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Eating disorders affect people of all ages, genders, and social backgrounds, despite the oft-repeated misconception that they only happen to rich white women. However, they develop most commonly in early adulthood and adolescence. In fact, eating disorders in adolescence are so common that around 5.4 percent of young adults between the ages of 13 to 18 will develop anorexia nervosa, bulimia nervosa, or binge eating disorder at some point in their lives. This comes out to millions of people in America alone.

Being a form of mental health/behavioral disorder, an eating disorder is primarily diagnosed via behavioral signs and solidified by the physical results of those behaviors. But the early warning signs of eating disorders in young adult children can be difficult to recognize for parents and loved ones. This is because eating disorders like anorexia nervosa are usually indistinguishable from other forms of mental health disorders like depression, or appear to be “dieting” or attempts at weight management. Additionally, although they are relatively common disorders, many disordered eating patterns aren’t very well understood, even among doctors and other medical professionals; in some cases, they may inadvertently trigger or worsen one by recommending their young patients lose weight. Luckily, there are a few key signs and symptoms of eating disorders that parents can be on the lookout for. Even better, there are more resources like online communities and treatment programs that have been tailored for adolescents at aquality center for eating disorders.

With that said, there are a few ways for parents to identify at-risk behaviors and start the conversation about eating disorder prevention and recovery.

What Are Common Warning Signs of Eating Disorders in Preteens and Adolescents?

There are a variety of different physical and psychological signs of eating disorders that parents can be aware of when it comes to adolescents (and also in children who haven’t begun puberty yet – some cases have been observed as young as age 7).In these early stages, certain eating disorders are more likely to appear than others. The average age of onset for bulimia nervosa and anorexia nervosa is around age 15, with cases developing earlier and later depending on the individual. The most common form of eating disorder, binge eating disorder, tend to develop a bit later, – around age 18 – but can begin at any time. Some others, such as ARFID and pica, can begin at a very early age and are not usually related to body image issues like the others. Some eating disorders may cause teens to refuse to eat or maintain a nutritious diet, while others may result in binge eating and purging behaviors.

Common forms of Eating Disorders

Anorexia nervosa – people typically view themselves to be overweight, even though medical and simple common sense viewpoints contradict that. This means that they will engage in restricting behaviors to reduce and eliminate weight gain. Anorexia nervosa results in extreme weight loss. Some people with the disorder will become malnourished and medically considered underweight. Others will still lose weight but maynot become underweight by medical standards, although malnourishment is still a concern. This is known as atypical anorexia nervosa.

Bulimia nervosa – people with this disorder also struggle with body image and a desire to lose weight, regardless of their actual body weight. While a person with bulimia nervosa may be dieting, they typically do not restrict food as in anorexia nervosa. Instead, they are driven by extreme hunger to engage in binge eating episodes (more below) and then compensate for the calories taken in by purging. This is usually done by self-induced vomiting, but methods such as abuse of laxatives or extreme exercise are also common. People with bulimia may experience weight loss, but this is not universal.

Binge eating disorder– is the most recently-occurring form of eating disorder in the United States. People with binge eating disorder also normally deal with body image distortions and are usually on a diet, attempting to lose weight. Unlike bulimia nervosa, however, binge eating disorder does not incur purging after binge eating episodes. These episodes consist of eating a large amount of food in a short period, often past the point of discomfort, and bring about feelings of shame and a loss of control over eating. Binge eating disorder can cause complications related to obesity and gastrointestinal problems.

Avoidant/Restrictive Food Intake Disorder (ARFID)– people with this disorder strictly avoid certain types of food or entire food groups. This disorder is not indicated by avoiding food because of allergic or cultural reasons. The foods that are not eaten often have a negative association with a traumatic event in a person’s life, such as choking or getting food poisoning in childhood, but this is not always the case. ARFID-related food restrictions impact a person’s physical health and social life, making social gatherings or meals with the “fear foods” present difficult. ARFID can also result in severe weight loss and related malnutrition.

What Kinds of Symptoms Indicate There May be an Eating Disorder?

The DSM-V has outlines for diagnosing eating disorders, listed here. However, these criteria are intended for psychiatrists and other mental health professionals to use. For parents and other loved ones, it’s useful to know about some early warning signs of eating disorders. There are behavioral, psychological, and physical symptoms to watch for that may indicate there is a problem.

Psychological Warning Signs of Eating Disorders

Eating disorders can present themselves as standalone disorders, but it’s relatively rare. One of the most common warning signs of a developing eating disorder is the presence of another mental health disorder. People with eating disorders often also suffer from depression, general anxiety, and especially PTSD. The latter disorder often triggers disordered eating behaviors as a coping mechanism for the negative emotions that come with it, and as a (disordered) way for the person to regain a sense of control over their lives. Eating disorders are also associated with OCD, borderline personality disorder, and various forms of self-harm and suicidal ideation. As a loved one, if you are involved in a person’s psychological treatment process, it’s wise to speak to them about these disorders and how they might relate to disordered eating.

Physical Warning Signs of Eating Disorders

Each eating disorder may result in different physical changes. While weight loss is a common occurrence, many if not most people with disordered eating are not the dangerously thin stereotype often presented in the media. However, they each can wreak havoc on the body. Malnutrition and lack of nutrients can lead to hair loss, skin problems, loosening teeth, and anemia. People with anorexia nervosa and ARFID who have become underweight are often cold even in warm weather as well. Bulimia nervosa can result in these kinds of symptoms as well as discoloration of the teeth and toothdecay due to frequent vomiting, as well as calloused knuckles. People with binge eating disorder often gain weight suddenly and may suffer complications related to being overweight. In general, rapid weight fluctuations are a sign that a person is dealing with disordered eating patterns.

Behavioral Warning Signs of Eating Disorders

Behaviors related to eating disorders can vary from person to person and disorder to disorder, but there are some signs that a loved one can observe. This list includes behaviors that may be present in anorexia nervosa, bulimia nervosa, binge eating disorder, ARFID, or others.

  • Isolating oneself from friends, family, and other social activities
  • An obsession with dieting, food, calories, and body shape
  • Wearing baggy clothes and/or multiple layers to hide weight and body shape
  • Frequent complaints of an upset stomach, constipation, diarrhea, or a sore throat
  • Discomfort at mealtimes
  • Being secretive about eating or refusing to eat in public
  • Hiding or hoarding food or laxatives/diuretics
  • Perfectionist tendencies and a need for control
  • Frequently discussing other peoples’ bodies or weight

While these are the most common signs of a developing eating disorder, it’s important to keep in mind that just as each person is unique, their symptoms can be as well. If a parent or loved one suspects that something is wrong, they should speak to their loved onein a safe, non-judgmental setting. It’s essential to be gentle but firm in these conversations; accusations and finger-pointing can drive a person away and further into their eating disorder. Early intervention is key to successful and long-term eating disorder recovery. Many of the symptoms associated with eating disorders, especially anorexia nervosa, can have severe medical and psychological risks, even including death in some severe examples.

What Kind of Treatment Is Available for People With Eating Disorders?

Eating disorders in adolescence should be taken very seriously by family and friends. These are serious mental health conditions that will not just “go away” with time. Untreated, they tend to worsen over time. Luckily, as the medical and psychiatric worlds learn more about eating disorders like anorexia nervosa and recognized that these disorders normally begin in adolescence and young adulthood, specialized eating disorder counseling programs for teens and young adults have been developed.

At many specialized centers for eating disorders, parents can find treatment programs that have been tailored to fit the special needs of adolescents in a comfortable, safe, and home-like setting. Whether teens need access to residential treatment, where they will receive medical and psychiatric monitoring before engaging in treatment or they would benefit from day treatment – there are several different options 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.