What are the Early Signs of Eating Disorders in Young Adults?

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Eating disorders can affect anyone, regardless of their gender, background, age, or ethnicity. But they’re most likely to develop during adolescence, as young people move from childhood into adulthood.

While eating disorders are serious mental health conditions, they are treatable. With the right support, young people can recover physically and mentally, reclaiming their lives and futures.

Recognising the signs of eating disorders and reaching out for support is the first step in the recovery process. While recovery from an eating disorder is always possible, research shows that early interventions are associated with better outcomes. This means spotting early signs of disordered eating behaviours can be especially important.

This blog outlines the early signs of eating disorders in young adults, why early intervention is so important, and what outpatient and inpatient treatment options are available to support young people in lasting recovery.

What Are Eating Disorders?

Eating disorders are medical diagnoses based on a young person’s eating patterns and medical tests. There are several different types of eating disorders, including:

  • Anorexia nervosa, characterised by restricting eating behaviours and a low BMI
  • Bulimia nervosa, involving cycles of binging and purging
  • Binge eating disorder, involving episodes of uncontrolled eating
  • Unspecified feeding or eating disorder

Some young adults may have eating problems that do not fit exactly into a medical diagnosis. This doesn’t mean that their condition is any less serious. It’s vital that every young person is listened to, cared for and receives the professional support they need.

Eating problems and eating disorders are not just about food, body shape, or weight. Disordered eating behaviours are often a coping mechanism for painful emotions, thoughts, or feelings. Underlying issues like perfectionism, low self-esteem, and interpersonal difficulties can contribute to and maintain eating disorders.

What Are the Early Signs of Eating Disorders in Young Adults?

The average age of onset of eating disorders is during late adolescence or early adulthood, around the age of 18. This means that looking out for the early signs of eating disorders around this time is especially important.

The early signs of eating disorders can look similar to those of other mental health conditions and may vary from one young person to another. But, while only a professional can make a medical diagnosis, any signs of disordered eating should be taken seriously. If you’re worried about a young person, you should reach out to a doctor or mental health professional as soon as possible.

When a young person starts to develop an eating disorder, you may see changes in their eating behaviours and their attitudes towards food, body shape, and weight. 

Preoccupation with Food

One of the first signs of an eating disorder is often a preoccupation with food. Young adults may start paying a lot of attention to the types of food they are eating and the calorie content. They may also want to plan what they eat in advance or find it stressful (or avoid) eating with other people.

You might notice that they:

  • Look at calorie labels on food
  • Precisely calculate their calorie intake
  • Follow strict diets or become preoccupied with “healthy” foods

Over-Evaluation of Shape and Weight

Many young people with eating disorders or eating problems place most or all of their self-value in their body shape or weight. They may experience body dissatisfaction and feelings of failure if their body is different to what they perceive as an “ideal”. Young adults may start to use disordered eating behaviours like diet restriction or excessive exercise to try to change their bodies, even when it harms their mental, physical, and social health.

As eating problems develop, some young adults may start speaking more about their body or weight or express their dissatisfaction with their body image. They may become increasingly distressed about and preoccupied with the way their body looks and engage in body checking. However, many young people with eating disorders also try to hide their thoughts, feelings, and behaviours from others, making it hard for others to recognise the signs.

Strict Exercise Routines

Young adults with eating problems can also use exercise (instead of or as well as food) to restrict their energy intake or to “purge” after episodes of uncontrolled eating. Some young people may start to follow regimented exercise routines and find it distressing to deviate from them. You might notice that others sometimes engage in hours of intensive exercise, without a clear routine.

A young adult’s exercise routine may be concerning when:

  • their routines are regimented and not flexible
  • they experience emotional distress if they have to change their routines or are unable to exercise
  • they continue to exercise even when they’re tired, fatigued, or otherwise unwell
  • exercise takes priority over other aspects of their social, work, and personal life

Secrecy and Shame

Adolescents and young adults with eating disorders often experience strong feelings of shame about their bodies, their eating behaviours, and other aspects of their lives. These feelings can cause them to hide disordered attitudes and behaviours. Young people may also prefer to eat by themselves to prevent other people from interfering with their eating and exercise patterns.

This might involve:

  • frequently saying they have already eaten (when they often haven’t)
  • wanting to eat in a different place, away from others
  • eating slowly
  • feeling ‘full’ very quickly

Mood Changes

Our eating patterns have a big impact on our mood. When young adults follow disordered eating behaviours, it interferes with the healthy production of hormones and disrupts the chemical balance in their brains and bodies. This can affect their emotional regulation, causing them to become more irritable and leading to feelings of depression and anxiety.

Young adults with eating disorders often also struggle with low self-esteem, affecting their confidence, energy, and resilience. 

Why Is Early Intervention for Eating Disorders Important?

Early intervention is when eating disorder treatment starts as soon as symptoms are recognised. Unfortunately, for many young people, barriers to treatment delay their access to recovery programs. Some only begin treatment after years of living with an eating disorder, while others don’t receive treatment at all.

Research shows that early intervention and treatment are crucial to recovery, and delaying treatment is associated with poorer outcomes. Receiving support quickly can reduce the impact of an eating disorder, preventing further harm to their mental and physical health. 

Recognising the early signs of an eating disorder is really important. It allows young people and their families to seek help as soon as it’s needed, paving the way for timely and effective treatment. But it’s also necessary to break down other barriers to treatment, such as a reluctance among young people with eating disorders to ask for help or a lack of specialist services available. Some early intervention programs and education campaigns aim to spread awareness and understanding about eating disorders and the importance of treatment and support, as well as identifying young people in need of help.

What Treatment Is Available for Young Adults Living with Eating Disorders?

Eating disorders are serious mental health conditions, but there is help available. With the right support, young people can recover from eating disorders and reclaim their lives and futures.

Eating disorder treatment can be inpatient (when a young person stays at a residential centre for the duration of treatment) or outpatient (when a young person has regular sessions with therapists, doctors, and other professionals while continuing to live at home). Mental health professionals can work with young people and their families to find the best level of care for each individual’s circumstance.

Eating Disorders Inpatient Treatment

Inpatient treatment is necessary when a young person requires 24-hour medical supervision and medical facilities. This may involve ICU beds along with doctors, psychiatrists, nutritionists, and other medical professionals. Eating disorders inpatient treatment programs keep young people safe as they engage in therapy sessions and other approaches that aim to overcome disordered eating behaviours.

Many young adults also benefit from inpatient treatment when they don’t require 24-hour medical supervision. Inpatient treatment can provide a safe, supported environment away from the stresses and triggers of everyday life for young people to begin their recovery journey. It can help young people move away from harmful cycles and find the space they need to self-reflect and heal.

Outpatient Eating Disorder Recovery Programs

Some young people move into outpatient care after a period of residential treatment, while others begin their treatment in outpatient settings. Outpatient treatment programs may involve intensive outpatient care, with sessions for several hours each day, or regular appointments (such as weekly appointments) with therapists and other professionals. Outpatient programs support and guide young adults to make changes in their everyday lives (such as in meal planning and eating and exercise patterns) while providing therapy and other psychological care.

CBT-E and Trauma-Focused Eating Disorder Care

There are several different evidence-based treatment methods for young adults. CBT-E, a type of cognitive behavioural therapy tailored to eating disorders, is the most established approach for adults. CBT-E addresses the underlying causes of disordered eating behaviours while working with young adults to develop healthy eating patterns. It may also address issues of perfectionism, interpersonal difficulties, and low self-esteem that often underpin disordered eating.

Most young people who enter inpatient treatment for eating disorders have experienced trauma. Traumatic experiences can have a lasting impact on the way a young person sees themselves and the world around them, causing and maintaining disordered eating behaviours. Addressing and healing from trauma is an important part of the recovery process, promoting mental and physical wellness with meaningful, lasting change.

The Wave Clinic: A Private Eating Disorder Treatment Centre that Makes a Difference

The Wave Clinic offers specialist mental health support for teenagers and young adults that focus on the future. Our world-leading programs combine clinical care with education, social responsibility, and an international gap year experience at our centre in Malaysia. We work with young people to rediscover their love of life, develop invaluable life skills, build supportive friendships, and find stability and resilience moving forward.

The Wave is a Global Centre of Excellence for the treatment of eating disorders. We focus on addressing underlying issues, treating co-occurring disorders, and providing trauma-focused care from the start of every recovery program. Our centre is fully equipped with qualified medical staff and licensed facilities for young people at the highest risk.

If you would like to find out more about our programs, get in touch today. We’re here to support you.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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