Eating Disorders in Teens: Warning Signs and How to Help

Eating disorders are serious mental health conditions that commonly emerge during adolescence. They have the highest mortality rate of any mental illness. Early recognition and intervention dramatically improve outcomes. As a parent, knowing the warning signs could save your teen's life.

This guide covers what parents need to know about eating disorders in teenagers.

What You Need to Know AAP

The reality:

• Eating disorders affect an estimated 9% of the US population
• Most commonly develop during teen and young adult years
• Affect all genders (not just girls)
• Affect all races, ethnicities, and socioeconomic groups
• Are serious medical and psychiatric conditions
• Are treatable with early intervention NEDA

Types of eating disorders:

*Anorexia nervosa:*

• Severe restriction of food intake
• Intense fear of gaining weight
• Distorted body image
• Often significantly underweight
• Can be fatal

*Bulimia nervosa:*

• Cycles of binge eating and purging
• Purging may include vomiting, laxatives, excessive exercise
• Often normal weight or overweight
• Serious health consequences

*Binge eating disorder:*

• Episodes of eating large amounts of food
• Feeling out of control
• No regular purging
• Often associated with shame and distress
• Most common eating disorder

*ARFID (Avoidant/Restrictive Food Intake Disorder):*

• Extreme picky eating beyond normal
• Food restriction not related to body image
• May avoid textures, colors, or types of food
• Can cause nutritional deficiencies

*Other Specified Feeding or Eating Disorders (OSFED):*

• Disordered eating that doesn't fit other categories
• Just as serious as named disorders

Warning Signs

Physical signs:

• Significant weight loss (or not gaining expected weight during growth)
• Dramatic weight fluctuations
• Feeling cold all the time
• Dizziness or fainting
• Hair loss
• Dry skin and brittle nails
• Dental problems (from vomiting)
• Swelling around jaw (from purging)
• Growth of fine body hair (lanugo)
• Delayed or absent menstruation

Behavioral signs:

• Skipping meals or making excuses not to eat
• Eating only certain "safe" foods
• Disappearing after meals (possible purging)
• Excessive exercise, even when sick or injured
• Wearing baggy clothes to hide body
• Frequent weighing
• Food rituals (cutting food tiny, arranging food)
• Cooking for others but not eating
• Avoiding social situations involving food
• Secret eating or food hiding

Emotional/psychological signs:

• Intense focus on body weight, shape, food
• Negative body talk
• Mood changes around eating
• Withdrawal from friends and activities
• Depression or anxiety
• Perfectionism and rigid thinking
• Denial of hunger
• Distorted perception of body size

In boys (often overlooked):

• Obsession with muscularity
• Excessive exercise for muscle definition
• Protein supplement or steroid use
• Restrictive eating for athletic performance
• Similar signs as above

What Causes Eating Disorders?

It's not:

• A choice or phase
• About vanity
• Parents' fault
• Just about food

It is:

• A complex mental illness
• Influenced by genetic, biological, psychological, and social factors
• Often triggered by dieting
• Associated with anxiety, depression, trauma
• Treatable with appropriate intervention

Risk factors include:

• Family history of eating disorders
• Personal history of dieting
• Anxiety or depression
• Perfectionism
• Low self-esteem
• Social media and cultural influences
• Certain sports or activities (gymnastics, wrestling, dance)
• History of teasing about weight
• Major life transitions

What to Do If You're Concerned

Don't wait:

• Early intervention has the best outcomes
• Waiting for "rock bottom" is dangerous
• Trust your instincts if something seems wrong

Talk to your teen:

• Choose a calm, private moment
• Lead with concern, not accusation
• Use "I" statements ("I've noticed..." "I'm worried...")
• Listen without judgment
• Expect possible denial or anger
• Reassure them of your support

What to say:

• "I've noticed you seem stressed around food lately. I'm here if you want to talk."
• "I love you no matter what. I'm concerned about your health."
• "I want to understand what you're going through."

What NOT to say:

• "Just eat normally"
• "You look fine/healthy/thin"
• "Why are you doing this to yourself/us?"
• "I don't understand why you don't just stop"

Get professional help:

• Start with pediatrician
• Request eating disorder screening
• Ask for referral to eating disorder specialist
• Treatment team typically includes: medical doctor, therapist, dietitian
• Don't try to handle alone

Treatment

Treatment is effective:

• Most people recover with treatment
• Earlier treatment = better outcomes
• Multiple approaches may be needed

Types of treatment:

• Outpatient therapy
• Intensive outpatient programs
• Residential treatment
• Inpatient hospitalization (for medical instability)
• Family-based treatment (FBT)—evidence-based for adolescents

Family involvement is key:

• Parents are essential to adolescent recovery
• Family-based treatment is first-line for teen anorexia
• You are not the cause, and you are crucial to the solution

Recovery is possible:

• Full recovery happens for many
• Recovery takes time—often years
• Relapses can happen but don't mean failure
• Ongoing support is important

How to Support Your Teen

During treatment:

• Follow treatment team recommendations
• Attend family sessions
• Create supportive home environment
• Don't comment on weight or appearance
• Focus on health, not weight
• Be patient—recovery takes time

At meals:

• Eat together when possible
• Be matter-of-fact about food
• Don't negotiate about eating
• Follow meal plan from treatment team
• Stay calm even when meals are difficult

Emotionally:

• Express unconditional love
• Separate your teen from their illness
• Validate their struggle without validating eating disorder behaviors
• Take care of your own mental health
• Connect with support groups for parents

What Other Parents Ask

Q: How did I miss the signs?
A: Eating disorders are secretive by nature—your teen likely worked hard to hide it. Don't blame yourself. Focus on getting help now.

Q: Is this my fault?
A: No. Eating disorders are complex illnesses with biological, psychological, and social factors. Parents don't cause eating disorders, and blaming yourself isn't helpful. Your role now is supporting recovery. AAP

Q: Will my teen have this forever?
A: Many people achieve full recovery from eating disorders. Recovery is possible and expected with appropriate treatment. Early intervention improves outcomes.

Q: How do I help without making it worse?
A: Work with the treatment team. Don't comment on weight or appearance. Create calm mealtimes. Express unconditional love. Focus on health and feelings, not weight or food. Take care of yourself too.

Q: What about siblings?
A: Keep siblings informed at age-appropriate level. Don't make the home entirely about the eating disorder. Watch siblings for signs they're struggling. Consider family therapy that includes siblings.

Emergency Signs

Seek immediate medical attention if:

• Fainting or passing out
• Chest pain or racing heart
• Severe dehydration
• Refusal to eat or drink anything
• Suicidal thoughts or self-harm
• Blood in vomit

Resources

• National Eating Disorders Association (NEDA): 1-800-931-2237
• Crisis Text Line: Text "NEDA" to 741741
• NEDA website: nationaleatingdisorders.org

The Bottom Line

Eating disorders are serious but treatable mental illnesses. Know the warning signs, don't wait to get help, and remember that parents are crucial to adolescent recovery. Early intervention saves lives. With appropriate treatment, recovery is possible. AAP

Key points:

• Know the warning signs
• Don't wait—early intervention matters
• Get professional help immediately
• Parents don't cause eating disorders
• Family involvement aids recovery
• Recovery is possible

Clara is here to support you through this difficult journey.