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Ask a Therapist: How Do You Identify Eating Disorders in Adolescence?

“How do you identify eating disorders in adolescence? I think my child has one.”

Eating disorders can have a destructive impact on the physical and mental health of teens, affecting not only adolescent girls but also boys. According to the American Psychiatric Association, disordered eating usually develops during adolescence and young adulthood and most often affects females ages 12 to 35.

While eating disorders may have different symptoms, there are warning signs that parents can look out for when examining their child’s relationship with food. 

So how can you identify eating disorders in adolescence and help your child? Chase Kerrey, LPC, the chief clinical officer at Doorways Phoenix — an outpatient clinic in Arizona — shared some insights. 

Types of Eating Disorders 

Eating disorders are behavioral conditions characterized by abnormal or disturbed eating habits. 

“Humans need food as a basic building block of life. Adolescents struggling with eating disorders treat food as a coping skill or means of control — either in its consumption or lack thereof — rather than as a source of survival, enjoyment, and nutrition,” Kerrey said. 

While there are several types of eating disorders, the three most common are anorexia nervosa, bulimia nervosa, and binge eating disorder: 

  • Anorexia nervosa: Individuals fear gaining weight and have a negative view of their body or body image. In some cases, they may purge or throw up meals to combat weight gain, resulting in weight loss.
  • Bulimia nervosa: Individuals often struggle with binging behaviors or overeating. They then engage in “corrective” compensatory behavior, such as purging, using laxatives or diuretics, fasting, or overexercising. 
  • Binge eating disorder: Individuals overeat but don’t engage in compensatory behaviors. Binge-related eating behaviors are associated with eating an amount of food that is disproportionately large compared to what’s usually considered normal. 

Identifying Eating Disorders in Adolescence 

Based on Kerrey’s experience, teens struggling with disordered eating tend to view their self-worth in binary terms like good or bad. They’re also inclined to focus on their weight and physical appearance when perceiving their self-worth. 

Additional warning signs of adolescent eating disorders include:

  • Dental cavities.
  • Eating large amounts of high-fat foods and sweets.
  • Eating in secret.
  • Eating more food at a meal than is considered the norm.
  • Skipping meals.
  • Visiting the bathroom soon after a meal.
  • Showing disgust at their eating habits.
  • Excessive exercise.
  • Irregular menstrual cycles.

Medical complications resulting from eating disorders could be serious and include:

  • Inability to maintain a healthy weight.
  • Constipation.
  • Fainting.
  • Disappearance of menstrual cycles.
  • Hair thinning.

What Causes Eating Disorders in Adolescence?

The root causes of eating disorders often vary from person to person. However, Kerrey said there seems to be a connection between the disorders and unresolved emotional problems and mental illness, such as low self-esteem, anxiety disorders, and depression. 

He recalled that many clients believed achieving their ideal body weight or chosen caloric intake would lead to a better life.

“They believe their eating disorder will give them something they have not yet learned to obtain naturally, such as confidence, peace, self-esteem, attention, or worth,” Kerrey said.

What Should You Do if You Suspect Your Child Has an Eating Disorder?

If you suspect your child is dealing with disordered eating, Kerrey advised you avoid downplaying the issue, because it’s not just about eating food. 

“In reality, adolescents struggling with eating disorders need help in addressing the underlying or unaddressed emotional struggles they face on the inside as much as any kind of weight-restoration measure,” he said. 

When you go to talk to your child, remember that eating disorders typically thrive in the dark. Your teen may not want to discuss their behavior. Kerrey suggested approaching your child in a way that shows your concern.

“If your adolescent knows that you perceive that something is amiss — that you’re not going to be dissuaded from asking questions and that you won’t disengage until you figure out what’s going on — then, chances are, they will give you a better idea of what’s going on,” he said. 

If you believe your child is indeed using food as a coping mechanism or means of control, seek the opinion of a trained licensed professional, such as a psychologist or licensed professional counselor. 

For Kerrey, a good rule of thumb is to associate a teen’s level of “stuckness” with their need for support. Adolescents are allowed to have a bad day or week from time to time. However, when you notice a pattern of emotional avoidance and/or problematic behavior or demonstrating emotion or behavior outside the norm for a period of time — it may be a sign your child can’t course correct on their own. 

What Is the Treatment for Eating Disorders in Adolescence?

Treating your child’s eating disorder, Kerrey explained, involves treatment on two fronts: physiological and psychological restoration. 

  • Physiological restoration: Adolescents with eating disorders often need to reestablish a healthy relationship with food while restoring healthy body weight. These tasks are best done with the help of a registered dietitian. 
  • Psychological restoration: Dialectical behavior therapy, cognitive behavioral therapy, and acceptance and commitment therapy can help adolescents learn alternative coping skills that will replace their eating disorder behaviors. 

Therapy can take place individually and in group settings. An intensive outpatient program involving group therapy a few hours a day a few days a week is often used to help young people. If outpatient treatment is not successful, short-term residential treatment where your child lives in a treatment center may be necessary. If there are serious medical complications, inpatient hospitalization may be required to stabilize your teen. In that case, upon discharge, partial hospitalization or short-term residential care may follow.

How Can You Support Your Child During Recovery?

To best support your teen, Kerrey noted it’s important you keep in mind how they’re feeling about what they’re experiencing.

“Many adolescents struggle with significant regret surrounding the development of their eating disorder, both in terms of the impact the addiction has had on themselves and their surrounding family,” he said.

By the time they receive treatment, most adolescents wish they could have chosen an alternative path before their behaviors became a habit. 

Recognize recovery from eating disorders can be difficult, and practice compassion with your teen. For example, if you see they’re feeling guilty, tell them that you could see how this is difficult for them and you’re here for them anytime they want to talk.

Helping Your Teen: Your Next Steps 

Parents often have a hard time identifying eating disorders in adolescence and addressing the issue. The good news is, you can seek health professionals who can help your child recover physically, avoid harmful eating behaviors, and feel better about themselves and their body shape. 

To find a mental health provider or treatment center near you specializing in eating disorders, you can use the Psychology Today search tool.

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