• What are eating disorders? 
  • What are the signs and symptoms of an eating disorder? 
  • What do I do if I think my child might have an eating disorder?

What Are Eating Disorders?

Eating disorders are extremely unhealthy attitudes, feelings, and behaviors around food and eating. Many teens develop an increased self-consciousness about appearance, body image, and weight. Most often, these circumstances are temporary and do not severely impact health or eating habits. By contrast, eating disorders are severe and dangerous conditions that impact a person’s mental and physical health and may go on for months or years. 

Eating disorders can affect anyone, but are most common among adolescents and teenagers, especially girls and women ages 12 – 35. 

While there is no single cause of eating disorders, family history, stress, and mental health challenges, such as anxiety and depression, are common risk factors.

Left untreated, they can seriously harm a person’s physical and emotional health and can sometimes be fatal. 

A person with an eating disorder may 

  • judge themselves based on weight and body shape 
  • worry obsessively about weight gain or looking “fat”
  • think they are overweight, even when they are thin
  • feel guilty after eating 
  • intentionally eat very little food or no food at all
  • overeat or “binge eat” 
  • overexercise or be obsessed with fitness
  • force themselves to vomit after eating
  • have no interest at all in food or eating
  • lose or gain large amounts of weight

How Common Are Eating Disorders? 

Here are some statistics related to eating disorders in the United States:  

  • Approximately 30 million Americans live with an eating disorder. (National Association of Anorexia Nervosa and Associated Disorders)
  • Eating disorders are the third most common chronic illness among adolescent females in the United States. (International Journal of Adolescent Medicine and Health)
  • 10 million men in the U.S. will suffer from an eating disorder in their lifetime. (National Eating Disorders Association)

There are four common types of eating disorders:

Anorexia Nervosa (anorexia)

Signs & Symptoms

  • not eating or eating very little on purpose
  • obsessive focus on food portions; counting calories
  • over-exercising
  • using laxatives, enemas, or diet pills to lose weight
  • extreme weight loss / looking very thin

Common Health Effects

  • feeling tired, weak, dizzy, or fainting
  • low blood pressure
  • irregular heartbeat
  • constipation and bloating
  • irregular menstruation
  • weak bones
  • slow growth
  • brittle, dry nails and hair

Bulemia Nervosa (bulemia)

Signs & Symptoms

  • purging (vomiting on purpose after eating to prevent weight gain)
  • binge eating (overeating and feeling out of control and unable to stop)
  • may look thin, but may also be average weight or overweight

Common Health Effects

  • feeling tired, weak, dizzy, or fainting
  • low blood pressure
  • irregular heartbeat
  • blood in vomit or feces
  • cavities and tooth erosion
  • swollen glands in cheeks

Binge-eating

Signs & Symptoms

  • eating large amounts even when not hungry
  • eating alone or in secret
  • overeating and feeling out of control to stop
  • feel guilty or upset after binge eating
  • gaining significant amounts of weight unlike anorexia or bulemia, people with binge-eating disorder do not attempt to lose weight

Common Health Effects

  • diabetes
  • obesity
  • high cholesterol
  • high blood pressure
  • fatty liver
  • breathing problems

Avoidant-restrictive Food Intake (ARFID)

Signs & Symptoms

  • more common in boys 
  • avoiding food; having no interest in food or eating
  • feeling disgusted by the smell, taste, or texture of food
  • worrying that they will choke or vomit if they eat
  • not overly worried about weight or body shape

Common Health Effects

  • weak bones
  • slow growth
  • poor overall health
  • tiredness, low energy
  • difficulty concentrating

What Causes Eating Disorders?

Genetics often play a role in eating disorders. This means that those who suffer from eating disorders often have a parent or relative who has struggled with a similar issue. Stressful events and environments are also common factors.

Some things that many people with eating disorders have in common are:

  • having a family member with an eating disorder
  • poor body image
  • dieting at a young age
  • excessive focus on appearance and losing weight/dieting
  • participation in activities that focus on body type or weight (dance, gymnastics, ice skating, wrestling)
  • mental health issues (anxiety, depression, obsessive-compulsive disorder)

What Is the Connection between Eating Disorders and Mental Health?

Eating disorders are often tied to a person’s overall person’s mental and emotional well-being. People with eating disorders may;

  • have trouble concentrating or remembering things
  • have low self-esteem
  • have a poor or distorted body image 
  • feel lonely, sad, anxious, or depressed
  • feel angry, moody, or out of control
  • think about hurting themselves
  • have drug or alcohol problems

How Are Eating Disorders Diagnosed and Treated? 

A doctor will perform a physical examination to review symptoms, check the patient’s overall health, and measure height and weight compared to previous exams. They will ask about family history, eating habits, feelings, and thoughts.

Because eating disorders are closely tied with underlying mental health issues, if an eating disorder is diagnosed, the healthcare provider will recommend additional consultations with a therapist, as well as a nutritional advisor or dietitian.

Treatment of eating disorders addresses both the patient’s physical and mental health. This includes regular physical exams to monitor weight and overall health, nutritional counseling, and talk therapy (individual, family, and group). A doctor may prescribe medication to treat depression, anxiety, and binge eating.

Why It Matters

Eating disorders can affect anyone. They are closely related to mental health, self-esteem, and societal representations of body image. Parents and caregivers can help prevent eating disorders by 

  • promoting healthy attitudes toward food, weight, and eating at home
  • avoiding talk about dieting, weight loss, or criticizing your own body or weight around your child
  • helping teens recognize unrealistic media representations of body shape and weight
  • helping teens develop ways to cope with stress. emotions, and peer pressure
  • building a relationship that is focused on trust and open communication

Knowing the warning signs of eating disorders and seeking help early can make a big difference in how well and how quickly a person can recover.

People with eating disorders often feel ashamed and try to hide the problem from family members and friends. Because of this, the problem is often very serious by the time parents and caregivers learn about it. The earlier a person gets treatment, the more likely they are to recover fully and quickly.

Thinking about your teen’s behaviors, habits, and environmental circumstances, complete this checklist to learn more about the warning signs and symptoms of eating disorders.

Thinking about your teen’s behaviors, habits, and environmental circumstances, complete this checklist to learn more about the warning signs and symptoms of eating disorders.

Behavioral Signs

weighing themselves frequently
exercising multiple times a day or for long periods of time
a change in behavior or unusual behavior around food (insisting on using certain utensils, cutting food into very small pieces)
wanting to eat alone; eating in secret
eating large amounts of food without appearing to gain weight
wearing baggy clothing
spending a long time in the bathroom after eating
vomiting after eating
social isolation

Psychological Signs

abnormally underweight or overweight
stomach pains or digestion problems
mouth infections
bad breath
sensitive or damaged teeth, cavities
feeling cold, having chills
Irregular heartbeat or heart palpitations
pale or yellowish skin
dry, brittle nails
fatigue or exhaustion
feeling faint or dizzy

Psychological Signs

  feeling guilty after eating
feeling stressed at mealtimes
having low self-esteem
being obsessed with others’ appearance and body shape
having a distorted body image (thinking they are overweight when they are not)
feeling depressed or anxious
intense mood swings
having panic attacks
self-harm
suicidal thoughts

Environmental Factors

stressful life events
abuse or bullying
media pressure or peer pressure to be thin
having an existing mental health challenge (anxiety or depression)
having a family member with an eating disorder
participating in activities in which being thin is important (dance, gymnastics, etc)

If you think your child may have an eating disorder, get help early. Patients have a much better chance of recovery when the issue is addressed in the early stages. Make an appointment with  your child’s primary care doctor or an eating disorders specialist at your local hospital. Or call or text the National Eating Disorders Hotline (800)-931-2237.

Promoting healthy attitudes toward weight, body type, food, and eating; and helping teens manage stress and peer pressure are important steps that can help prevent eating disorders. 

But eating disorders can affect anyone, regardless of background and circumstances. If you think your child may be showing signs of an eating disorder, take action right away.  Your caring support and getting your teen the help they need early on will help them get on the road to wellness sooner and give them the best chance of a full recovery.

Start the Conversation 

People suffering from eating disorders often experience anxiety, guilt, shame, or embarrassment. They may try to hide or deny the problem, or they may not recognize that they have a problem. Before approaching your teen about an eating disorder, educate yourself as much as possible, so that you can share helpful information to help your child understand their condition.

Choose the right time and place to check-in. Make time to speak with your child when you are both feeling calm and can speak privately in a comfortable space and without distractions.  How are you feeling? How are things going?  Is there anything you’d like to talk about? 

Express concern without panic or judgment: Speak calmly and respectfully. Avoid sounding critical or confrontational. Share the specific behaviors you’ve observed and explain why they concern you.  You seem stressed or worried.  I noticed … 

Offer support, not solutions: Let them know you’re there for them and you want to help them. I love you. I’m here for you. I want to help you. Let’s work on this together. 

Be patient and prepared for pushback: Your teen may deny or resist the conversation or become angry or defensive. Stay calm and respectful and let them know you care, you’re there for them, and you believe in them. I’m here to help with whatever you need, whenever you’re ready. 

Keep the lines of communication open: Your teen may not open up immediately. It may take time and gentle persistence. Try to check-in and have brief chats with your teen several times daily. This will help make more serious conversations feel like less stressful events.

Next Steps: 

Don’t go it alone. Eating disorders are complex illnesses that can be long-term, and are best treated with the help of a team of professionals that includes a physician, a therapist or counselor who specializes in eating disorders, and a nutritionist.  Make an appointment with your child’s primary care physician, call your local hospital or clinic. or call the National Eating Disorders Helpline at 800-931-2237 for support.

Communicate regularly with your teen’s doctor and any other healthcare professionals who may be involved in their treatment (e.g., therapist and nutritional counselor). Treatment often involves family or group therapy with parents and caregivers involved. 

Ask your child’s doctor or counselor or call your local hospital about local resources or support groups. Or contact the National Eating Disorders Association for online support group options.

Explore these resources to learn more about eating disorders.

A Therapist Discusses Eating Disorders

 

Social Emotional Learning

Responsible Decision Making

How can I help my child . . .

  • recognize and handle peer pressure
  • make safe, healthy, responsible choices
Social Emotional Learning

Self-Management

How can I help my child . . .

  • get/stay organized and manage their time responsibly?
  • take initiative and develop independence?, (communicate problems and ask for what they need, stay organized, and set and reach goals)
  • be responsible and reliable?
  • better manage stress and strong emotions?
Social Emotional Learning

Social Awareness

How can I help my child . . . 

  • recognize others’ emotions and develop empathy?
  • be aware of their own impact on others?
  • be open to and accepting of differences?