Eating disorders frequently emerge during adolescence, but often, the symptoms aren’t what parents might expect. Unfortunately, many eating disorders go undetected and untreated because parents don’t recognize the warning signs.

General Information about Eating Disorders

An eating disorder occurs when eating habits or food-related behavior cause significant distress or impairment in someone’s life. Eating disorders include:

• Anorexia. Teens with anorexia nervosa are dangerously thin, but think they are overweight. They usually become obsessed with restricting food, exercising, and weighing themselves.
• Bulimia. Teens with bulimia nervosa engage in binge eating behavior and purging. They will eat large amounts of food in one sitting, but then, to compensate for eating too much, they will force themselves to vomit or use laxatives excessively.
• Bingeing. Teens with binge eating disorder eat excessive amounts of food at one time, but they don’t purge or fast afterward. Most teens with this disorder are overweight.
• Other. Extreme food restrictions, excessive nighttime eating, and purging without bingeing are just a few examples of other eating disorders.

Warning Signs of Eating Disorders

Eating disorders can be difficult to treat, so early intervention is an important key to addressing these disorders effectively. The best people for identifying an eating disorder in a teen early are his or her parents. To help parents, below is a list of subtle warning signs to look for:

1. Suffers from insecurity about their body. While all teens feel self-conscious at one time or another, harsh self-criticism can indicate a more serious problem. Pay attention if your teen uses harsh descriptions of themselves, such as complaining about being ugly or fat.
2. Disappears during or after meals. If your teen has an eating disorder, you may find them absent during or after meals. Some people with eating disorders either:
   • skip meals altogether (your teen might make excuses about having already eaten or not feeling hungry),
   • have a phobia about eating in public, and may avoid restaurants or family gatherings, or
   • leave quickly after a meal so that they can reduce their calorie intake by vomiting.
3. Exercises excessively. While exercise is a very healthy activity, some teens with eating disorders can become obsessed with compensating for calories consumed by spending hours each day working out.
4. Restricts eating. If you notice a change in your teen’s eating habits, pay attention. Teens with eating disorders sometimes crash diet or stop eating entire food groups. They may become very rigid or restrictive in the foods they consume. There may be a problem if their portion sizes are too small, if they eat the same things every day, or they become obsessed with checking food labels.
5. Hides food. Teens who binge eat often stash or hide large amounts of food. Take notice if food disappears out of the pantry, lots of empty food wrappers appear in the trash, or you find a large stash of food somewhere.
6. Cooks big meals for others. Ironically, teens with anorexia like to be around food, even though they don’t want to eat. A warning sign is if your teen prepares a lot of food for friends and family, but only watches them eat it, without joining in.
7. Experiences body changes. There are some specific body changes that can indicate an eating disorder:
   • An underweight teen might frequently complain she can’t get warm or she is freezing.
   • Teens might begin wearing baggier clothing to hide significant weight gains or losses.
   • Dehydration often accompanies bulimia and anorexia and can lead to problems with dry skin.
   • Calluses on the knuckles are often the first signs that a teen may be inducing vomiting.
   • Frequent purging causes swollen salivary glands, which can cause cheeks to look puffy or swollen.

Final Thoughts…

Individually, these warning signs are not significant and could be indicators of more non-threatening changes, but if you see a few of these signs, it is a good idea to talk to your teen’s doctor about a potential eating disorder. Your pediatrician will run a complete physical exam, which will help them assess your teen’s overall health and eating. If your teen’s doctor suspects your teen may have an eating disorder, you must not delay to get your teen help with a mental health professional. Eating disorders do not resolve on their own.