Eating Disorders and Adolescence: Spotting the Signs

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Eating disorders are serious mental health conditions that usually develop during adolescence. They are complex disorders that have a pervasive effect on a young person’s life, affecting their mental and physical health, relationships with friends and family, emotional and social development, and performance at school.

The good news is that eating disorders are treatable, and no matter how serious the condition, most young people can make a full recovery. However, recovery from eating disorders requires professional treatment and support. What’s more, earlier interventions usually lead to better treatment outcomes.

This means that spotting the signs of eating disorders is really important. It’s the first step to seeking professional support for a young person and beginning the path to recovery. Parents, teachers, and other community members all have a responsibility to look for and be aware of the signs of eating disorders in adolescents to help prevent and treat the illness in young people. 

How Common Are Eating Disorders In Adolescents?

Eating disorders are common among adolescents. Recent data suggests that between 6-8% of adolescents have an eating disorder.  

There are several types of eating disorders that may develop before or during adolescence. These include:

Sometimes, young people experience eating problems that do not fit exactly into any diagnosable eating disorder. However, this doesn’t mean that their eating problem isn’t serious. It’s important that all adolescents with eating problems receive the professional support they need to recover and look towards the future.

What Age Do Eating Disorders Usually Develop?

The average age of onset of eating disorders is during late adolescence, around the age of 18. However, many young people develop eating disorders earlier in their teenage years. 

Anorexia nervosa has one of the earliest age of onsets of all eating disorders. A recent study found that 75% of people develop anorexia nervosa before the age of 22, with an average age of onset of 16.2.

Eating disorders can also develop among pre-teens, known as early-onset eating disorders. While early-onset eating disorders are still rare, data suggests that in some parts of the world, they are rapidly increasing.

What Are the Signs of Eating Disorders in Adolescents?

It can be hard to recognise when a young person has an eating disorder. It’s normal for young people to experience feelings of shame about their thoughts and behaviours and they may try to hide it from others. Some adolescents may also keep their eating disorder secret to have more control over their eating and exercise.

If a young person shows any signs of an eating problem – or other mental health issues – it’s important to seek professional support, even if these signs are different to what you might expect. Below, we’ve listed some of the more common signs of an eating disorder, but be aware that eating disorders can manifest in many different ways.

Some warning signs include:

Significant Changes in Weight

Adolescents with eating disorders may quickly gain or lose a lot of weight. This can happen through disordered eating behaviours such as diet restriction, excessive exercise, or binge eating. 

While weight changes can have many different causes apart from disordered eating, it’s important to pay attention to a young person’s wellbeing, look out for other signs of mental health concerns, and seek professional advice if necessary.

Lying or Secrecy About Eating Behaviours

Young people with eating disordered often try to hide their eating behaviours. They may lie about whether they’ve eaten or how much. They may also avoid eating with other people by staying away from social gatherings that involve food or taking food to their room from a family meal. They may express anxiety about eating with others.

Some young people may try to hide or secretly throw away food at the end of a meal or move food around on their plates so it looks like they’ve eaten more than they have.

Eating a Lot of Food in a Short Time

Eating disorders such as bulimia nervosa and binge eating disorder involve episodes of binge eating. Binge eating is when someone consumes a lot of food in a short time and experiences a loss of control when eating.

If a young person shows repeated episodes of binge eating, it may be a sign of an eating disorder. Adolescents with bulimia nervosa may follow binge eating with ‘purges’, such as inducing vomiting, using laxatives, or excessively exercising.

Strict Exercise Routines

Young people with eating disorders sometimes use exercise to try and control and change their body shape or weight. They may exercise a lot more than usual and follow strict exercise routines, experiencing anxiety if they are unable to exercise as they planned. 

Some adolescents may have disordered eating behaviours related to ideas about health and fitness. In recent years, social norms that connect health and fitness to body shape and weight have spread across conventional media and online platforms. 

Like beauty ideals surround an ‘ideal body’, health and fitness ideals can present a single, unrealistic misconception of health that leads to body disatisfaction and low self-esteem. These thoughts and feelings can underlie disordered eating and excessive exercise, as young people try to change their body and habits to meet this ideal.

Eating Very Slowly

Young people with eating disorders such as anorexia may eat slowly to limit their energy intake. Slow eating and small portions are often some of the early signs of an eating disorder. Adolescents may also cut food into small pieces when eating their meals.

Wearing Baggy or Loose-Fitting Clothes

Some young people may wear loose clothes to hide changes in weight. They may also lie about their weight to others.

What Do Eating Disorders Look Like Among Boys?

About one in four eating disorders are experienced by men and boys. However, most research into eating disorders has focused on women and their experience of the conditions. This means that the signs and symptoms of eating disorders in boys or other gender identities can be missed or overlooked, even by experts.

Many of the signs of eating disorders in boys are similar to those in girls. However, research shows some symptoms and patterns that are specific to, or more often found in, male eating disorders.

It’s important to be aware of the ways that eating disorders tend to affect adolescent boys so you can spot the signs of the condition.

Body Image Concerns

Social and cultural norms surrounding beauty and body image often play a big role in the development of eating disorders. Social ideals of a ‘perfect body’ (that is unhealthy for most people) can cause young people to experience dissatisfaction and psychological distress about their own body shape or weight.

Social ideals of male bodies are different to those of female bodies. Adolescent boys may be more likely to idealise a lean and muscular figure rather than only a low body weight. This means that eating disorders among boys are more likely to focus on muscle building as well as weight loss, such as cycles of ‘bulking and cutting’.

Muscle Dysmorphia

Some adolescent boys with eating disorders also experience muscle dysmorphia, a type of body dysmorphic disorder. Adolescents with muscle dysmorphia are preoccupied that their bodies are not lean or muscular enough. They often see their body as less muscular or smaller than others perceive it.

Muscle dysmorphia can underlie disordered eating behaviours, causing adolescents to restrict their eating, over-exercise, or use cycles of bulking and cutting to change their body shape. At the same time, disordered behaviours can also contribute to the development and maintenance of muscle dysmorphia.

What Are Some Common Signs of Eating Disorders in Adolescent Boys?

As with all young people, eating disorders can look very different from one adolescent boy to another. It’s important to seek professional help and support if you’re worried about a young person’s eating behaviours, whatever form they take.

Some common signs of disordered eating in boys and men include:

  • body dissatisfaction
  • thinking a lot about their body image
  • being afraid of losing muscle
  • exercising excessively in order to ‘bulk up’
  • cycles of bulking and cutting
  • using steroids to gain muscle
  • following strict diets
  • losing interest in hobbies or activities they used to enjoy
  • tiredness or exhaustion
  • symptoms of other mental health conditions such as anxiety or depression

Treating Eating Disorders Among Adolescents

If you’re worried that a young person has an eating disorder, the most important step is seeking professional support. This might involve making them aware of the options available, helping them access treatment, or seeking professional advice yourself about what to do next.

There are several evidence-based treatment approaches available that can support young people in recovering from eating disorders. These include:

  • Family-based therapy (FBT)
  • Enhanced cognitive behavioural therapy (CBT-E)
  • Integrated trauma and eating disorder treatment

Some young people may need to try more than one type of treatment until they find an approach that works for them. It’s important to stay patient throughout the treatment process, remain optimistic, and accept that recovery may not always be linear.

Supporting a Child with an Eating Disorder

If your child has an eating disorder, it can be hard to know what to do. Sometimes, adolescents can become withdrawn, sensitive, or irritable, making it difficult to start a conversation. However, speaking to a young person about their eating disorder is really important.

Even when a young person seems angry or finds it hard to speak about their experience, it’s important to keep trying. You should stay calm and non-judgemental, give them the space to speak, listen carefully, and be patient.

While treatment plays a huge role in a young person’s recovery, parents’ love and support can also make a big difference. It can help to learn more about eating disorders yourself so you can understand their experience and know how to respond. Make sure your child knows that you love and care for them, and keep expressing this, through both words and actions. Be ready to support them in the treatment process, communicating with their treatment team and listening to your child’s thoughts and concerns.

The Wave Clinic: Specialist Recovery Programs with Care and Sensitivity

The Wave Clinic is a residential treatment space for young people that specialises in eating disorder recovery. We deliver expert care with care and sensitivity, support adolescents and young adults to recover from mental health disorders and build fulfiling futures.

Our core elements of treatment emphasise personal development alongside clinical care. We provide personal learning programs, vocational qualifications and education, volunteering opportunities, internships, and enriching experiences. We work with young people to discover new life paths, build life skills, and find stability and resilience within themselves, their relationships, and their community.

If you’re interested in our programs, contact us today. The Wave is a Global Centre of Excellence for the treatment of eating disorders, setting the standard for young people’s mental health support around the world.

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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