Eating disorders often show up for the first time during adolescence when older children have more control over what and when they eat. This is also a time in a teen’s life when there becomes a higher focus on self-identity that often includes worrying about their physical appearance.

Unfortunately, eating disorders sometimes go undetected for longer than they should due to a lack of awareness and the tendency of teens to hide their struggles with food.

Knowing how to recognise the most common eating disorders makes it possible to guide them towards the help that teens need to develop a healthy relationship with food.

What are the main types of eating disorders?

There are several types of eating disorders, but the three that tend to affect teens the most are the following:

• Anorexia occurs when teens try to eat as little as possible to lose weight. Teens believe that their body is bigger than it really is, and they have unrealistic views about how being thin equates to being beautiful.
• Bulimia involves cycles of binging and purging on food. A teen with this disorder will often binge on their food until they are past the point of being full. Once they realise that they have binged, they feel a sense of guilt and anxiety about gaining weight that makes them purge. A teen with bulimia may also do other things to control their weight such as exercising excessively after a binge.
• Binge-eating similar to bulimia but without the purging. An adolescent who binge-eats usually does so as a way to numb themselves from pain or as a distraction from unpleasant thoughts. After a binge, a teen will also feel guilty about losing control over their eating habits, but this only leads them to eat more to make themselves feel better. A teen who binge-eats may be overweight but not always. Extremely active teens who have a high metabolism may binge-eat for months to years before it begins to have an effect upon their body size. However, their eating disorder still harms their mental health, and eating large amounts of unhealthy food is rough on their growing bodies.

What are the causes of eating disorders?

An eating disorder is sometimes connected to physiological processes within a teen’s body such as a hormonal imbalance. However, it can also be associated with lifestyle disruptions such as being bullied or living within a stressful environment.

As a parent, it helps to remember that even good types of stress can be hard for a teenager to deal with because they lack the coping skills that adults have. Frequent moves are an example of life stressors that a teen may face and controlling their eating habits may help a teen curb feelings of anxiety that develop from these situations.

In many cases, an eating disorder develops when a teen struggles with low self-esteem. This could come from their own perception of how their body is changing as they proceed through adolescence. Alternatively, bullies or seeing unrealistic photographs of celebrities on social media could cause a teen to develop a poor body image.

What does an eating disorder in teens look like?

Adults should look for any unusual changes in a teen’s eating habits. A teen with anorexia may refuse food or act like they are eating by pushing food around on their plate. Teens with bulimia and binge-eating disorders may be unable to stop eating when they are full. They may also hide or stash food in places where they can eat alone and away from other people’s watchful eyes.

Can an eating disorder occur with other mental health conditions?

Co-existing mental health conditions are very common for teens with eating disorders. Some teens use food to ease their symptoms of depression. Other teens may control their eating habits as a symptom of obsessive-compulsive disorder.

It is also common to find that a teen struggles with body dysmorphic disorder, which means that they see distorted images of their own body that do not represent reality. For example, a teen may see themselves as grossly overweight in the mirror when the scale reflects that they are within a normal weight range.

What are the treatment options?

Every case of an adolescent eating disorder should first be addressed with a professional consultation that helps to identify the underlying causes for their challenges with food. Once that happens, teens are given a personalised treatment plan that includes therapeutic counselling and activities that help them to develop healthy eating habits.

Some teens may also need medication to help strengthen their bodies and address other mental health conditions. All teens who are recovering from an eating disorder receive medical care and nutrition services that help them get back on track with good health.

A teen who is struggling with an eating disorder needs our help to find relief from the anxiety and discomfort that they experience each day. For most teens, it takes patience, time and a combination of therapies to help them develop a healthy mindset that allows them to once again enjoy their meals.

Dr Jeff Nalin is a licensed clinical psychologist and founder. He is also the executive director of Paradigm Treatment Centers.