Eating disorders are fairly common. You’ve likely heard of anorexia and bulimia nervosa. Binge eating disorder is another lesser known diagnosis. It shares many symptoms with bulimia but does not include compensatory (i.e. purging) behaviors. If you worry your child might have an eating disorder, it’s important to learn the signs of eating disorders in teens.
Types of Eating Disorders
To understand the signs of eating disorders in teens, it helps to know what each eating disorder looks like and how they are different from each other.
The three main types of eating disorders are anorexia, bulimia, and binge eating disorder. There are two other types of eating disorders too, but they mostly serve as general categories for cases that don’t fit neatly into the main three.
Anorexia Nervosa
To be diagnosed with anorexia, a teen must maintain a weight well below healthy levels. Anorexic teens also have an intense fear of gaining weight and a distorted view of their body. Though past criteria for anorexia included loss of menstruation, that is no longer required. It is important to note that while anorexia is most common in girls, anorexia affects boys as well.
Bulimia Nervosa
Bulimia, like anorexia, is marked by a fear of gaining weight and a distorted body image. However, instead of being underweight, teens with bulimia are usually of normal weight or slightly above a healthy weight. They often binge eat when upset or hungry and then feel compelled to compensate through purging. Purging can include vomiting, laxatives, excessive exercise, or fasting.
Binge Eating Disorder
This disorder involves consuming large amounts of food in response to emotional triggers. Unlike bulimia, teens with binge eating disorder do not attempt to purge after overeating. However, like bulimia, teens with Binge Eating Disorder also have feelings of shame, guilt, and disgust after overeating.
Why Early Recognition of Signs of Eating Disorders in Teens Matters
Eating disorders are dangerous and need immediate attention. Anorexia can lead to life-threatening starvation, while bulimia can cause severe electrolyte imbalances and even death. Binge eating disorder can result in long-term health problems and emotional distress.
Getting Help for Your Teen
If you notice signs of eating disorders in your teen, take action quickly. Talk to your pediatrician and seek professional counseling. Your teen is still the same amazing person underneath it all, and with the right support, they can recover.
Helping teens grow and families improve connection,
What Parents Should Know About Eating Disorders in Boys
Eating disorders happen to boys too. It’s not as commonly discussed as eating disorders in girls, and it’s not quite as prevalent. However, it definitely happens. In fact, it’s a real and growing concern. If you’re worried your son might be struggling with one, it’s key to know what eating disorders in boys can look like, the warning signs to watch for, and how you can step in to help.
Eating Disorders in Boys Vs. In Girls
When boys have eating disorders, they often look different from those in girls, which can make them easier to overlook. Girls may focus on being extremely thin, while boys typically aim to look “cut” or “chiseled.” This can lead to excessive weightlifting, eating very little, and, when they do eat, focusing almost entirely on protein.
Signs Your Son Might Have an Eating Disorder
There are some key signs to watch for if you are worried about eating disorders in boys.
1. Obsession with Working Out
Is your son spending way too much time at the gym? Does he lift so much weight that you worry about injury? This can be a warning sign of eating disorders in boys.
2. Focus on Body Fat Percentage
While girls often talk in pounds, boys talk in body fat percentages. I’ve heard boys aim for as low as 4% body fat to look “cut.” This is not healthy — our bodies need fat to function.
3. Frequent Dieting
Some boys skip meals or eat only fruits and veggies to get thinner. This is another sign of eating disorders in boys. Even if their goal isn’t to look emaciated, their ideals can still be just as unrealistic as girls.
4. Cutting Out Entire Food Groups
Many boys try to bulk up on protein and cut carbs, avoiding bread, chips, and sweets entirely. This can be another sign of unhealthy body obsession.
Why This Is A Problem
Over-focusing on body image can have serious consequences. Starvation plus excessive exercise is dangerous for physical health. It can also stunt emotional development and character development. If your son is only thinking about his body, he might:
Skip social events to avoid missing a workout
Be distracted on a date, worried about food choices
Struggle to focus in class due to low calories
How to Help
Body image issues in teenage boys are more common than ever. If you notice signs of eating disorders in boys, talk to your son. If he continues to over-focus on his body image, give me a call, and we can talk about your son’s situation. Your concern and involvement can help him get back on track to being a well-rounded young man.
Helping teens grow and families improve connection,
Many teen girls struggle with their body image because of the unrealistic standards set by models in ads. In fact, some governments are taking action to address this issue. In France, a bill was passed to ban ultra-thin models and require photoshopped images to be labeled. If your teen is struggling with an eating disorder, it’s important to learn how media influences teen body image, and find out what to do to help your teen.
How Media Affects Teen Body Image
The constant stream of images in the media shape how we see ourselves. Models often have professional makeup, photoshopped features, and unrealistic beauty standards. When teen girls compare themselves to these images, it’s easy to feel “not good enough.” Since they are still developing their sense of self, they are especially vulnerable to these messages.
Why Teen Girls Are So Affected
Teenagers aren’t always sure of who they are, so they often rely on external things like appearance to define themselves. They choose certain styles, admire celebrities, and aim for an “ideal” body type. Since our culture glorifies thinness, many teen girls feel pressure to look a certain way. This has a huge negative impact on teen body image.
Changing the Definition of an Ideal Body
Many girls I work with in therapy believe that being extremely thin or fit will make them happy, confident, and lovable. It takes a lot of effort, but some girls eventually shift their thinking. Instead of comparing themselves to edited images, they start focusing on a medically healthy body type. They learn to eat in a way that fuels their bodies, exercise for health rather than appearance, and accept that their body will naturally settle at a healthy weight. Over time, they begin to appreciate looking like a young woman rather than striving to continue to have the weight of a young girl.
The Role of Media in Eating Disorders and Teen Body Image
There are many factors that contribute to eating disorders, but media plays a role. That’s why I appreciate efforts like France’s law to reduce the pressure on young girls. Struggles with anorexia, bulimia, and body image can be incredibly challenging to overcome, and every small step toward change helps.
Helping teens grow and families improve connection,
Family based treatment (aka Maudsley Method) empowers parents to act as a critical part of the treatment team when healing a teenager from an eating disorder. This is done in consult with a therapist, dietician, and medical doctor. Parents follow the advice of their treatment team to get the adolescent’s caloric intake back on track so health can be restored. This is a very emotionally taxing process, but it also hopefully keeps the teenager out of the hospital. Many parents have lost their authority to the eating disorder over the course of the last several months or even years. When they are not only given permission, but required to take back that authority, there are often encouraging results.
Eating disorders are so nasty! They are cruel, unkind, and abusive to their victims. They take over a person’s relationships, personality, ambitions, and dreams until you find your teen is a shell of her former self. I should know…I had one for 7 years. Now I help parents fight back against the eating disorder monster. Here are some thoughts on the process:
Parents of teenagers call me for a number of varying concerns, one of which is that their daughter has an eating disorder. Once in counseling for any reason, girls frequently reveal they believe they are fat. Of the girls who believe they are fat, a significant number are actively trying to lose weight. If their efforts are dangerous enough, they qualify for an eating disorder. Lately I have been seeing a lot of girls with eating disorders, so it seems like a good time to address this.
The first thing that might have struck you as odd is that I wrote, “If their efforts are dangerous enough, they qualify for an eating disorder.” You might be wondering what I mean by “dangerous.” Girls (and less often boys) that are trying to lose weight are usually doing so in unhealthy ways. For example, there are numerous risks associated with frequent self-induced vomiting. It rots teeth, has the potential to burn a hole in the esophagus, and can cause electrolyte imbalances; sometimes these electrolyte imbalances have caused death.
Other dangerous things adolescents do to lose weight is crash diet, work out too hard (causing sickness and injury), take laxatives, fast, cut out certain food groups, and use drugs. All of these things can be dangerous. Nutrition is an essential part of our health. Girls who are struggling with an eating disorder are nutrition obsessed, but often eat very unhealthily.
One example comes from a girl I know who has an eating disorder. She has numerous misconceptions about food based on the current cultural fads. She believes carbohydrates are like putting poison into her body. If she eats salads for lunch and dinner then she assumes she has eaten a very healthy diet for that day. In fact, all she has done is eat a low calorie diet while missing out on essentials like carbohydrates and proteins.
Therapists are by no means nutritionists, but we are often required to address nutritional issues. For this reason, in most cases, eating disorders are treated in conjunction with a registered dietician. The dietician helps the teen plan appropriate eating. The therapist then helps the teenage girl with the emotions surrounding staying on a food plan; this can be extremely challenging.
Eating disorders are primarily emotional. Girls with anorexia are in tight control over their diet. They control their food in what appears to be an unemotional manner. However, anorexic teens live with constant feelings of self-disgust, shame, and fear. This differs slightly from teenagers with bulimia, who also feel the self-disgust, shame and fear plus a numbing during a binge.
If you are concerned your daughter has an eating disorder, here are a few questions you can ask. First, ask your daughter if she feels comfortable with her body. You can directly ask if she’s ever trying to diet. Find out from her how much she is concerned with her daily diet. Nearly all girls are conscious of these things, but many still eat normally and exercise moderately. You want to determine if it seems a bit extreme. If your daughter is very defensive when you ask these questions, that can also be a sign of trouble.
Helping teens grow and families improve connection,
