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Coming to the realization and acceptance that your child is developing an eating disorder such as anorexia nervosa, bulimia nervosa or binge eating disorder is a difficult scenario for any family. While eating disorders can begin at any age, late adolescence and young adulthood are the main periods of onset. However, more and more often, clinicians and therapists are seeing eating disorders like anorexia nervosa beginning earlier than ever, even as young as age 8. Thankfully there are helpful resources available for parents, siblings, and other loved ones to help secure treatment.

Eating Disorder Development: When Should I Start to Worry?

Recent estimates suggest that about 30 million people (20 million women and 10 million men) in the United States have or will experience an eating disorder. If left untreated, common eating disorders like anorexia nervosa and bulimia nervosa can result in serious health conditions, including fatal conditions like tachycardia, heart arrhythmia, and heart attacks. These conditions worsen over time, as the physical and mental strains of untreated eating disorders continue. Concerned parents should take steps to action when they see telltale signs of an eating disorder such as self-criticism about the child’s body, engaging in dieting and excessive exercise, and discomfort at mealtimes (or avoiding them altogether).

The Role Puberty Plays in Body Image and Eating Disorder Development

While late adolescence is considered the prime era for eating disorders to begin, the pressures of early adolescence are just as dangerous in triggering disordered behaviors. Chief among these pressures are the hormonal changes of puberty. The beginnings of sexuality often cause children to view their bodies differently than before and desire to look like the “beautiful people” seen on TV and in their Instagram feeds. Body image and trying to reach an “ideal” weight or body size are prime contributors to dieting and eating disorders. 

In virtually every case,eating disorders such as anorexia nervosa can begin with what seems like “regular” dieting. But consistent dieting, especially at an age where the body is still developing and a person’s lifelong relationship with eating is developed, can trigger disordered eating behaviors like purging, calorie restriction, or binge eating episodes. 

Dieting and puberty aren’t the only triggers for eating disorders. Many other factors, in some combination, are commonly found to have contributed to their development as well.

Some of the factors that may contribute to the development of common eating disorders in adolescence include:

  • Media and Societal Pressures:The tendency of movies, TV shows, and print advertising to present a “perfect” body (which is almost always skinny and slim) put pressure on young people to try and match that ideal. The constant influence of social media, especially with younger people, has also exacerbated this drain to self-esteem. For people who are already at risk because of other contributing factors, increased vulnerability to societal messages regarding beauty and weight can be the tipping point.
  • Genetics: As with every form of mental health disorder, including depression and anxiety, people whose parents have an eating disorder are more likely to experience one themselves. While this can be partially explained by the “nurture” side of the eternal debate,research also shows the development of eating disorders tends to happen in both members of a set of twins.This may show that there are genetic factors contributing to a person’s likeliness to show the signs of anorexia nervosa or another form of disorder.\
  • PTSD and Trauma: A common trigger for disordered eating behavior, PTSD occurs following a traumatic event, which can include abuse, certainly, but may also result from any difficult experience such as a parent’s divorce, or even being in a car accident. It is common for survivors of trauma to experience feelings of shame and unease, and disordered eating behaviors like purging can give them a temporary sense of relief. Clinicians at eating disorder treatment centers suggest about 50% percent of people seeking treatment for ED have significant PTSD symptoms as well.
  • Undeveloped Coping Skills: Most eating disorder behaviors are a coping response to stressors (such as PTSD or flawed body image), a momentary escape from negative thoughts and feelings. An inability to constructively cope with pain, depression, anxiety, and low self-esteem, all of which require some kind of response, can thusly inform engagement in disordered eating behaviors. Behaviors like restricting, bingeing, purging, and excessive exercise all result in the release of dopamine in the brain. Dopamine is the “feel good” brain chemical also associated with narcotics. Disordered eating and exercise behaviors can become psychologically addictive in the same way.

What Are the Most Frequent Symptoms of Eating Disorders?

1. Body Dysmorphia

Also known as dissatisfaction with one’s body, this often results in an obsession with body size and weight. Teens may complain and worry about being “fat” or wanting to lose weight, even when their doctor thinks they should gain weight.

2. Secretive Behavior

Parents may find food wrappers hidden in their child’s room or stashes of laxatives or diuretics (used for purging). Wearing baggy clothes (to hide their body’s shape) or hoarding food are signs of anorexia nervosa or binge eating disorder, respectively.

3. Frequent Dieting

Compulsive dieting, obsession with weight, and counting calories are also common. In some eating disorders, like ARFID, a diet may serve to justify eliminating some food groups.

4. Weight Changes

Although the teen years are a time of many physical changes, significant weight fluctuations are cause for concern. Eating disorders might result in brittle hair and fingernails, tooth discoloration, dry skin, or in extreme cases of anorexia nervosa, the growth of small hairs across the body (known as lanugo).

5. Secretive Eating

Although this is more associated with binge eating disorder and bulimia nervosa than anorexia nervosa, parents may notice food missing from the kitchen periodically or find wrappers in the trash. These are signs of secret binge eating episodes.

6. Excessive Exercise

Exercise is, of course, a wonderful practice in moderation. However, as a form of calorie purging, excessive exercise can be an indication of one of several forms of eating disorders. Parents should look out for examples of punishing exercise that ignores pain, injury, bad weather, or replaces social engagements or appointments.

Eating Disorders Cause Health Complications If Left Untreated

There are many different health risks associated with eating disorders that can affect adolescents in the short and long term. Along with alleviating the mental health distress caused by ED, this is just one of the many reasons why early intervention is so important for children and adolescents with eating disorders. While many of the physical complications of eating disorders can be corrected by implementing a dietician and nutritionist-approved diet centered around restoring nutritional balance, when the eating disorder isn’t treated, more severe health problems can occur. Some of the most common health risks young people with eating disorders may face include:

Heart Complications

With a lack of nutrients, the body has less energy and less ability to maintain its basic functions.Even adolescents can suffer relatively severe heart problems such as arrhythmia, palpitations, and even cardiac arrest as the heart doesn’t receive enough energy and nutrients to properly function.


Studies show nearly one in three children with anorexia nervosa show signs of anemia, including low red blood cell counts. Similarly, the same study found that about half of the patients with AN have a low white blood cell count.

Kidney Function

Dehydration and fluid loss resulting from anorexia nervosa and bulimia nervosa can lead to kidney malfunction, producing highly concentrated urine in small amounts as their body doesn’t have enough water to function. This is a sign that the kidneys are less able to filter toxins and can lead to renal failure.

Bone Strength and Density

Adolescents grow quickly in the years from are 11 – 18, and it’s a critical time in bone growth and development. Malnutrition caused by eating disorders negatively disrupts this crucial growing process, increasing the chances of depleted bone tissue and stunted bone growth. As a result of insufficient calcium levels in teenagers with ED, early-onset osteoporosis and other bone maladies are significantly increased until calcium levels are restored.

Gastrointestinal Issues

Both restricted eating binge eating can wreak havoc on the intestinal tract. This can result in constipation, diarrhea, ulcers, and other GI tract issues. On the other hand, once a healthy diet is restored, this issue typically resolves quickly.

Menstruation and Hormonal Systems

For young women, the lack of regular menstrual periods is a common result of malnutrition caused by eating disorders.Especially in the tween years, when puberty is relatively new, this can have long-lasting complications for fertility and pregnancy in later years. During this critical period on their transition to adulthood, improper nutrition also interferes with hormonal production. Researchers believe this may also explain why teens with eating disorders experience stunted growth.

What Can I Do to Help My Teenager Get Help for Anorexia Nervosa or Another Eating Disorder?

It can’t be stressed enough that early intervention is the key to a full recovery from eating disorders.Being aware of the early warning signs and consulting a doctor, psychiatrist, or mental health professional early on dramatically increase that chance.Parents may wish to raise the issue of their child’s eating habits gently but firmly before consulting a professional, but if they are resistant or not forthcoming, it’s wise to make an appointment.

Securing medical and mental health care, in combination, are essential to reversing the slide into disordered eating behaviors. Other important things parents can do include:

  • Making sure regular physicals are kept
  • Taking to a professional ED counselor even before talking to their child
  • Coordinate treatment between your doctor, an eating disorder treatment facility, and the child’s school system to ensure they don’t fall behind
  • Reach out for support from other parents of children with eating disorders, local community services, etc.

Learn How Clementine Can Make the Difference in Your Teen’s Life

No parent wants to see their child struggle with a potentially life-threatening disorder. Although anorexia nervosa, bulimia nervosa, OSFED, or any eating disorder can be frightening for young girls and their families, the right treatment center can guide their recovery with compassion and knowledge. If you or a loved one have been diagnosed with an eating disorder, remember that long-term recovery is possible with the help of a strong support system and early intervention. 

If you want to learn more about the nationwide, residential, or day treatment adolescent eating disorder recovery programs available at Clementine, don’t hesitate.Call 1.855.900.2221 today to speak with our compassionate and professional admissions specialists.


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.