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Most of the most well-known eating disorders, including anorexia nervosa, bulimia nervosa, and binge eating disorder, first show signs at an average age of 18 – 21 years old. While the need for eating disorder counseling may not appear until adulthood, the symptoms of most eating disorders normally appear much earlier. A sad fact is, the beginnings of most eating disorders in adolescence appear much earlier than 18 – some cases of anorexia nervosa have been reported as early as age 6.

There are many approaches to eating disorder counseling available, which can vary considerably depending on the age, gender, medical history, type of disorder, and the specialty of the center for eating disorders. Specialization is key – every program should be tailored for the individual receiving the treatment. For example, a program designed around making a person with anorexia nervosa more comfortable with eating larger portions will not be effective in helping a person with binge eating disorder.

For these reasons, age-appropriate eating disorder counseling is urgent when addressing various eating disorders in adolescence. The years when a child becomes an adult are crucial developmental times, bringing with them special needs that cannot be ignored.

Nutritional Needs

As an adolescent’s body undergoes rapid changes in size and shape, there are many necessary nutrients. Without nutrients like calcium, a variety of vitamins, and low-fat proteins, teenagers can begin to experience distorted or stunted growth. If denied the proper nutritional balance for their age, teenagers can experience a shortfall in the development of muscle mass, bone density, and body fat.

These deficiencies can cause complications in later life and adulthood, including anemia, diabetes, and osteoporosis. To prevent later nutritional deficiencies and the complications that come along with them, adolescent centers for eating disorders normally include both planned nutritional meals and training for how to prepare them. The latter aspect helps alumni continue to ensure proper nutrition after they have completed formal eating disorder treatment.

Medical Complications

The onset of eating disorders in adolescence is not always gradual; sometimes severe symptoms and their attendant health complications arise very quickly. These symptoms can cause medical conditions requiring emergency care as well as long-term complications. Any disorder which reduces the amount of nutrition taken in, whether due to food restrictions or because of purging (a la bulimia nervosa), can cause the delay of puberty or even its arrest. These complications, if left untreated, can take years to correct.

Depending on the type of eating disorder, other complications can occur, which vary in severity. Teens with anorexia nervosa may face the growth effects mentioned above as well as symptoms of malnutrition such as losing hair, dry and brittle skin, anemia, and low body temperatures. Those with bulimia nervosa and binge eating disorder may experience complications such as heart disease, high blood pressure, sleep apnea, and diabetes.

Psychosocial Considerations

Most teens that enter a center for eating disorder treatment have a distorted or negative self-esteem and self-image. In many cases, their body dissatisfaction leads to the kinds of self-harming behaviors that define their eating disorder. The flawed perception that they are “too fat” is the main self-identity dissatisfaction behind the caloric restriction of anorexia nervosa. In a similar vein, poor or warped self-image often leads to extreme fad diets, which perpetuate a cycle of binge eating and purging.

The adolescent years are when people begin to compare themselves to their peers (and far too often) the photoshopped, idealized images in the media. The negative thoughts and feelings that can arise from these may become solidified as a central part of an adult’s identity if eating disorder counseling is ignored during these formative years. Because teenagers’ identities are so malleable, early intervention is crucial to healthier psychosocial development.

Getting Help Early Counts

The factors above should outline what a critical time adolescence is in both natural development and the onset of disordered eating behaviors. The upshot of this is clear; if you have suspicions that your daughter is experiencing an eating disorder, it’s better to contact a center for eating disorders sooner rather than later. This lets the professionals design an appropriate treatment plan and nips a developing disorder in the bud.


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.