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Besides the myriad physical, emotional, and even hormonal changes that adolescence brings, one new aspect of life for a teenager is increasing responsibility. This might mean taking on a part-time job, becoming a leader on an afterschool team or club, or even just doing more chores at home. It’s a natural progression as adulthood approaches.

Unfortunately, this time is also when eating disorders such as anorexia nervosa, bulimia nervosa, or binge eating disorder begin to develop. These potentially life-threatening disorders can be halted through specialized eating disorder treatment programs. Central to these adolescent programs is the concept of taking increased responsibility for the individual’s eating and health habits.

Although adolescents are still children, and allowances should be made for this, parents can look at time spent in eating disorder treatment as an opportunity as well as a crisis. The first order of business is always to address the emotional root causes of the eating disorder and to rectify the disordered behaviors. However, treatment can also help the teenager begin to set a foundation for when they leave the home. This increasing sense of responsibility and self-reliance will serve them well into adulthood.

Signs That an Adolescent Is Developing an Eating Disorder

The first symptoms of a growing eating disorder are often subtle. There are certain things parents can look out for that will indicate whether further recovery steps should be taken.These include body dissatisfaction and other clues, such as:

  • Food rituals
  • Eating in private but not at meals
  • Mood swings
  • Feelings of worthlessness or self-loathing
  • Feeling a loss of control regarding food intake
  • Obsessive meal planning
  • Frequent dieting
  • Intense focus on body size and shape
  • Expressed fear of gaining weight
  • Weight fluctuations, both increases, and decreases
  • Dizziness and fainting

Certainly, each different eating disorder will have differing symptoms. An adolescent with anorexia nervosa for, example, will lose weight due to severe food restriction, whereas a case of binge eating disorder will usually induce weight gain. A common thread, however, is dissatisfaction with their body and a negative body image.  If parents observe these symptoms in their son or daughter, it’s time to consult an eating disorder recovery center or an eating disorder-focused therapist. They can help make a diagnosis of the situation and plan out the next steps to securing treatment.

Eating Disorders Can Have Serious Health Risks

Although untreated eating disorders can cause malnutrition and even death, they take time to reach that point. Earlier on, they can cause several different negative effects on an adolescent’s health. Health problems related to dysfunctional eating disorder behaviors and thought patterns include:

  • Nausea
  • Bloating
  • Salivary gland swelling
  • Intestinal obstruction
  • Constipation
  • Stomach pain
  • Blood sugar spikes and crashes
  • Insulin resistance
  • Depression
  • Anxiety
  • Nutritional deficiencies

Many of these symptoms worsen if left untreated into adulthood. Disorders that cause weight gains such as binge eating disorder and some cases of bulimia nervosa can cause type 2 diabetes, high blood pressure, and other obesity-related conditions. When severe weight loss happens, the result can be anemia, severe problems with the gastrointestinal process, organ failures, and seizures. Eating disorders are sometimes deadly – anorexia nervosa, in particular, has the highest mortality rate of any mental health disorder.

Increasing Responsibility and Decreasing Disordered Eating

The programs at adolescent eating disorder treatment centers are focused on providing a toolset for teenagers to use after they discharge. This self-reliance is grown by starting the client with a clean slate in terms of responsibilities. At first, the eating disorder treatment experts handle all meal planning, movement and exercise schedules, and other day-to-day tasks. As the clients meet the expectations at each level of the program, more responsibility is conferred on them.

Each level of the treatment program provides teens guidance and support in challenging disordered eating attitudes and behaviors through structured activities and exercises. Meal planning and preparation, self-guided therapy and meditation, mindful exercise programs, and more become second nature to the adolescent as they progress through the program.

Time spent in a residential eating disorder treatment center is limited and precious; the clinical care and medical stabilization provided there can’t go on forever. An increasing responsibility level system allows the adolescent in treatment to gradually improve their self-reliance and self-confidence regarding their eating habits and thought patterns. Although relapses can always happen, this sets the basis for continued recovery as they become adults.

What Kinds of Activities Increase Self-Reliance?

The foundation of eating disorder treatment is understanding a person’s relationship with food and eating. Many types of eating disorder therapy focus on self-understanding; being mindful of how emotions influence behaviors and vice versa allows the client to experience their urges to use disordered behaviors without acting on them.

Some of the mainstays of eating disorder treatment that facilitate self-understanding include:

  • Cognitive Behavioral Therapy –This common form of therapy emphasizes that disordered behaviors are learned and can be corrected.Accomplished by helping the client objectively assess their behaviors, CBT is highly effective across a wide spectrum of mental health disorders.
  • Daily Exposure Therapy – Part of taking responsibility for one’s actions is facing the things one fears – such as eating certain foods or gaining weight. Exposure therapy gradually forces a client to engage with these feared activities, removing the stigma against them and allowing them to try healthier eating patterns.
  • Life Skills Development – This is important for anyone undergoing eating disorder treatment, but it’s essential for adolescents. Adolescent-focused eating disorder treatment includes an educational component – although their focus is on recovery, they must learn to balance that with their responsibilities in school. In a similar vein, daily chores and time management skills are foregrounded. They set the stage for a lifetime of self-control.

Not all of the activities are only for individuals. Some, like CBT, can be performed in both group and individual settings. Group therapy is also a mainstay in eating disorder treatment. A group setting encourages sharing emotions; having a sense of being heard by people who understand your experiences personally facilitates new perspectives and further sharing. Being part of a support system for other clients also promotes a sense of responsibility.

The family is also crucial to adolescent eating disorder recovery. Family support for the program helps stress the importance of continuing the recovery plan following residential treatment. Increased responsibilities learned in treatment can also be implemented when they return home, helping to cement the teen’s new role in the family as they approach adulthood.

Aftercare and Continuing Education Are Essential

Eating disorders are chronic; they have a way of coming back again and again, even if a person has undergone treatment successfully.For this reason, most eating disorder treatment centers offer a robust alumni program, with various resources for people to continue their recovery.

These resources range from educational webinars to alumni reunions, and sometimes just a friendly shoulder to cry onif needed. Normally there is a database of useful materials at their command as well, which can continue education about their eating disorder and ways to combat it.

In addition to helping their graduates, there are usually resources for the parents available at adolescent eating disorder treatment centers.There might be parents’ groups or support sessions available, orthey may also tap into the online resources to keep up to speed on their responsibilities as a parent of a teen with an eating disorder. The center might also provide a lifeline to parents if their child relapses, provide support, and plan a return to the center if necessary.


Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.