating behaviors. The National Eating Disorder Association (NEDA) reports that almost a quarter of children and adolescents worldwide (22 percent) show disordered eating—distorted eating behaviors and attitudes towards food, weight, shape, and appearance.
Causes of Eating Disorders and Disordered Eating in Adolescence
There is no one single cause of eating disorders in adolescence. Instead, genetics, environment, and social factors each play a role. Some research indicates that eating disorders can run in families. A teen with a parent or sibling (especially a twin) who has an eating disorder is more likely to develop one, too.
“The current use and popularity of social media can lead to negative influences for individuals with eating disorders in addition to the general diet culture,” said Angie Clark, DNP, APRN, PMHNP-BC.
Teens associate these thin, “perfect” bodies with popularity and acceptance, and feel they can’t measure up. Research by the American Psychological Association found that reducing social media use by 50 percent for just a few weeks helped some teens improve how they felt about their weight and their overall appearance.
As a result, social influences contribute to poor self-image and feelings of shame, anxiety, and self-consciousness. Consequently, teens think obsessively about their food intake and eating behaviors. They also exercise to unhealthy levels in an attempt to attain the societal standards for body acceptance.
But there are ways even within your own family or support system that can help. “Positive influences include role modeling of balanced eating within the family system, assuring the individual has a robust team of support, and eating disorder support groups,” said Angie.
Furthermore, eating disorders are more prevalent in teens who have experienced childhood trauma, depression, and anxiety. Therefore, effective eating disorder treatment addresses the underlying causes of eating disorders as well as the symptoms.
How Many Teens Have an Eating Disorder?
Teens and young adults are more likely than any other age group to experience an eating disorder. In fact, 1 in 7 men and 1 in 5 women experience an eating disorder by age 40. And 95 percent of people with eating disorders are between the ages of 12 and 25, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
In addition, many more teens have disordered eating symptoms. Disordered eating behaviors are not as severe as a full-fledged eating disorder. However, they set the stage for a diagnosable condition. If left untreated, disordered eating can progress into a life-threatening eating disorder.
Eating Disorders in Teenage Males
There is a common misconception that eating disorders only occur in young girls or women. While eating disorders are twice as likely to occur in females, the rate of eating disorders in teenage males is increasing. Research published in JAMA Pediatrics found that 17 percent of boys have disordered eating behaviors.
According to the National Eating Disorders Collaboration, males account for approximately 20 percent of those with anorexia nervosa, 30 percent of those with bulimia nervosa, 43 percent of those with binge eating disorder, 55–77 percent of people with other specified feeding or eating disorder, and 67 percent of people with Avoidant/restrictive food intake disorder.
Another common eating disorder in teen males is bigorexia or muscle dysmorphia. Boys with this disorder believe they are small and skinny despite their muscular physique. Therefore, they become obsessive about diet and working out to build muscle. This type of male eating disorder typically requires treatment.
Signs and Symptoms of Teen Eating Disorders
Teen eating disorders are very common, and symptoms should be cause for serious concern. The more aware parents are of the behavioral and psychological signs and symptoms of eating disorders, the earlier their child can receive life-saving treatment. Early intervention can prevent extensive health complications that can continue into adulthood.
Behavioral Signs of Teen Eating Disorders
- Making excuses to avoid eating
- Over-exercising; obsessed with exercise to lose weight or gain muscle
- Secretly storing food or eating alone, particularly at night
- A distorted body image; body dysmorphia (an obsessive focus on a perceived flaw in one’s appearance)
- Compulsive use of laxatives, diet pills, and weight-loss aids
- An intense, obsessive focus on calories and caloric intake
- An unwillingness to discuss weight gains or weight losses
- Resistance to social situations where eating is expected
- Extended bathroom use during or right after meals
Physical Symptoms of Teen Eating Disorders
- Sudden or extreme loss or gain of weight
- Repeated weight cycling, going up and down within a short period
- Constipation or vomiting
- Skin rashes or dry skin
- Erosion of tooth enamel; dental cavities
- Loss of hair and/or poor nail health
- Obvious signs of exhaustion, insomnia
- Irregular menstruation or absence of menstruation
- Easily bruised; more prone to physical injury
- Cold sensitivity; inability to tolerate cold
- Feeling tired
- Cardiovascular issues
- Stunted growth due to poor nutrition, such as with anorexia.
- Electrolyte imbalances
Psychological Eating Disorder Symptoms
- Feeling distressed or ashamed about eating
- Depression
- Anxiety
- Obsessed about one’s appearance and others’ perceptions
- Expressing guilt about eating
- Intense mood swings
- Panic attacks
- Self-harm
- Suicidal thoughts
Signs and Symptoms of the Most Common Eating Disorders
The three most common eating disorders in adolescents are anorexia nervosa, bulimia nervosa, and binge-eating disorder. Avoidant/restrictive food intake disorder (ARFID) is also becoming a more prevalent disorder in children, more commonly found in boys.
Teen Anorexia Symptoms
Teens with anorexia nervosa are obsessed with food and calorie intake to lose weight, which can result in self-starvation. Adolescent anorexia is extremely dangerous and leads to more deaths than any other psychiatric disorder.
Signs and symptoms of teen anorexia include:
- Severe dieting or highly restrictive eating habits
- Obsessive fear of putting on weight
- Low self-esteem tied to body dysmorphia
- Lethargy and general exhaustion
- Muscle wasting and extreme thinness
- Problems concentrating, combined with extreme sensitivity
Adolescent Bulimia Symptoms
Bulimia nervosa, also called binge-purge syndrome, is characterized by binging a large amount of food, followed by forced purging through vomiting or using laxatives, diuretics, or diet pills.
Signs and symptoms of teen bulimia include:
- Repeated binge eating, particularly of junk foods and sweets
- Constant trips to the bathroom during and after meals
- Excessive buying and use of laxatives, diuretics, and/or diet pills
- A sore throat for no obvious health reason, with swollen salivary glands in the neck and the jaw
- Indigestion, acid reflux, and gastrointestinal problems
- Gum disease, bad teeth, bleeding gums
Teen Binge-Eating Disorder Symptoms
Teens who have a binge-eating disorder engage in compulsory eating behaviors. That is, they eat large amounts of food in a short period. However, with teen binge eating disorder, bingeing is not followed by a forced purge. Instead, they eat to the point of being uncomfortably full, which triggers feelings of shame, regret, guilt, and/or depression.
Signs and symptoms of teen binge-eating disorder include:
- Repeated binge-eating episodes
- Eating more rapidly and aggressively than normal
- Claiming to be full but continuing to eat
- Expressions of disgust or regret after binge-eating
- Weight cycling or weight gain
- High cholesterol and high blood pressure
Signs and Symptoms of ARFID
Children with ARFID are extremely picky eaters who often lack interest in eating food. It’s a form of eating disorder where the child may not struggle with body image concerns but still have a limited intake. Because of this, children with ARFID can cause numerous health problems, such as dehydration, weight loss, malnutrition, and unstable vital signs.
Children with AFRID symptoms fall into three categories:
- Selective/picky eaters who react strongly to smells, tastes, and/or textures of food
- Children who are uninterested in eating. They have a low appetite and will say they are not hungry.
- Those who avoid food for fear it may result in choking, pain, or an upset stomach.
Children with ARFID are at risk of vitamin, mineral, and protein deficiencies, delayed puberty, and overall poor growth. In the worst cases, children require tube feeding and nutrition supplements.
What Should You Do if You Think Your Teen Has an Eating Disorder?
Even though approaching the topic of an eating disorder with a teen may feel awkward, it’s important not to shy away from the subject. If you think your child or someone you care for could be suffering from one, addressing it is crucial.
“There often is a lot of guilt and shame surrounding eating disorders, which can lead to individuals not wanting to disclose that they are struggling,” said Kallie, MA, LPCC, a therapist in our HEaL program. “Talking with a teen about a suspected eating disorder allows for the teen to understand they are supported and have a loved one who is willing to help them through the difficult experiences. Early intervention of disordered eating has the best outcome of the individual making a full recovery.”
Some strategies to look into a suspected eating disorder can include:
Be Prepared for the Conversation
Learn as much as you can about eating disorders before you initiate a dialogue with them. And think about what you want to say before you say it. If you rehearse, you’ll feel less anxious. Also, don’t mention the topic at mealtimes or when the young person is emotional. Approach teenagers when they’re relaxed.
Ask Open-Ended Questions
If you hop into lecture mode about the dangers of eating disorders, a young person is likely to shut down. Instead, ask open-ended questions about their feelings. “How have you been feeling lately?” or “How did the party go?” might lead teenagers to open up. Then, you’ll have a more natural segue to talk about their eating behaviors.
Avoid Shaming
Accusatory language gets you nowhere. Saying, “You’re not eating enough,” or “You’re looking too thin” makes a child defensive. Instead, remind them there’s no shame in admitting they’re struggling. Explain that eating disorders are common and there are ways to get help.
Express Compassion
While your goal is to support the teenager, refrain from immediately jumping into fixing mode. What the child needs most is to know you feel for them. Let them know you’ll do whatever you can to help. Listen to what they say. Explain that adolescence is a challenging time. Tell them you care deeply about their well-being. Overall, create a safe space where they feel free to share what’s happening.
Get an Eating Disorder Assessment
If your conversation leads you to believe there’s an issue, contact a registered dietician, mental health counselor, or doctor to schedule a formal assessment. A professional can help you understand what’s happening and to determine the next steps.
Why Adolescent and Teen Eating Disorder Treatment Is Important
“Early intervention is key! If you suspect someone you care about has developed disordered eating patterns, seek support for them as soon as you can,” said Angie. “Intervening early greatly increases the likelihood of recovery. Start by expressing your concern in a non-judgmental way and ask how you can best help them, avoid comparisons, and listen to their feelings to validate their experience.”
And without treatment, eating disorders can cause serious health problems, such as kidney disease, liver disease, and heart disease. Young girls can experience stopped menstrual cycles, which can lead to early bone loss and painful fractures. Young males with anorexia nervosa typically have low levels of testosterone and vitamin D, and they have a high risk of osteopenia and osteoporosis.
Moreover, restrictive eating disorders impact linear growth and development. Many of the effects of malnutrition can be treated and reversed; however, stunted growth can be irreversible. Adolescents can achieve “catch-up” growth with early and aggressive weight restoration. However, they may never reach their projected adult height.
Getting help also extends to other supporting induvial alongside the patient. Kallie shares just how important it can be: “Through eating disorder treatment, caregivers learn and gain a vast array of psychoeducation on topics such as learning about the medical and psychological responses to a starved brain, how to respond to behavioral dysregulation surrounding meals/snacks, and how best to support their loved one within the home environment.”
Additionally, studies show that eating disorders nearly always co-exist with other mental health issues. A National Institute of Mental Health study of teens with eating disorders revealed that up to 90 percent of the 10,000 participating teens reported mental health problems, such as anxiety and depression. In addition, teens with eating disorders are also at greater risk for substance use disorder and self-harming behavior.
Above all, eating disorders can be life-threatening. If you suspect your teen has an eating disorder, early intervention is key to prevent long-term mental and physical complications.
During this challenging time, Amy Roethler, RDN, LD, reminds parents and caretakers that it’s okay to focus primarily on this healing journey.
“Do not feel bad about making your family and your child a priority during recovery. Doing this gives your child an optimal chance to recover, and you may find that your family can positively reconnect during this process. Working with eating disorder-informed providers will allow you to learn how best to help your child navigate recovery.”
Treatment for Eating Disorders in Rochester, Minnesota
The care team at PrairieCare is ready to help your teen overcome their eating disorder with a tailored treatment plan that includes nutrition assessments and clinical care. Our specialized Healthy Eating and Living (HEaL) program is the only Partial Hospitalization Program (PHP) in Rochester that helps teens and their families heal from disordered eating.
Our HEaL program is a full-day program that uses Family Based Therapy. This approach gives families the tools to play an active role in supporting their loved ones, which has been proven to be an effective way to recover from an eating disorder. During this time, we help young people manage their physical and mental health with therapeutic and educational experiences that help them build lifelong resiliency.
Our team also recognizes that mental health conditions such as anxiety, depression, and obsessive-compulsive disorder are often linked to struggles with food and body image. Our integrated program in Rochester creates sustainable healing by addressing teen eating disorder symptoms while treating primary mental health conditions.
Contact Our Team Today
If you believe your loved one is struggling with an eating disorder, our team in Rochester can help. Call us at 952-826-8475 to access a no-cost mental health screening, learn about our HEaL program, or talk with a trained team member. Get started today.
You can also fill out our no-cost mental health screening request form. Within one business day, our team will contact you by phone to complete a screening and determine if your loved one is a good fit for one of our programs.