How to spot signs of an eating disorder in your teen

[5 MIN READ]

In this article:

• Teens can experience several different kinds of eating disorders, including avoidant restrictive food intake disorder (ARFID).

• Signs of an eating disorder in your teen could include isolation, excessive exercise, food restrictions and secretive eating.

• The Providence Adolescent Eating Disorders Program focuses on helping teens develop a healthy relationship with food.

The COVID-19 pandemic punctuated many different kinds of changes. For children, it was particularly difficult to be isolated from their peers for weeks and sometimes months at a time. As a result, many teens started experiencing problems with eating disorders.

It has been almost four years since the nation shut down in response to the pandemic, and many aspects of our society have largely gone back to “normal.” But children who started having problems with their eating habits may still be struggling — and some of them could just now be showing signs of that struggle to their loved ones.

Feb. 26-March 3 is National Eating Disorders Awareness Week, so we’re shining a spotlight on some of the not-so-obvious warning signs of an eating disorder that parents might miss. Keep in mind that any of these warning signs — especially by themselves — may not mean anything alarming. But it’s a good idea to find a non-confrontational way to talk to your teen about the issues — especially if they are exhibiting two or more warning signs. You can learn a lot simply by observing their reaction to your questions.

Types of eating disorders

An eating disorder is a serious condition that disrupts your child’s life and affects their health in numerous ways, including kidney and heart issues, osteoporosis, hair loss, organ failure and even death. Eating disorders can involve a number of behaviors and eating patterns, ranging from severe overeating to self-imposed starvation and excessive dieting.

The different types of eating disorders include:

• Anorexia nervosa – a condition that causes your teen to severely restrict the amount of food they eat because they are convinced they’re too heavy, even when they’re dangerously underweight.
• Binge eating disorder – a condition that causes repeated episodes during which your child feels out of control as they eat large amounts of food in a short timeframe, even when they’re not hungry or already uncomfortably full.
• Bulimia nervosa – a condition that causes a repeating cycle in which your teen binge eats large amounts of food in a short amount of time and then purges in a variety of ways, including self-induced vomiting, excessive laxative or enema use, or misuse of diuretics to compensate.
• Other specified feeding or eating disorder (OSFED) – a condition in which your teen doesn’t meet the strict criteria for anorexia or bulimia, but they have a significant disorder that is affecting their healthy eating and longevity.

Avoidant restrictive food intake disorder (ARFID)

ARFID is a fairly new eating disorder, but it can be just as harmful as the above disorders. Teens who have ARFID are extremely selective eaters and may eat a very limited variety of preferred foods. This can lead to poor growth and nutrition, as well as social challenges.

“ARFID can really impact a teenager’s functioning,” says Barbara Oyler, PMHNP, manager of the adult and adolescent partial hospital programs at Providence St. Vincent Hospital. “Treatment usually involves developing a hierarchy of foods that they are unwilling to eat, and slowly working our way up that list so that they eventually feel more uncomfortable with those foods. It’s a very, very hard process.”

Signs of eating disorders

Teens and young adults who have eating disorders can become very skilled at hiding their problem, so it may be difficult for you to recognize the signs. Some of the more obvious signs could include catching your child throwing up after meals, or noticing they’re eating little to no food and having difficulty maintaining a normal weight. Here are a few of the more subtle signs:

1. Isolation
   Your child may show signs of low self-esteem and body image, and not be socializing with their loved ones or peers as often as they used to. In particular, they may not want to eat with other teenagers and will make excuses for why they would prefer to have meals and snacks in private.

2. Excessive exercise
   Take a close look at how much your teen exercises now, versus how active they were a year or two ago. Has the amount significantly increased? Are they becoming obsessive about it, exercising even when they are injured, sick or tired? If so, it’s possible they are especially focused on their body shape and weight.

3. Secretive eating
   Have you noticed large amounts of food mysteriously going missing? It’s possible that your teen is sneaking the food into their room so they can eat in private. Be aware, though, that many teenagers shut themselves in their room away from their family members, so don’t assume they are secretively eating just because they’re alone a lot.

4. Food restrictions
   Some people who are struggling with an eating disorder believe that certain groups of food should be off-limits for them. Your teen may be preoccupied with counting fat grams and calories and refuse to eat certain types of food because they believe they’re not healthy. They may also equate eating with self-control.

Eating disorder treatment options

If you suspect your teen has an eating disorder, ask them about it. They may be relieved that they don’t have to hide anymore. The next step is to talk to their pediatrician to determine whether you should find a local treatment program for them.

The Providence Adolescent Eating Disorders Program, located at St. Vincent Medical Center in Portland, Oregon, helps patients between the ages of 13 and 18 recover from eating disorders. We start with a two-and-a-half-hour appointment, during which we talk to both the teenager and parents and measure the patient’s vital signs, height and weight.

“We don’t just focus on the eating disorder,” said Oyler. “We also look for signs of depression, anxiety, trauma, obsessive-compulsive disorder (OCD), substance use and previous treatment. Then, based on all that data, we offer recommendations for a level of care.”

That care could include a partial hospitalization program, inpatient medical stabilization or an outpatient treatment trial.

There are also programs available, at Providence and beyond, to help caregivers of young adults, including community forums to share feedback and experiences with others going through a similar situation.

If your teen has an eating disorder, they’ll need your support and unconditional love, as well as access to proper treatment resources.

Contributing caregiver

Barbara Oyler, PMHNP, is the manager of the adult and adolescent partial hospital programs at Providence St. Vincent Hospital.

Find a doctor

If you are looking for a pediatrician or mental health professional who specializes in eating disorders, you can search for one who’s right for you in our provider directory.

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Related resources

Youth mental health

How eating disorders can be harmful

Know the warning signs of teen suicide

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.