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Eating Disorders and Youth

Eating disorders are marked by a variety of emotional, physical, and behavioral changes. While some of the behaviors may appear to be little more than teenage dieting and body dissatisfaction, taken together they can indicate a serious, life-threatening eating disorder. The average age of onset for eating disorders is 12- to 13-years-old [1], with eating disorder specialists reporting an increase in the diagnosis of children, some as young as five or six. [2]

It's important for parents, relatives and school personnel to be aware of risk factors and symptoms of eating disorders so they can take steps to address these issues early (before Stage 4) to ensure the best possible outcomes for the young person affected.

See below for more information and resources about eating disorders and young people.

Social Media and Eating Disorders

Social media can help individuals with eating disorders, by providing them with access to peer support, treatment options, and other information. However, it has also been shown to heighten the exposure of messages that promote eating disorders. Images of skinny legs, thin stomachs, and jutting ribs are posted to social media sites, along with “thinspirational” messages such as “Pretty girls don’t eat” and “Skip dinner, be thinner.” [3]

Additionally, “pro-ana” (pro-anorexia) and “pro-mia” (pro-bulimia) websites have found a global platform through social media websites such as Facebook, Twitter, Tumblr, Instagram, and Pinterest. Using these websites, users support each other’s self-harming behaviors and promote the notion that an eating disorder is a lifestyle choice, rather than a serious mental illness. Individuals can now come together through monthly challenges that encourage eating disordered behavior. For example, some Instagram users seek likes to complete tasks, such as “1 like = 2 hours of fasting.” [3]

There is also growing concern around “fitspo” or “fitspiration.” This includes content that often focuses on “clean eating” and fitness programs. While this movement was initially thought to be a healthy alternative to the pro-anorexia and pro-bulimia content, they may also overvalue and reinforce obsessive thoughts and behaviors around food and exercise, even if they may appear to or claim to promote health.

In reality, social media makes it easy for individuals with eating disorders to seek and gain approval of their actions, and it amplifies behaviors associated with these disorders – obsessions, comparisons, and competition. In response to this, social media sites have made attempts to censor content that encourages eating disorders, but it can be difficult to prevent all of the content from getting through. [3]

Tips for Parents and Relatives

Do: [2]

  • Notice: Pay attention to warning signs of eating disorders, including changes in behaviors around food, physical changes, types of social media use, and conversations about food or body image.

  • Listen: Listen openly, reflectively, and without judgment. If you do not understand, ask how your child is feeling and how you can best support them. Validate their feelings instead of immediately offering solutions.

  • Learn: Learn more about eating disorders and recovery, including facts and myths. Reading about or speaking with other parents who have supported their children in recovery is also helpful and is often a part of treatment programs.

  • Support: Remind them that you are there to support them and just want them to be well. Focus on positive personality traits and emotional health instead of exclusively focusing on food-related behavior. Model recovery in your own relationship with food, weight, and exercise, and work to create an environment where the whole family is promoting healthy behaviors and alternatives.

If your child denies having a problem, simply and calmly:

  • Repeat what you have observed, i.e., evidence that there is a problem
  • Repeat your concern about their health and well-being
  • Repeat your conviction that the circumstance at least be evaluated by a counselor or therapist
  • End the conversation if it is going nowhere or it either of your become too upset.
  • Take any actions necessary for you to further your responsibilities.
  • Leave the door open for further conversation

Do Not: [4]

  • Judge: When your child is struggling or discusses something personal, do not express judgment, make jokes, or be dismissive of their thoughts, feelings, or behaviors. They may feel confused, ashamed, or frustrated and are trusting you for support.
  • Argue: While it is painful to watch someone you love struggle, avoid expressing anger and frustration. Confronting your child with a group of people, making accusations, or getting into arguments will likely make communication and support more difficult and may lead them to feel more isolated.
  • Lecture: Do not oversimplify the problem or focus on giving advice on things like appearance, weight, or exercise. While there may be times when your child is looking to you for specific answers, make sure the focus is on what they want and need in that moment.
  • Ignore: Do not dismiss warning signs at any stage as simply a “phase.” Eating disorders have the highest mortality rate of all mental health disorders so it is crucial to get treatment and support as early as possible. If the person is throwing up several times a day, passing out, complaining of chest pain, or is suicidal, get professional help immediately.

Tips for School Personnel

If a student consistently shows one or more of the signs or symptoms listed below, it is cause for concern and a student's parents or guardians should be contacted: [5]

Emotional

  • Perfectionism: The student may have an intolerance for imperfections in academics, eating, social life, etc, and may overvalue self-sufficiency, creating a reluctance to ask for help. Other signs of perfectionism related to disordered eating include: expressing body image complaints/concerns like being too fat regardless of weight; being unable to accept compliments; having moods affected by thoughts about appearance; constantly comparing self to others; self-disparaging remarks; referring to self as fat, gross, ugly; overestimating body size; seeking constant outside reassurance about looks; and striving to create a “perfect” image.
  • Withdraw: The student may appear withdrawn across different areas of his or her life. This includes changes in attitude/academic performance; flattened or absent emotions; and increased time spent alone or pulling away from friends. They may appear sad, depressed, anxious, ashamed, embarrassed, or express feelings of worthlessness.
  • Changes in thoughts or conversations about food: They may display rigid or obsessive thinking about food, eating, and exercise (e.g., labels foods as good/bad or on/off limits; appears uncomfortable or unwilling to share food; inflexible about diet without reason). There may be incessant talk about food, weight, shape, exercise, cooking, etc. The student may also appear obsessed with maintaining unhealthy eating habits to enhance performance in sports, dance, acting, or modeling.

Behavioral

  • Mealtime rules or rituals: You may observe rigid dietary rules or chaotic food intake, including skipping meals, carefully calculating food intake, hoarding food, or refusing to eat food prepared by others or without knowing exact ingredients. The student may also may frequent trips to the bathroom, particularly around mealtimes.
  • Avoidance: The student may avoid the cafeteria, work through lunch, or eat alone. They may also wear very baggy clothes to hide a very thin body (anorexia) or weight gain (binge eating disorder) or to hide their body because of concerns about body shape/size. If asked, the student may deny difficulty with food or body image despite evidence that it is an area of concern.
  • Compulsivity: He or she may show some type of compulsive behavior like compulsive hand-washing, hoarding, repetitive movements/speech, or a need for constant reassurance. This may also look like exercising for long periods with obsessional attitude or exercising excessively every day. The student may have difficulty sitting still and may hover over chair instead of sitting, constantly jiggle legs, get up from their desk as every opportunity, or offer to run errands.

Physical

While they may vary based on the type of eating disorder, here are some common physical signs of an eating disorder:

  • Sudden weight loss, gain, or fluctuation in short time

  • Complaints of abdominal pain

  • Feeling full or “bloated”

  • Feeling faint, cold, or tired

  • Dark circles under the eyes or bloodshot eyes/burst capillaries around eyes

  • Calluses on the knuckles from self-induced vomiting

  • Dry hair or skin, or other signs of dehydration,

  • Blue hands/feet

  • Fainting or dizziness upon standing

  • Frequent fatigue

Also on mentalhealthamerica.net

Eating Disorders

Body Dysmorphic Disorder

Therapy

Finding Therapy

Medication

Paying for Care

Additional Resources

National Eating Disorders Association (NEDA)
Helpline: (800) 931-2237
Email: info@nationaleatingdisorders.org
www.nationaleatingdisorders.org

National Association of Anorexia Nervosa & Associated Disorders, Inc. (ANAD)
Helpline: (630) 577-1330
Email: anadhelp@anad.org
www.anad.org

Binge Eating Disorder Association (BEDA) 
Toll Free: (855) 855-2322
bedaonline.com

Eating Disorder Hope
www.eatingdisorderhope.com


Sources

[1] Swanson, S., Crow, S., Le Grange, D., Swendsen, J., Merikangas, K. (2011).Prevalence and Correlates of Eating Disorders in Adolescents.Archives of General Psychiatry, Online Article, E1-E10.

[2] National Eating Disorders Association. (2016). Parent toolkit. Retrieved from http://www.nationaleatingdisorders.org/sites/default/files/Toolkits/ParentToolkit.pdf

[3] Rojas, M. (2014). Social media helps fuel some eating disorders. Retrieved from http://www.usatoday.com/story/news/nation/2014/06/01/social-media-helps-fuel-eating-disorders/981751...

[4] National Eating Disorders Association. (2012). The role of the educator: Some “Don’ts” for educators and others concerned about a person with an eating disorder. Retrieved from https://www.nationaleatingdisorders.org/sites/default/files/ResourceHandouts/SomeDontsForEducators.pdf  

[5] National Eating Disorders Association. (2016). Educator toolkit. Retrieved from https://www.nationaleatingdisorders.org/sites/default/files/Toolkits/EducatorToolkit.pdf

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