In the United States alone, as many as 10 out of 100 young adults have been diagnosed with an eating disorder. The causes of eating disorders in adolescence are many, including biological factors, genetics, and environment; additionally, a disordered body image is nearly always present. While eating disorders such as bulimia nervosa and anorexia nervosa are also observed in boys and young men, girls tend to be diagnosed more frequently.

Depending on the specific type of disorder, eating disorders are typically characterized by compulsive relationships with food, restricting calories and negative body image issues. Eating disorders can affect people from all different walks of life. The professionals at centers for eating disorders define body image as the way adolescents and adults see themselves, while a negative or distorted teen body image refers to an irrationally unrealistic perception of how they look. Body image issues, combined with co-occurring factors, are some of the contributing causes of the need for eating disorder counseling for adolescents.

How Eating Disorders Relate to Body Image in Teens

Most modern studies and clinical studies show a negative body image is normally present in the development of eating disorders in adolescence. The beginning of puberty also normally coincides with a child’s development of a negative body image in the first place. This is the time when most kids begin to think more about their attractiveness and the size and shape of their body, in comparison to their peers. While this all begins in early childhood, body image continues to develop as people age and begin to receive feedback from their loved ones, friends, peers, coaches, teachers, etc.

Through studies performed at centers for eating disorder treatment and the evidence provided by eating disorder counseling, it has been proven these years are also the time when other mental health disorders normally begin to appear, increasing the chance for a dual diagnosis. Some additional signs of a negative or distorted body image include:

Feelings of jealousy about the shape or size of their friends’, family’s, or even celebrities’ bodies
Experiencing derogatory thoughts about their body
Frequently comparing their body to others
Showing obsessive checking behavior around mirrors
Self-harm, such as cutting

Signs and Symptoms of Eating Disorders

Some of the most frequent signs of eating disorders such as anorexia nervosa and bulimia nervosa include:

Avoiding social situations that involve food
Hiding or hoarding food for binging episodes
Going to the bathroom directly after meals
Anxiety
Depression
Fainting, tiredness or general weakness (or even anemia)
Menstrual issues in young women (infrequent periods or the loss of periods altogether)
Frequent or obsessive dieting
Body dysmorphia (distorted self-perception and thoughts about their own body)
Excessive exercise
Abusing laxatives or diuretics
Restricting certain food groups (common in ARFID and orthorexia)
Developing rituals surrounding food or mealtime (eating foods in a certain order, excessive chewing, etc.)

Parents may notice one or several of these symptoms in their children and unfortunately may not give them a second thought. After all, adolescence is a time of great changes in how people look, feel and act. However, it is important for parents to pay attention to the development of negative body image as they relate to their child’s eating habits. Centers for eating disorder treatment stress the importance of honest, non-judgmental communication during this time.

What Is Disordered Body Image?

Characterized by a chronic dissatisfaction with one’s appearance and finding imaginary flaws in their appearance or exaggerating them, negative body image is a key aspect of most eating disorders. In cases of eating disorders in adolescence and adulthood, there are often compensatory behaviors the individual feels are necessary to correct these “flaws.”

These compensatory behaviors can range from dieting and fasting to avoidance behaviors or binge eating and purging. Negative body image develops most often in early childhood, with 50 percent of pre-adolescent girls and 30 percent of pre-adolescent boys stating they dislike their bodies. Similarly, around 60 percent of adult women and 40 percent of adult men report they have a negative body image.

Does a Negative Body Image Cause Eating Disorders?

Not exactly, but on the whole, this is an important causative factor in almost every eating disorder. Eating disorders are high-risk and complicate mental illnesses which can be caused by interrelated aspects of a person’s emotional and psychiatric health. Poor body image in adolescence is just one of the main contributing factors to developing an eating disorder.

However, it is important for parents and families to be aware of burgeoning disordered body image in their children. As adolescence continues and teens begin to come to grips with their sexuality and self-esteem, they may place a very high, even unreasonably, value on their personal appearance. Their focus on weight and the shape of their body may become overwhelming.

Overthinking one’s weight and shape is a common symptom of many different eating disorders; it is found in the well-known disorders such as anorexia nervosa and bulimia nervosa, but is also common in binge eating disorder, orthorexia and other unspecified disorders.

Why Is Adolescence a Critical Time for Body Image

In addition to being a time when most people begin to evaluate their body in relation to others, adolescence is a time of profound change. Teenagers undergo sweeping physical changes to their bodies, and they also experience hormonal changes that affect the brain chemistry and subsequently mood. Even beyond the growing self-awareness that might lead to a disordered body image, adolescents have to navigate an increasing school workload, new responsibilities, and greatly increased social pressures – all of which cause stress. Some of the stressors that come to the forefront during adolescence may include:

Sports and Athletics

Athletics are often a rewarding experience for teenagers who are growing into adults. They can imbue a sense of responsibility, perseverance, teamwork and grit in young adults. Many parents and educators alike consider sports and athletics to be an important rite of passage. However, depending on the individual, sports can become triggering for an eating disorder; especially those athletic activities that put the focus on a person’s weight or body shape.

Putting a premium on a specific weight can have negative consequences. Parents may want to consider encouraging a sport that does not have a weight-class system or weight restrictions for their athletically-inclined teens and keep an eye out for signs of an exercise obsession or excessive exercising.

Social Media

The growing importance of social media, with its constant comparisons to others and its tendency for users to only show an idealized version of themselves, is increasingly paramount in the development of eating disorders in adolescence. Once upon a time, television or magazines were the only point of comparison, but social media has made peer pressure and the need to “fit in” that much more intense. It is often difficult for teens to understand, at least at first, that the images influencers and Instagram models put out are just as carefully posed and photoshopped as any Cosmopolitan photoshoot.

Dating

Adolescence, the age where a child becomes an adult, is fraught with situations that can potentially affect a young adult’s self-esteem. During those first fumbling attempts at dating, a simple rejection can throw a teen’s entire life into disarray. Unfortunately, these feelings of inadequacy can become laser-focused on a teens’ perception of their attractiveness. “If I just lose some weight, maybe he’ll ask me out.” Sound familiar? It is a sensitive subject, but if parents notice sudden depressive behaviors or the introduction of the disordered behaviors listed above, they should calmly and openly discuss it with their kids.

Early Intervention and Eating Disorder Counseling

If parents believe they are seeing the signs of body image problems, it is best to act quickly to discuss their worries with their child, and if necessary contact a center for eating disorder treatment. While this may cause some trepidation, it is necessary to provide teens every tool to build a healthy life as they navigate this difficult stage. If parents are unsure of where to start as they voice their concerns, it is important to remember playing the blame game is rarely helpful.

What Are My Options?

It is important to approach eating disorder treatment in adolescence cautiously and with the help of professionals. The first step should always be to consult your family doctor. Even if they are not specialists in eating disorder counseling, they will know the basic signs and can point you in the right direction, such as a center for eating disorder treatment.

If a child has developed an eating disorder such as bulimia nervosa or anorexia nervosa and their condition is in the more advanced stages, residential treatment may be necessary. This provides a safe and controlled treatment environment where the medical, psychiatric and emotional concerns of your teen can be addressed. Additionally, if a teen is experiencing issues with depression or anxiety, they can receive psychiatric care during their residential stay as well.

Some other treatment options for eating disorders include:

Inpatient Treatment: The purpose of inpatient eating disorder treatment is to help stabilize patients who are dealing with medical and mood instability. They will be closely monitored by a team of medical and psychiatric professionals until they can step down to a residential level of care.
Partial Hospitalization: This type of treatment is ideal for those who are medically and psychiatrically stable but may still benefit from a supportive program that can help them transition back into a regular routine. Sometimes referred to as “full-day outpatient care,” teens may find this is a great continuing treatment option before returning to school.
Outpatient/Intensive Outpatient or Day Treatment: This level of care is ideal for patients who are both medically and psychiatrically stable. They may have already completed an inpatient treatment program and are continuing counseling or they may have work and school commitments that prevent them from participating in other forms of treatment.

Adolescent Eating Disorder Treatment at Clementine

Every parent should be aware of the stresses that may influence a flawed or distorted body image in adolescence, and how they can instigate and perpetuate eating disorders such as anorexia nervosa. While a distorted or negative body image doesn’t necessarily mean you teenager has an eating disorder, it does greatly increase their chances of developing one. Body image is only one factor that benefits from eating disorder treatment. When teens are in the appropriate treatment program, they have a greater chance of enjoying a long-term recovery.

At Clementine, we are proud to support teens and their families as they begin on the path to recovery. By providing a safe, comfortable and home-like setting, we make it possible for teens to focus on their disordered behaviors by replacing them with healthy life skills that will help them reach toward a brighter future. Interested in learning more about the adolescent eating disorder treatment programs we have available? Call 855.900.2221 or contact our friendly admissions team today for more information.

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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.

Disordered Body Image in Adolescent Eating Disorder Treatment