FFFEating Disorders in Teens

No. 2; Updated March 2018

In the United States, as many as 10 in 100 young women suffer from an eating disorder. Disordered eating related to stress, poor nutritional habits, and food fads are relatively common problems for youth. In addition, two psychiatric eating disorders, anorexia nervosa and bulimia, are on the increase among teenage girls and young women and often run in families. These two eating disorders also occur in boys, but less often.

Parents frequently wonder how to identify symptoms of anorexia nervosa and bulimia. These disorders are characterized by a preoccupation with food and a distortion of body image. Unfortunately, many teenagers hide these serious and sometimes fatal disorders from their families and friends.

Symptoms and warning signs of anorexia nervosa and bulimia include the following:

  • A teenager with anorexia nervosa is typically female, and a perfectionist and a high achiever in school. At the same time, she suffers from low self-esteem, irrationally believing she is fat regardless of how thin she becomes. Desperately needing a feeling of mastery over her life, the teenager with anorexia nervosa experiences a sense of control only when she says "no" to the normal food demands of her body. In a relentless pursuit to be thin, the girl starves herself. This often reaches the point of serious damage to the body, and in a small number of cases may lead to death.
  • The symptoms of bulimia are usually different from those of anorexia nervosa. The patient binges on large quantities of high-caloric food and/or purges her body of dreaded calories by self-induced vomiting, extreme exercise, or laxatives. The binges may alternate with severe diets, resulting in dramatic weight fluctuations. Teenagers may try to hide the signs of throwing up by runing water while spending long periods of time in the bathroom. Frequent vomiting can cause a serious threat to the patient's physical health, including dehydration, hormonal imbalance, the depletion of important minerals, and damage to vital organs.

Binge eating can also occur on its own without the purging of bulimia and can lead to eventual purging. Children with binge eating disorder also require treatment from a mental health professional.

Avoidant/Restrictive Food Intake Disorder (or ARFID) is another eating disorder which can occur in younger children or adolescents. It involves a disturbance in eating or feeding which includes substantial weight loss or a lack of expected weight gain, and nutritional deficiencies. ARFID can lead to dependence on a feeding tube or dietary supplements.

With comprehensive treatment, most children and teenagers can recover from disordered eating. The child and adolescent psychiatrist is trained to evaluate, diagnose, and treat these psychiatric disorders. Treatment for eating disorders usually requires a team approach, including individual therapy, family therapy, working with a primary care physician, working with a nutritionist, and medication. Many children and adolescents also suffer from other problems including depression, anxiety, and substance abuse. It is important to recognize and get appropriate treatment for these problems as well.

Research shows that early identification and treatment leads to more favorable outcomes. Parents who notice symptoms of anorexia or bulimia in their teenagers should ask their family physician or pediatrician for a referral to a child and adolescent psychiatrist.