How to Recognize Signs of an Eating Disorder

Does she see herself as fat when she’s not–and measure her self-worth by her weight? Learn the early warning signs of eating disorders (perhaps surprisingly, for boys as well as girls).

All teenagers worry about their appearance. Self-esteem can be precarious during adolescence, and body consciousness comes with the territory. But if you’ve noticed that your child is fixated on weight, you’re probably worried. So what’s the difference between normal behavior and behavior that might indicate an eating disorder?

Distorted Body Image

While other people see a normal (or painfully skinny) kid, teenagers with eating disorders look into the mirror and see a different person entirely. They have a distorted perception of their own appearance, and no amount of reassurance from family and friends–all of them saying, “You’re not fat”–will change that conviction.

Fixated on Appearance

Young women (and some young men) who develop eating disorders are extraordinarily focused on their appearance as a measure of self-worth. While other kids tend to stake their identities on their interests and accomplishments, these teenagers have their emotions, and their lives, wrapped up in thoughts of food and appearance. 

Extreme Dieting

Anorexia nervosa, the most common eating disorder, is self-imposed starvation, usually by a young woman who is otherwise high-functioning. Personality types more likely to develop the disorder include athletes, perfectionists, and over-achievers. They are driven to maintain a dangerously low body weight because of a distorted self-image. Detecting anorexia can be very difficult because it typically affects high-performing kids.

Signs of Anorexia

Kids with anorexia become dangerously thin. They often obsess over calorie counts and nutritional facts, and can spend many hours exercising to burn off calories. Kids with the disorder may skip meals and have a pattern of excusing themselves from eating socially. You might become worried about anorexia if you notice that your child is losing weight unexpectedly. Other signs include irregular periods, thinning hair, and constant exhaustion. Despite their extreme thinness, kids with the disorder usually don’t think that they are unhealthy and actually want to lose even more weight.

Overeating

Kids with bulimia nervosa, the other common eating disorder, indulge in periodic and usually secretive binges. Many kids with bulimia say they feel out of control during their binges and describe them as “out of body experiences.” To compensate, many will purge afterward or diet strenuously. Teenagers with the disorder may be very influenced by the ideal body perpetuated in media and popular culture. It can be difficult to diagnose the disorder because people with bulimia can have a normal body weight or may even be overweight.

Signs of Bulimia

People with bulimia are sensitive to their disorder and will try to keep their unhealthy food habits a secret. However, there are still signs to look out for, such as the absence of large amounts of food. Kids with bulimia will sometimes also hoard food in their rooms. Other signs might include exercising excessively or using diet pills or laxatives. Many kids with bulimia will purge after eating. You might notice that your child is going to the bathroom immediately after meals, or spends a lot of time in the bathroom, which could indicate purging. A sore throat, sore knuckles, discolored teeth, and poor enamel are other warning signs.

What can parents do?

• Try to establish healthy eating habits. Make a routine of eating healthy, balanced meals as a family.
• Don’t criticize your child’s weight or appearance. Adolescence is a difficult time for most kids, and it’s essential to provide them with a nurturing and supportive environment.
• Some kids are more likely than others to develop eating disorders. Be extra vigilant if you have a family history of eating disorders or if you know that your child is under extreme pressure to look a certain way.
• Eating disorders are very serious and can even be deadly. If you think your child has an eating disorder, you should contact a doctor for help immediately.

Food for thought…

• Detect signs that your college student may developed an eating disorder.
• Dr. Eugene Beresin, director of child and adolescent psychiatry residency training at Massachusetts General and McLean Hospital, and a professor at Harvard Medical School, talks about the difficult but rewarding road to recovery for young women with eating disorders.
• Get tips from a Westchester County-based certified nutritionist about dealing with eating disorders.
• Download comprehensive toolkits from NEDA, including help with parent-school communications, financial assistance (even negotiating with your insurance provider), and questions to ask when interviewing a therapist.
• Read “Before I Disappear,” by Barb Herding, a fictional story of 16-year-old young woman hospitalized as a result of her eating disorder that has spiraled out of control.

Did You Know?
-Courtesy of NEDA (National Eating Disorders Association)

• The peak onset of eating disorders occurs during puberty and the late teen/early adult years, but symptoms can occur as young as kindergarten.

• Eating disorders affect people from all walks of life, including young children, middle-aged women, and men and individuals of all races and ethnicities.

• Four out of 10 Americans either suffered or have known someone who has suffered from an eating disorder.

• Three out of four Americans believe eating disorders should be covered by insurance companies just like any other illness.

• 42% of 1st-3rd grade girls want to be thinner (Collins, 1991).

• 81% of 10 year olds are afraid of being fat (Mellin et al., 1991).

• 46% of 9-11 year-olds are “sometimes” or “very often” on diets, and 82% of their families are “sometimes” or “very often” on diets (Gustafson-Larson & Terry, 1992).

• 35% of “normal dieters” progress to pathological dieting. Of those, 20-25% progress to partial or full-syndrome eating disorders (Shisslak & Crago, 1995)

References

Collins, M.E (1991). Body figure perceptions and preferences among pre-adolscent children. International Journal of Eating Disorders, 199-208.

Gustafson-Larson, A.M., & Terry, R.D. (1992). Weight-related behaviors and concerns of fourth-grad children. Journal of American Dietetic Association, 818-822.

Mellin, L. McNutt, S., Hu, Y., Schreiber, G.B., Crawford, P., & Obarzanek, E. (1991). A longitudinal study of the dietary practices of black and white girls 9 and 10 years old at enrollment: The NHLBI growth and health study. Journal of Adolscent Health, 27-37.

Shisslak, C.M., Crago, M., & Estes, L.S. (1995). The spectrum of eating disturbances. International Jourmal of Eating Disorders, 18 (3), 201-219.