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It’s difficult for parents to know the right time to get mental health treatment for their children, especially during the turbulent adolescents years. There are many reasons for this. First, it’s hard to tell the difference between normal adolescent “growing pains” and the onset of serious mental health conditions. Secondly, there is unfortunately still a considerable stigma associated with behavioral and mental health conditions – this is true for adults and even more so for teenagers. Lastly, parents might not know how to broach these difficult subjects in a way that’s helpful and supportive of their adolescent child, which can cause understandable hesitation. However, any mental health condition, which certainly includes eating disorders, is more likely to be recovered from if it is caught early and treatment begins before the disorder sets in.

Teenagers are not as likely as adults to understand that eating disorders are illnesses, not moral failures — they don’t usually have the wisdom to over the guilt they feel regarding their eating disorder and asking an adult for help. That’s why parents should always be on the lookout for signs their son or daughter is struggling with body image, being dissatisfied with their weight, and especially modifying their eating behaviors in an unhealthy way. Disordered eating behaviors almost always get worse when they aren’t treated, and studies indicate that early intervention is often essential to long-term eating disorder recovery, especially for adolescents.

Knowing What Eating Disorders Entail Is Essential

There are several different eating disorders listed in the Diagnostic And Statistical Manual Of Mental Disorders (the current edition, the fifth, is usually abbreviated to DSM-V) and many more that are considered subsets or atypical versions of those. The most well-known disorders are anorexia nervosa and bulimia nervosa, although e most common eating disorder in the United States is binge eating disorder. Atypical forms of each of these disorders exist, as do less-common but still dangerous disorders such as ARFID, orthorexia nervosa, pica, and exercise addiction. Parents should always be aware of the symptoms of these disorders:

  • Anorexia nervosa
    • This disorder is characterized by extreme food intake restriction, obsessions with weight and calorie-counting, body image distortions, and weight loss. People with anorexia nervosa can become severely underweight due to this weight loss, and have difficulty increasing their weight to a medically acceptable level (atypical anorexia nervosa also involved food restriction, but the individual may not become underweight and can actually be overweight or obese). Behaviorally, parents might notice that their child counts their calories compulsively, expresses that they feel fat or overweight, eats sparingly, and/or exercises compulsively to lose weight.
  • Bulimia nervosa
    • Bulimia nervosa is a disorder that involves a cycle of binge eating episodes followed by purging to get rid of the calories taken in during the episode. Purging can come in different forms. The most common is self-induced vomiting directly after the binge eating episode, which can also extend to after regular meals as well if the condition becomes more severe. Other forms of purging might include abusing laxatives or diuretics, abusing diet pills, or exercising excessively after meals. People with bulimia nervosa often become underweight, but in many cases, they remain at a “normal” weight or are overweight. Other signs parents can look for regarding bulimia nervosa are also body image distortions and frequent dieting.
  • Binge Eating Disorder
    • Binge eating disorder also involved frequent and repeated binge eating episodes, but unlike bulimia nervosa, there are no compensatory purging activities. People with binge eating disorder often feel that they cannot control their eating habits, which brings a sense of guilt and embarrassment when they binge eat. BED can interfere with a person’s psychosocial health as well as their physical health, causing social isolation as well as several nutritional deficiencies and health risks related to obesity. People with binge eating disorder often follow a strict diet in public but do not lose weight. Being secretive about binge eating and evidence of binge eating sessions such as hoards of food or their wrappers are good signs for parents to look out for.
  • Other Eating Disorders
    • ARFID (Avoidant/Restrictive Food Intake Disorder)-formerly known as selective eating disorder, is a condition wherein a person avoids a food type or food group because of an aversion to the flavor, texture, or another sensory aspect of the food. They may also experience phobias about this “fear food” that involve fear of choking or food poisoning. Unlike other eating disorders, body image and desire to lose weight is not a contributing factor in ARFID, although severe weight loss can occur.
    • Orthorexia Nervosa – People with orthorexia nervosa also avoid certain foods, but their avoidance is driven by an extreme desire to only eat food they consider “healthy” or “pure.” Orthorexia can interfere with a person’s daily activities and every meal, in that they refuse to eat many foods that are served at regular meals. It can also cause extreme weight loss and social isolation.
    • Pica – This condition, which mostly beings in smaller children, is a compulsion to eat items that are not considered to be food – rocks, chalk, hair, etc. This eating disorder is usually treated through cognitive retraining processes like CBT. Please note that pregnant women sometimes get cravings to eat non-foods; this is not considered to be pica.

When Should You Start to Consider Eating Disorder Treatment?

Even before beginning to search for specialized eating disorder treatment centers, the family and friends of a teenager at risk for developing an eating disorder should understand the early warning signs and symptoms of common eating disorders. If they are properly up-to-date on what to look for, it will be easier to relay this information to their adolescent child, who may be secretive and dismissive of the idea of treatment. This knowledge will also help the parents find the appropriate care providers for their child’s specific disorders.

Some early warning signs of common eating disorders include:

  • Sudden and extreme weight loss or weight fluctuations
  • Obsession with calories, weight, body shape, and appearance
  • Refusal to eat certain foods or food groups
  • The development of food rituals that may include eating foods in a specific order, excessive chewing, not allowing foods to touch, etc.
  • Excessive exercise, often past the point of illness or injury
  • Stoppage of menstruation
  • Social isolation
  • Depression and/or anxiety, especially concerning food and body image
  • Hiding or hoarding food
  • Eating in secret and/or consuming large amounts of food in secret
  • Wearing baggy clothes to hide their body
  • Discomfort at meals
  • Dizziness, fainting, and sleep problems

Reaching Out for Help

If your child reaches out to you for help for their eating habits, of course, it’s time to seek professional help. However, if you see any of the above symptoms, you may want to start looking for assistance If thoughts surrounding food, dieting, body weight, exercise, and body shape are ruling someone’s life, you may want to start by consulting your family doctor. Better yet, you can reach out to a mental health professional who specializes in adolescents. Either can give you a referral to an expert on eating disorders or an eating disorder treatment center.

Recovery from eating disorders begins with admitting there is a problem. Although many people find it difficult to talk about emotional problems or are secretive about their eating habits (out of a sense of shame), in the long run, the difficult conversations now will lead to better recovery outcomes later. The good news is that, with the help of a therapist or the admissions team at an eating disorder treatment center, these difficult conversations can be manageable.

How Should You Talk to Your Kids About Eating Disorders?

The National Eating Disorders Association recommends that parents and close family take the time to understand the disorder before patiently and compassionately raising the subject. The parents should be ready to demonstrate their knowledge of the eating disorder in a firm but nonjudgmental way, but also -importantly – listen.Speaking about a mental health condition can be scary for teenagers, and if they’re talking, you should carefully hear what they have to say. The more knowledgeable the individual’s family can become about how the treatment process works, the better. Some introductory questions parents may want to use include:

  • How long have you been feeling this way about food and eating? Have your eating habits changed a lot?
  • What kind of new thoughts and behaviors started? What were you trying to achieve with thesenew behaviors?
  • Have you noticed any physical health changes like lack of sleep, digestive problems, or dizziness? Any emotional changes like anxiety or depression?
  • How are you feeling right now?

Make Sure You Act Right Away

Teenage eating disorder treatment is a long and complex process. However, with the help of professional eating disorder counseling and a reliable support system at home, adolescents can become fully recovered. Call an eating disorder treatment facility for more information on what kinds of adolescent eating disorder counseling programs are available.


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.