Eating Disorders in Teenagers

What is an Eating Disorder?

Eating disorders are characterized by a persistent hyperfocus on food, body weight, and exercise that causes a person to go to extremes. This complex group of mental illnesses facilitates dangerous eating behaviors in the person dealing with it and negatively impacts their health, emotions, and ability to function.

Eating disorders have serious physical consequences, having the highest mortality rate of all psychiatric disorders. The conditions commonly result in the body not receiving appropriate nutrition and lead to damage in multiple regions of the body, such as the:

• Heart
• Digestive system
• Bones
• Teeth
• Mouth

It is a common myth that you can tell someone has an eating disorder just by looking at them. In reality, people dealing with the condition can have a variety of body shapes – even athletes that look incredibly in shape can be coping with an eating disorder. Eating disorders can also impact people of any age, though typically they occur during adolescence.

What Are the Symptoms of Eating Disorders in Teens?

There are multiple kinds of eating disorders with a range of symptoms. Depending on the disorder that a person has, different symptoms will take shape. However, there are some general signs that indicate an eating disorder, many focusing on behavior around meals, unusual eating habits, and overall health.

Some more specific symptoms include:

• Behaviors and attitudes that suggest dieting, weight loss, and control of food are primary concerns
• Skipping meals or only eating small portions
• Frequent dieting
• Noticeable changes and fluctuations in body weight
• Extreme concern for body shape and size
• Preoccupation with weight, food, calories, carbohydrates, fat grams, and dieting
• Refusing to eat certain foods or food groups
• Appears uncomfortable eating around others
• Food rituals – not allowing food to touch, excessive chewing, only eating particular food groups
• Withdrawing socially
• Low self-esteem
• Extreme mood swings
• Sleep problems
• Frequent checking of their reflection
• Gastrointestinal complaints
• Menstrual irregularities
• Difficulty concentrating
• Dizziness and fainting
• Impaired immune functioning
• Dental issues
• Dry skin, thin hair, brittle nails

Types of Eating Disorders

The most three common eating disorders in teens are:

• Anorexia Nervosa
• Bulimia Nervosa
• Binge-Eating Disorder

Other common eating disorders include avoidant/restrictive food intake disorder and rumination disorder.

Anorexia Nervosa

People with Anorexia Nervosa take serious measures to try and avoid eating, and the quantity and quality of the food intake they do have are highly controlled. Teens with this condition become extremely thin for their body, though due to their distorted body image, they continue to diet even at this unhealthy weight.

Signs of Anorexia Nervosa

• Rapid and excessive weight loss
• Restricting, hiding, or discarding food
• Obsessively counting calories or grams of fat in the diet
• Denial of feelings of hunger
• Developing rituals around preparing food and eating
• A distorted view of one’s body weight, size, or shape, sees self as “too fat”
• Compulsive or excessive exercise – despite weather conditions, illness, injury, or fatigue
• Dresses in layers to disguise weight loss or to stay warm
• Emotional changes – such as irritability, anxiety, and depression
• Restricting relationships and pleasurable activities, leading to social withdrawal
• Thinning hair
• Feeling cold, tired, and weak
• Dizziness and fainting
• Irregularities or absence of menstrual periods (in females)

Bulimia Nervosa

This eating disorder causes individuals to engage in overeating (binging), which most commonly occurs during the evening and nighttime. The clinical definition of the disorder defines Bulimia Nervosa as binging and purging on average once a week for at least three consecutive months.

After binging, people with Bulimia Nervosa carry out compensatory behavior to lose weight, this can include:

• Vomiting
• Excessive exercise
• Fasting
• Taking laxities
• Enemas

As teenagers with Bulimia Nervosa can maintain a normal weight and can present as seemingly healthy, this illness often goes unnoticed.

Signs of Bulimia Nervosa

• Eating unusually large amounts of food with no apparent change in weight
• Frequent trips to the bathroom after meals
• Peculiar eating habits or rituals
• Hiding food or discarded food containers and wrappers
• The disappearance of large amounts of food in short periods of time
• Excessive exercise or fasting
• Inappropriate use of laxatives, diuretics, or other cathartics
• Overachieving and impulsive behaviors
• Frequently clogged showers or toilets
• Weakness and fatigue
• Dental issues and discolored teeth
• Odor in breath, plus use of excessive mouthwash, mints, or gum to cover it up
• Stomach pain
• Irregularities or absence of menstrual periods (in females)
• Scarring/calluses on the hands caused by self-inducing vomiting
• Drinking excessive amounts of water or non-caloric beverages

Binge-Eating Disorder

Binge-Eating Disorder is characterized by excessive and uncontrollable eating, soon followed by feelings of guilt and shame. This is similar to Bulimia Nervosa, though individuals affected by Binge-Eating do not compensate to lose weight after overeating – consequently leading to weight gain. A medical professional will diagnose a teenager with Binge-Eating disorder when they binge at least once a week for three consecutive months.

Signs of Binge-Eating Disorder

• Eating an unusually large amount of food within a few hours
• Gaining weight
• Feeling the inability to control how much they eat
• Feelings of disgust, depression, or guilt after overeating
• Eating in secret because of feeling embarrassed by how much they are eating
• Hiding food or discarded food containers and wrappers
• Eating to cope with negative emotions
• Low self-esteem
• Experimentation with different diets
• High blood pressure
• Diabetes
• Skin disorders
• Heart disease
• Irregularities or absence of menstrual periods (in females)

Diagnosing Eating Disorders

To identify an eating disorder a physical exam and psychological evaluation will be carried out to identify specific signs, symptoms, and eating habits. The earlier a person’s condition is diagnosed, the higher the chance they have of a complete recovery. However, diagnosing eating disorders in adolescents is difficult as:

• Many hide their symptoms
• Many are in denial about their condition, as well as those around them
• Family and friends may not know the signs to look out for
• They can seemingly look a ‘healthy weight,’ yet may be very malnourished
• Many secretly restrict food, binge, purge, and over-exercise, while behaving normally in front of others

This means teens with eating disorders commonly do not receive any medical diagnosis until their eating disorders are at advanced stages.

Treating Eating Disorders

Eating disorders can be extremely complex to treat and require close supervision throughout the process. However, it is vital that teenagers engage in treatment as these conditions are unlikely to go away on their own. Eating disorders are often co-occurring with other mental health conditions, meaning a comprehensive evaluation should first be completed by the person with the eating disorder and their family to understand how to best tackle treatment. A mental health professional should also keep in close contact throughout this time, as medical complications are frequent during the process.

For the best success when treating an eating disorder in teens, a multi-pronged, individualized approach should be taken covering many areas of the person’s well-being. Even when an individual may not fit into the clinical definition of a particular eating disorder – for example, their unhealthy behavior has not occurred over consecutive months – they should still seek medical guidance on how to overcome their negative relationship with food and body image.

Medical Treatment

Due to malnutrition and the strain under or overeating can cause, the person undergoing treatment firstly needs a health check-up. After, appropriate personalized care can be administered, whether that be a hospitalization, intravenous therapy, or medication.

Psychiatric Treatment

Psychiatric medication may be prescribed to ease any simultaneous mental illnesses – with substance abuse, anxiety, and depression co-occurring most frequently with eating disorders. It is also common that teenagers in this position also suffer from trauma, causing them to participate in self-harming behavior – such as cutting or burning themselves – and have an increased risk of suicide. For these reasons, individual therapy is an essential part of treatment.

Individual therapy uses both cognitive and behavioral techniques to help people identify harmful thoughts, behaviors, and triggers associated with their eating habits. It then educates on how to build healthier coping mechanisms to modify how to handle these difficult thoughts and emotions. It also deals with the trauma that may be behind eating disorders, aiming to heal the person from the past to build a healthier future.

Family therapy is also advised when tackling eating disorders. Loved ones play a vital role in the recovery, with the education and understanding attending therapy together brings making a world of difference. Family therapy also allows any trauma that initially came from the family unit to be addressed and the conditions the eating disorder was built in to be changed, meaning a higher chance of a successful recovery.

Group therapy can also be extremely valuable as it allows the recovering person to talk about their condition in a safe, judgment-free space full of people who understand what they have been through. This opportunity also allows the individual to hear what tools other people used to move forward from their eating disorder, acting as a source of inspiration and giving hope in overcoming their disorder.

Nutritional Rehabilitation

The goal of nutritional rehabilitation is to restore a person’s health and reach a healthy body weight – this can mean losing or gaining weight depending on the eating disorder being treated. This kind of counseling includes a combination of healthy eating, meal planning, nutritional rehabilitation, and goal setting. This allows for a healthier relationship with food to be cultivated and teaches the individual skills on how to consume a balanced diet going forward.

Contact Us

Eating disorders can be challenging to overcome, but it’s important to remember recovery is absolutely possible. At Clearfork, our team of highly trained staff is here to assist you in this process, giving each one of our clients high-quality and individualized care. Please don’t hesitate in contacting us today to find out more about how we can help get your’s or your loved one’s life back on track.