The Doctor is in: Eating Disorders
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How to Help Your Child With an Eating Disorder

Eating disorders are serious health conditions characterized by an unhealthy pattern of eating and dieting. These conditions are both physical and mental, influencing the way a person thinks about food, body image and self-worth.

For the parents of teens, eating disorders can be scary. By learning what eating disorders are, how they develop and how they’re treated, you can ensure your child gets the necessary support.

Many people with eating disorders don’t realize how severe their symptoms are, leading them to believe they don’t need treatment. If you notice any changes that affect your child’s normal functioning, don’t watch and wait. Seek help for your child, even if they don’t want it, and be firm and consistent with treatment.

Parents should establish healthy habits around nutrition and exercise from a young age. Try to create a positive, supportive environment in the home by modeling healthy habits for your child. In addition, parents should develop and enforce boundaries for their child’s social media use, in order to teach safe social media habits and protect against harm.

Open communication is also key to maintaining a healthy relationship between parent and child. Express concern in a nonjudgmental, open-ended manner. This can be as simple as asking your child, “How are you feeling in general?” rather than probing about their weight or diet. Establishing those lines of communication can help your child work through their feelings in a safe environment.

I hope that sharing some of the ways I have helped my patients will help parents navigate these conversations and find the treatment their children need.

Types of eating disorders

The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder. While the symptoms and psychology of each disorder may differ slightly, they all seriously impact a person’s health and daily functioning.

  • Anorexia occurs when a person doesn’t eat enough food to maintain a healthy body weight. Due to a severe fear of gaining weight and an unrealistic view of body shape or weight, people with anorexia may use extreme measures to lose weight. This may include fasting methods like cutting calories or skipping meals, or other methods like overexercising or using laxatives. People with anorexia are at high risk of medical complications due to malnutrition and/or psychological complications due to underlying mental health issues.
  • Bulimia is a serious condition that includes uncontrollable cycles of bingeing and purging. People with bulimia eat an excessive amount of food in a short period of time, known as bingeing. Then, due to guilt, shame or fear of weight gain, they purge the calories they just ate through behaviors like vomiting, using laxatives or diuretics or overexercising.
  • Binge-eating disorder occurs when a person eats a large amount of food in a short period of time, often past the point of feeling full. Unlike bulimia, binge-eating disorder is not followed by episodes of purging. However, it shares the same feelings of guilt and shame invoked by other eating disorders which perpetuate an unhealthy, uncontrollable cycle of dieting.

Risk factors

We don’t know the exact cause of eating disorders. Anyone can have an eating disorder, but certain risk factors may increase the chance of developing one.

Eating disorders commonly begin in the adolescent years, from ages 10 to early 20s, in both boys and girls. Adolescence is the transition from childhood to adulthood – a time of change, uncertain identity and intense social expectations. This loss of control, often amplified by the influence of social media, can lead to a poor relationship with food and weight and, in some cases, lead to an eating disorder.

In addition to age, other factors that may increase the risk of developing an eating disorder include:

  • A family history of eating disorders
  • Other mental health issues, including depression, anxiety, obsessive-compulsive disorder and substance use disorder.
  • A history of frequent dieting or starvation, especially with cycles of weight loss and gain
  • Cultural factors that value thinness or dieting, including high-performance sports, bullying about weight and the rise of social media among teens
  • Stress, trauma or a significant life event

Symptoms

Disordered eating can present in many ways. It’s important to recognize that your teen’s symptoms may not fit perfectly with the criteria used by doctors to make a formal diagnosis. Knowing the common signs of eating disorders will help you determine when to call a doctor.

Behavioral symptoms of an eating disorder include:

  • Excessive focus on food, dieting or weight loss
  • Skipping meals, making excuses for not eating or preferring to eat alone
  • Pushing food around their plate without actually eating
  • Frequently taking weight or checking in the mirror for flaws
  • Eating large amounts of food at once, or eating regularly without maintaining a healthy weight
  • Purging behaviors like vomiting, using laxatives or overexercising
  • Changes in energy level or mood
  • Withdrawing from usual social activities

Physical symptoms of an eating disorder include:

  • Dramatic weight changes
  • Dental issues from self-induced vomiting
  • Brittle hair and fingernails
  • Irregular heartbeat or blood pressure
  • Irregular periods

Treatment

Eating disorders are treated with counseling and, in some cases, medication. The main goal of treatment is to address the underlying issues causing the eating disorder so the patient can regain control over their relationship with food.

In adolescents, family counseling is a primary method of treatment. Family is one of the most important factors in supporting healthy habits. For parents, family counseling can give you the tools to properly care for your child and provide you with personal support.

Like family counseling, individual counseling aims to address the child’s underlying mental health conditions, build skills and change their way of thinking.

Another form of counseling is nutritional counseling, which involves building an eating plan for your child and helping them take the small steps to get there.

A doctor may decide to add medications to the treatment plan if psychotherapy is not enough. This typically includes antidepressants to treat co-occurring psychological conditions associated with eating disorders, such as depression or anxiety disorders. Parents should closely monitor a child or teen who is taking medication.

Advice for parents

If you decide to seek professional help, a great first step is reaching out to your teen’s pediatrician or primary care physician. The doctor will be able to assess their symptoms and connect you with additional resources if they suspect an eating disorder. After diagnosis, it may be beneficial to maintain communication with your child’s school to provide them with additional support outside of the home. Guidance counselors can be a useful resource in the academic environment, especially if bullying and/or peer pressure have asserted a strong influence on your child’s life.

Try to understand that an eating disorder is an illness – something that’s not necessarily in your child’s control. Recovery may take a long time and can include relapses along the way. Recognize that these conditions are multifaceted and often require family involvement in treatment. And if you are a parent whose teen has an eating disorder, don’t forget to seek support for yourself. With your patience and assistance, your teen can overcome their eating disorder.

Learn more about eating disorders in teens and how parents can help a teen with an eating disorder.

Related:

Encouraging Your Teen to Develop Good Eating Habits

Why Prioritizing Exercise Can Benefit Your Teen’s Life.