Disordered-Eating-In-Teens

By Amanda Mittman, RDN, LDN

As parents, there is no manual that we are given for our children that tells us how to feed them or how they should eat. One of the biggest questions I get from parents in my practice as a dietitian is “Is my kid’s behavior around food normal?”  Quite often the answer is yes- for example, in younger children with picky eating and asking for snacks every 5 minutes. And as our children grow up, feeding and eating doesn’t really get any easier. Adolescents and teenagers are especially influenced by their peers and social media, and what parents say becomes less and less important. In both girls AND boys, the pressure to have their bodies look a certain way dramatically rises, along with the intense desire to fit in. Did you know that a 2015 study showed that 80% of 10 year old girls had been on a diet, and that more than one-half of girls and one-third of boys aged six to eight wanted a thinner body? As a clinician who works in eating disorders and disordered eating, sadly this is not surprising. And as social media takes a larger role in our kids’ lives as each year passes, this is not going away.  Unfortunately, diet culture and the harm it causes is here to stay.

How much should we be paying attention to what
our kids eat?

What are some signed to watch out for in your teen? If you suspect that your adolescent or teenager is struggling with their body image and eating, some signs to watch our food are eating in secret, hiding food in their room, increasing exercise, not wanting to eat in front of the family, not eating previously enjoyed foods, decreasing overall food intake, self-isolating, losing weight or gaining weight.  You may also hear your kid say things like “I am so fat,” “My (body part) is so big,” or “If I gain weight I’ll be gross”

Body image can be so important to our teens

What should parents do when they notice one of these signals? Depending on your relationship with your child, asking them if something is going on in a NON-JUDGEMENTAL way is the best approach. Even if your child says that nothing is going on, eating disorders are often hidden and sometimes even your child is unaware what is happening. Parents should contact their primary care provider with their concerns and if needed, get a referral to an eating disorder informed dietitian and therapist. It is important that the clinicians are eating disorder informed so they can support your child without praising weight loss or seemingly healthier behaviors.

Open communication is the key

Should teenagers be dieting? Absolutely not.  Teenagers are still growing and need ample vitamins, nutrients, and calories. Dieting in teens can be extremely dangerous, as they do not have the scientific knowledge to understand what they are doing with their bodies. Real harm can be done, and often that first diet is a slippery slope to other diets or a full-blown eating disorder.  Teenagers should not diet or do detoxes or cleanses (which unfortunately are promoted by many social media influencers). While they may seem harmless, dieting apps and programs like Noom and Weight Watchers are also diets (as much as they would not like you to think they are!) and so these are also inappropriate for children of any age. If your teenager wants to become a vegetarian, the reasons should be explored and appointment should be made with their PCP and a Dietitian to educate on balanced vegetarian eating. 

Radical diets are dangerous

What are some of the eating disorders parents should be on the lookout for with teens? There are many eating disorders, such as Anorexia Nervosa (restricting and restrict/binge type), Bulimia Nervosa (purging with vomiting, laxatives, and exercise), Binge Eating Disorder, ARFID and orthorexia (obsession with “clean” eating). Often eating disorders do not fit into a particular category and are labeled “OSFED” (other specified feeding and eating disorders).  So often we think of people with eating disorders like Anorexia Nervosa having very thin bodies or those with Binge Eating Disorder in larger bodies– and that is a myth. Eating disorders of any kind can occur in people of ALL size bodies.

Be on the lookout for laxative use

What about teens who are very active?  When’s too much activity for a teenager? Activity is so important for teenagers, especially now—as they are mostly indoors doing remote school. Exercise helps build strong bones, boost the immune system and is great for mental health, among many other benefits. Parents should absolutely encourage their teenagers to get outside and be active and play a sport, but to be mindful if their child gets overly upset if they miss a workout, want to exercise multiple hours in the day, or make comments about using exercise to change the shape of their body.

Play sports safely–but stay active!

Every parent I have met and worked with wants the best for their child and for them to have a good relationship with food and their body. The best thing you can do as a parent is to be a role model by not disparaging your own body in front of your children, exposing your children to pictures and images of people in all size bodies (ie. Fat and differently abled), and not focusing on weight or body talk in the home. No foods should be off limits and referred to as “healthy” or “unhealthy.” Your child is going to be exposed to all sorts of diet culture messages from their friends and social media—how wonderful it is that they will feel safe and not judged in their own home!  Parents with a history of  their own disordered eating or eating disorder can also seek support- it’s NEVER too late. 

Stay connected with your teen

Resources: https://www.nationaleatingdisorders.org/, https://www.nationaleatingdisorders.org/warning-signs-and-symptoms; https://renfrewcenter.com/for-friends-and-family/tips-for-parents