How To Know If Your Teen Has An Eating Disorder

Posted on March 3rd, 2015

The Facts

It is common for children to become more focused on their appearance as they transition from childhood to “teen-hood.” Our culture and social media communicate powerful messages about what an ideal body should look like. Traditionally, teenage girls and young women have been targets of these messages, but increasingly, teenage boys and young men are also becoming targets.

A decrease in our culture’s daily physical activity levels has resulted in an increased focus by healthcare professionals guiding teens to make “healthier lifestyle choices.” This has led to an increasing focus on body weight and physical activity by educators: Teens are getting weighed annually (and publicly) at their school and required to participate in school sanctioned conditioning programs. This is placing additional pressure on teens and their perceived appearance of their body.

Dieting behaviors are becoming increasingly prevalent in younger age groups, and the types of dieting behaviors utilized by younger age groups (severe food restriction, vomiting, dieting pills, and laxatives) are posing greater health risks to teens. Many parents are surprised to learn that sometimes these behaviors can become life-threatening and require immediate hospitalization due to cardiac or electrolyte abnormalities.

Given these facts, how can a parent know when their teen’s focus on their appearance and behaviors such as “watching my weight” and “working out” shifts from being healthy to unhealthy? What behaviors suggest that your son or daughter may be developing an eating disorder?

Myths About Eating Disorders

MYTH #1: Eating disorders only affect teenage girls.
Truth: Eating disorders do affect teenage girls more than boys, but eating disorders are found in people of of all ages and backgrounds.

MYTH #2: My son or daughter would have to be really skinny to have an eating disorder.
Truth: Eating disorders affect boys and girls of all different body shapes and sizes.

MYTH #3: Eating disorders are a “fad” and are not really that dangerous to my teen’s health.
Truth: Eating disorders pose severe health risks that can lead to permanent damage to the body (e.g. heart, bones, brain) and can be life-threatening.

MYTH #4: Our bodies’ appearance and weight is something we can ultimately control.
Truth: An individual’s appearance and weight is significantly influenced by his/her genetics.

Warning Signs

What characterizes an eating disorder from normal teen self-consciousness is some form of “extreme” dieting behaviors (see below). Additionally, a preoccupation with weight, body image, and low self-esteem are hallmark features of an eating disorder.

It is important to understand that the eating disorder is serving the teen by helping him/her manage self-hatred, negative emotions and emotional pain. For example, food restriction can help a teen feel a sense of control, bingeing on food can help soothe overwhelming emotions, and purging food (e.g. vomiting, laxative abuse, excessive exercise) may help a teen manage feelings of self-loathing.

Common Examples Of “Extreme” Dieting Behaviors

  • Episodes of severe food restriction (eating very small portions, skipping entire meals or going prolonged periods of time with minimal food)
  • Eliminating whole categories of foods (sweets, fats, meat, dairy, carbs) from their intake. A parent might observe their teen initially cut out sweets and reduce their fat intake, but this elimination process continues until the teen is no longer getting balanced nutrition at meals or snacks. Sometimes, the only food that is “okay” for the teen to eat narrows to just fruit and vegetables.
  • Prolonged periods of minimal food intake can lead to “bingeing” on larger quantities of food as a result of extreme hunger. The amount that a teen binges can vary: some may only eat a small amount of food, others may eat large quantities. Regardless of quantity, the teen will usually report this binge experience as feeling “out of control.”
  • Teens usually report overwhelming shame following a food binge and attempt to “get rid” of the food by purging it either via vomiting, taking excessive amounts of laxatives/diuretics, and/or excessively exercising “to burn-off the calories”
  • Excessively exercising (spending several hours per day working out) and prioritizing this above anything else (e.g. spending time with friends)
  • Drinking excessive amounts caffeine as an appetite suppressant, diuretic, and laxative
  • Drinking excessive amounts of water to suppress hunger signals and minimize caloric intake

How To Approach Your Teen If You Suspect An Eating Disorder

It is best to approach your teen with your concerns in a loving and non-judgmental way. You can validate and normalize your teen’s experience by letting them know that there are many teens who struggle with eating issues. Educate your teen by letting them know that these behaviors – while they may seem “normal” in their peer group – can be very dangerous to their health, and potentially life-threatening. Also let them know that the longer they have an eating disorder, the harder it is to recover. As their parent, you want to help them “nip this in the bud” to prevent this from becoming a lifelong struggle. Reassure your teen by letting them know there are health professionals who can help them get back to the life that they were living prior to their eating disorder.

Anticipate that your teen will likely become angry with you and deny that they have an eating disorder. Addressing the problem may make your teen feel vulnerable and threatened. You are identifying a destructive behavior that is their only means of coping at that moment. By voicing your concern, you are communicating that you want to help them develop new coping strategies. As we all know, changing one’s behaviors, especially if you are a teenager, can be very challenging.

Who Can A Parent Call To Get Help?

Reassure your teen that you will support them to identify and develop healthier coping strategies by scheduling an appointment with a medical provider, therapist, and registered dietitian as soon as possible.

Ideally, it is recommended that you schedule these appointments with healthcare professionals that treat teens with eating disorders. Specialists are critical, as individuals with eating disorders (teens included) are known to downplay or under-report their behaviors. Often, this is due to fear of having to give up the behavior as well as shame. Unless the healthcare provider knows which questions to ask, it is unlikely that the teen will volunteer any information and actually may go out of their way to hide their extreme dieting behaviors.

This specialized “multidisciplinary team” is not only essential in ensuring a comprehensive assessment, but will also put your teen in the hands of seasoned healthcare professionals and maximize his/her ability to successfully recover from the eating disorder.

Los Gatos Teen Therapy, your teen’s pediatrician and your teen’s school counselor can be good resources to help you find eating disorder specialists in your community.


If your teen has struggled with an eating disorder, what resources have you found helpful?

What are your concerns about approaching your teen to discuss his/her eating behaviors?

What has worked for you in talking with your teen about his/her eating behaviors?

Share your thoughts in the comments section below.

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Would you like additional guidance in this area? Los Gatos Teen Therapy provides individual teen therapy, family therapy, group therapy, parent support counseling, and in-home teen and family coaching 7 days a week, including afternoons, evenings, and weekends. For more information, contact us at 408.389.3538.

3 thoughts on “How To Know If Your Teen Has An Eating Disorder

  1. Lindsay Smith

    This is such an important topic. Thank you so much for giving us a better idea of what we can look for to know if the way our teens are eating or thinking about/talking about their bodies are problematic. Sometimes it can be hard to recognize when this is a problem, but it is so true that the sooner they get help, the better off they will be. I also really appreciate the ideas you provided about who a parent can contact to get help.

  2. katie bell

    Lindsay, Thank you for your comment below. If any parent or healthcare provider has a specific question, they are more than welcome to call me (or any provider at The Healthy Teen Project) at 650 941 2300 for consultation.
    In my experience, it can be very helpful to have a direct conversation with a provider (Therapist, Registered Dietitian, Psychiatrist or Medical Provider) who specializes in eating disorders as a means to sort out the issues and discern if follow up with an Eating Disorder specialist is warranted.

  3. Steve Dang

    Thanks for writing this article on eating disorders! In high school while I was wrestling, I totally developed an eating disorder, anorexia. While I’m far from those years, I still struggle with it mentally. Thanks again!

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