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Eating Disorders

  • 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?

Key Ideas:

What Are Eating Disorders?

As children move into middle school, they 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. They can be generally defined as extremely unhealthy attitudes, feelings and behaviors around food and eating.

According to the American Academy of Child and Adolescent Psychiatry, 10 in 100 women suffer from eating disorders.  Some of the disordered eating is around stress, poor nutritional habits, and trendy food diets but the two most severe are anorexia nervosa, a form of starvation, and bulimia, binging food and then purging it.  While these two eating disorders are most common in girls ages 12-25, it can also be seen in boys and the preoccupation with food and body image can start much younger.

Left untreated, eating disorders 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)

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 children recognize unrealistic media representations of body shape and weight.
  • helping children 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.

Check-In:

Thinking about your child’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

PHYSICAL 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.

Connect & Communicate:

Promoting healthy attitudes toward weight, body type, food and eating; and helping children 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, act right away.  Your caring support and getting your child 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 child about an eating disorder, educate yourself as much as possible, so that you can share helpful information to help them 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 child 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 child may not open up immediately. It may take time and gentle persistence. Try to check in and have brief chats with them several times daily. This will help make more serious conversations feel like less stressful events.

Promote Healthy Eating Habits:  Provide magazines and books that will inspire your child to read more about healthy food choices and habits.  When possible, allow them to choose what the family will eat for meals. Place healthy foods out on the counter for when they come home.  Find interesting recipes to make and enjoy with your child at home.

Eat Meals Together:  As much as possible, eat meals together.  Discuss what foods you are eating and the ways in which they support the body and brain development.  Help create a healthy relationship to food.

Discuss the Media’s Impact on Body Image:  Find or highlight movies, magazines or television shows that portray women in unrealistic ways.  Discuss why that happens and how that can influence how girls feel about themselves.  Contrast that with stories of celebrities and brands that refuse to be airbrushed. You can start here: https://www.getthegloss.com/article/these-beauty-brands-refuse-to-airbrush-now-let-s-make-it-the-norm

Next Steps: 

Don’t go 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.

Contact & Collaborate:

Communicate regularly with your child’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.

Continue Learning:

Explore these resources to learn more about eating disorders.

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