Adolescence is a time of major change. Moving on from childhood, adolescents face changing roles in society, changing bodies and attitudes, new activities and responsibilities, and so much more. With so much about their lives in flux, it can be hard to know what to do when challenges such as negative body image or disordered eating behaviors arise. It’s sadly ironic that the very time when a person’s life changes so dramatically and is so full of uncertainty is the same time that mental health disorders most commonly begin.

According to the NEDA (National Eating Disorders Association), almost 30 million Americans have or will experience an eating disorder in their lifetimes. Even though it’s become a stereotype that keeps people from getting help from professionals, the fact remains that adolescence remains the most common time when eating disorders develop. Adolescents and young adults aged 15 – 24 are the most likely to develop an eating disorder, including anorexia nervosa and bulimia nervosa, and they may not know what to do if they start seeing the signs of disordered eating behaviors in themselves. This is even more troubling when you consider the potential health risks that come with eating disorders.

We don’t want to harp on the doom and gloom of eating disorders – they are treatable, after all, and negativity doesn’t help the situation – but it must be briefly addressed. Eating disorders are the most dangerous form of mental health disorder known to medical science. Various health and emotional risks can result from an untreated eating disorder, with rates of malnutrition, liver and kidney disease, and suicide dramatically increasing.Preventing these complications is possible, and much easier if early action is taken. Following a diagnosis of an eating disorder, parents and teens looking to enter treatment may feel they’re facing a long, hard road – but the path to recovery contains hope for the future.

What Should I Do if I Think I’m Developing an Eating Disorder?

First, let us congratulate you on your self-awareness and sincere wish to repair your relationship with food and eating. It takes courage to face a problem head-on, and very often eating disorders can skew a person’s thought process. Indeed, the body dysmorphia that comes with many eating disorders causes them to perceive their body weight and shape in a distorted way – they might think they are “fat” or overweight even if a doctor would say they are at an unhealthy weight. So your ability to objectively look at how you relate to your body and your eating patterns is a wonderful first step.

Here are some steps you can take if you think you’re developing an eating disorder.

1. Learn More About Eating Disorders

Did you know that the most common kind of eating disorder isn’t anorexia nervosa or bulimia nervosa, but binge eating disorder? Did you know it’s possible to have anorexia nervosa without becoming medically underweight? Eating disorders come in as many forms as the people who get them. That’s why if you notice unusual eating patterns or attitudes about food in yourself, you should educate yourself about what the symptoms are.

There are various organizations with an online presence that can help you with this. Check out NEDA for a list of symptoms, for starters. The National Eating Disorder Association has been around for decades, and they’ve been able to put together a comprehensive and easy-to-understand encyclopedia of common and not-so-common eating disorders. Try to remain objective about your eating patterns and feelings about your body – it can be difficult with an eating disorder confusing your mind and causing distorted self-perception, so remember to sit back and think without bias.

NEDA also has a useful screening quiz that you might be able to use. It’s not the same as seeing a doctor or therapist who can make a full and complete diagnosis, but it can give you an idea about which, if any, of your eating patterns or self-perceptions might indicate there is a problem. As with looking over the symptoms of an eating disorder, try to answer the questions as objectively as possible. Once you’ve done your research and learned more, it’s time to take the next, most courageous step of all.

2. Find Someone to Talk to About Your Developing Eating Disorder

By “someone” we mean a trusted adult –although you can certainly talk to your friends about the issue if you trust them, most adolescents will need the help of a trusted adult to take the next steps. Most likely you’ll want to talk to your parents first, but if this isn’t the case, don’t worry. Speaking to mom or dad about a difficult personal problem or something you feel ashamed about isn’t easy for everyone. Just keep in mind that eventually they’ll have to be involved – and beyond that, they love you and want you to be your healthiest self.

There should be many adults in your life you can speak to – like a family friend, aunt or uncle, your grandparents, or even a teacher or coach.Your school might provide resources like adolescent-focused counselors. In a pinch, you can contact an anonymous helpline provided by NEDA, which can provide some support visa phone or chat. This should only be a stopgap solution, though – if you’re really struggling, or if you are feeling a desire to self-harm (a frequent co-related symptoms of eating disorders), please talk to your parents as soon as you can.

At some point, you’ll want to speak with a professional, and of course, your parents will eventually come into the loop, but the first step is talking to someone – anyone – who will caringly listen to what you have to say. It’s the essential first step to getting better.

3. Figure Out What Your Options Are for Eating Disorder Treatment

There are essentially two main kinds of treatment for eating disorders – residential and day treatment. In residential treatment, clients of the eating disorder treatment facility will go to live at the center for 30 or more days. Their lives will focus entirely on treatment during that time – residential provides 34/7 care as well as full medical, psychiatric, therapeutic, and nutritional support.

During these troubled times, full of COVID quarantine protocols and social distancing, however, residential may not always be available or the best option. Many programs have a virtual option, using Zoom for individual and group sessions while employing the facility’s standard program as closely as possible to the in-person experience.

An even better option for teenagers who still need to attend classes, work, etc. is a day treatment program.

Day treatment programs(which are sometimes called outpatient programs, although they don’t strictly overlap in their scope and the types of treatment available)are a great option for adolescents who need to balance school, social life, and treatment. If there are medical needs, either separate from the eating disorder or related to them, that you have to address, you may want to seek out a partial hospitalization program (PHP).

The programs at most day treatment centers for eating disorders are held in the evenings allowing you time during the day to take care of your responsibilities. Many teenagers with eating disorders also participate in sports and other athletic activities. Exercise rehabilitation is often a major part of eating disorder treatment programs because people with eating disorders often exercise compulsively as a coping mechanism or purging technique. Be prepared to have your sports activity temporarily halted while you’re in treatment.

Many of the day treatment sessions will be centered around group therapy, including family therapy and give-and-take sessions with adolescents with similar situations. Additional care levels include residential eating disorder treatment, where teens have access to 24-hour care, a typical 5-day per week partial hospitalization program, and inpatient care, where adolescents who need medical and psychological stabilization are often best served.

4. Invest in Yourself and Your Future by Investing in Recovery

The best thing you can do after researching your options, speaking to an adult you can trust, and finding a recovery program is to fully commit to getting better. That sounds easy, but the truth is, eating disorders are insidious – they’ll tell you that there is no problem, that you don’t need help, and so on. It can be hard to ignore them, but give it your all and listen to the people in your life supporting you through recovery.

If you understand that it will be a difficult and most likely, long process, you might be able to avoid the expectation that you’ll be suddenly “cured” after 30 days. We know this sounds negative, but it’s not; there are so many positives that stem from the eating disorder recovery process that the challenge of treatment is completely worth it.

Because of these factors, it’s not uncommon for teens (and adults!) in treatment to want to quit, to get back to their old routine. That’s why you should regularly remind yourself what’s at stake – your emotional wellbeing, your physical health, and your family and friend’s worries as well. If you’re an adolescent who’s struggling with an eating disorder, remember how much life still has to offer you. Reach out for help and you’ll find that hands are reaching back to help you.

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.