Signs of Disordered Eating in Children and Teens

Written by Loren Gianini, PhD and Barbara Smolek, MPA.

What should you do if your daughter tells you that she’s routinely skipping lunch, but insists “it’s not a big deal because all my friends do too”? Should you be worried if you notice your child and his or her friends are trading tips on how to pose for pictures so that they look thinner? How about if your child has started to eat more than usual when he or she is feeling frustrated? What are the signs your child might be struggling with an eating problem?

Recently, our Center was approached by a local K-12 school to help parents struggling with these sorts of questions.  During our talk with parents, we discussed how to distinguish the red flags of an eating disorder from normal adolescent behavior. Here are four key, take-home messages from our eating disorders awareness back-to-school night:

1. Trust Your Gut

If you notice a change in your child’s eating behavior and are concerned, trust that feeling, even if your pediatrician says that your child’s weight is in the healthy range (Many individuals with eating disorders are actually not underweight.).  For example, you may notice that your child, who has always been a picky eater, is now making excuses not to eat with the family, pushing food around on the plate, and covering their plate with a napkin before clearing it. If you’re wondering how to address your concerns with your child, read here how to ‘call it as you see it.’

2. Eating Problems: Not Simply an Intake Issue

If your child seems to go above and beyond the training regimen recommended by their sports team, take note. This could mean trying to get in extra practice before or after school, or trying to train through an injury or illness, even though their coach has recommended they take some time to recover. If your child exercises in order to compensate for food they’ve eaten, rather than for fun or for health, this may also be cause for concern.

3. Digital Dilemmas

Are you noticing your child using social media in ways that focus exclusively on appearance? Are they competing in the “thigh gap” challenge, or wanting to pose to show as little of themselves as possible? Remind your children that these challenges are unhealthy, unrealistic, and undermine a healthy self-image. Teach them – explicitly, and by your own example – how to manage normal body image concerns in the digital age. Remind them of those in the media who stand up to Photoshop and choose instead to show realistic images that accurately reflect the acceptability of a range of body types.

4. The Fine Line with Food Rules

Has your child recently decided to go gluten-free, even though they do not have celiac disease, or to become a vegetarian, and as a result is eating far less at meals or parties? Experimentation in moderation with new approaches to food, like vegetarianism, can be supported, so long as your child is still eating a broad variety of foods, i.e., not just eating vegetables. People who struggle with disordered eating may adopt rigid food rules which give them an excuse to exclude large groups of foods from their diets. A healthy approach to eating includes flexibility, choosing from a wide variety of foods, and for a growing adolescent, this should not include weight loss. Weight loss or failure to gain as expected can be signs that your child is having some difficulty with eating. During adolescence, kids need adequate nutrition in order to grow; in fact, kids often put on significant weight during puberty as their bodies get ready for a growth spurt.

Adolescence is a time of experimentation, rebellion, and growing independence.  For the susceptible few, decisions made to become more rigid about eating and/or exercise can lead to a slippery slope both in terms of physical and mental health. If you see a troubling shift in your child’s behavior, including but not limited to those listed above, say something. Be mindful to express your concern (rather than your frustration).

Your child may be angry or deny that there is a problem, but you can approach this as you would when dealing with any other kind of medical issue. If your child had a cold, you might monitor the symptoms for a while and then seek consultation from a doctor if the symptoms did not improve, or worsened.

Here, you can monitor what’s happening by talking to teachers and school counselors who can share observations of your child when they are not with you. Pay attention to the attitudes and behaviors of your child’s peer group.

If the behaviors of concern persist or worsen, you can insist that you speak together with an expert who can provide an objective assessment. This might be your pediatrician or a mental health provider who is an eating disorders specialist. Families play a vital role in helping those with eating problems, and research indicates that early intervention is key.

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