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April 2018: Eating Disorders in Adolescence

It is common for adolescents to feel a little insecure about their appearance or body. However, adolescents who have eating disorders can become obsessed with their weight, how their body looks, and eating or not eating to the point that they can cause serious harm to their bodies. Eating disorders have many causes, including biological and psychological factors, but they are treatable. While treatment should include mental health services, adults can help adolescents establish a positive body image, healthy eating behaviors, and other habits that will set them on a healthier path.

How Common are Eating Disorders?

Almost three percent of adolescents ages 13-18 are diagnosed with an eating disorder. Generally, adolescent girls are at a higher risk for developing an eating disorder than are boys. Eighty percent of adolescents and young adults with bulimia are female and about one quarter of children with anorexia are boys. Adolescents also have an increased risk  of developing an eating disorder if they have a family history of eating disorders, other mental health or substance use disorders, or experienced negative childhood events such as parental death or abuse.

What are the Most Common Eating Disorders?

The three most common eating disorders include anorexia, bulimia, and binge-eating disorder.

  • Anorexia: People with anorexia limit how much they eat, which can cause weak bones, seizures, and heart issues. Women and girls die from anorexia more than any other mental health disorder.
  • Bulimia: People who have bulimia eat a lot of food at one time and then try to get rid of the food or weight they may have gained by engaging in behaviors such as throwing up, taking laxatives, or exercising heavily. Over time, bulimia can damage the throat, teeth, stomach, and heart.
  • Binge-eating disorder: People who eat a large amount of food in a short time but do not try to get rid of the food may have a binge-eating disorder (BED). This disorder can cause obesity, which is associated with health conditions such as Type 2 diabetes and heart disease.

Adolescents who seek treatment but do not meet the criteria for a specific eating disorder may be diagnosed with Other Specified Feeding and Eating Disorder (OSFED).

What are the Signs of an Eating Disorder?

Though symptoms vary by eating disorder, common symptoms include: 

  • Excessive worry about weight gain
  • A severe or rigid diet
  • The desire to eat alone due to embarrassment
  • Using the bathroom often after meals
  • Repeated unhealthy actions to lose or gain weight
  • Obsession with physical appearance and how others perceive their body
  • Feelings of guilt and shame around eating habits
  • Experiencing abnormal stress or discomfort about eating habits

Prevention4 things you can do to prevent eating disorders

Although more research is needed to better understand eating disorders and how to prevent them, there are strategies you can use to help children and adolescents develop healthy behaviors and relationships with food.

  • Encourage healthy eating habits. Adolescents begin making their own eating choices as they become more independent. Have meals as a family to ensure they get the nutrition they need and have conversations about healthy eating to make nutrition a priority. Adolescents may eat at restaurants with friends more often, become interested in different diets for humanitarian reasons, or be concerned with eating enough protein to participate in sports. For these reasons and more, providing guidance on nutrition and healthy eating is essential for all adolescents.
  • Avoid unhealthy dieting around your adolescent, and eat a balanced diet instead. Making healthy changes to improve your diet can be an important step, but extremely restrictive and unbalanced diets can be harmful. If you or your adolescent want to make dietary changes because of a health concern, consult your health care provider to ensure you are doing so safely.
  • Nurture a healthy body image by discussing self-image and reassuring the teen that body shapes can vary. Also, talk with your adolescent about the messages they receive from media and avoid criticizing your own body.
  • Get help from your child's health care provider. At well-child visits, providers may be able to identify early indicators of an eating disorder.

What Should I Do If I See the Signs?

It is important to recognize that eating disorders are real medical illnesses, and they are treatable. Here are steps you should take if an adolescent shows signs of an eating disorder.

  • Don’t wait. Approximately a quarter of teen boys and half of teen girls have dieted; this includes more than one in three girls who are at a healthy weight. Extreme dieting could evolve into an eating disorder, so seek help if you are worried about a change in your adolescent’s weight or relationship with food.
  • Talk to a professional. If you’re concerned that an adolescent may have an eating disorder, talk to a health care provider. Currently, most adolescents with eating disorders receive treatment for mental health issues but only a minority receive services specifically for eating disorders. 
  • Identify treatment options. Treatment varies based on the type of eating disorder that an adolescent may have and an individual’s needs. It may include talk therapy, medicine, and nutrition counseling. In extreme cases, hospitalization may be needed to recover.
  • For immediate support, call a helpline. If an adolescent (or anyone) needs immediate support, call the National Eating Disorders Association’s Helpline at 1-800-931-2237. People who are uncomfortable speaking on the phone can text "NEDA" to 741741 to connect with a trained crisis counselor at Crisis Text Line
Content created by Office of Adolescent Health
Content last reviewed on April 18, 2018