Recognizing the Signs of Eating Disorders in Teenagers: Symptoms of the Different Types & Support Options
The early signs of an eating disorder can be easy to miss. A skipped meal, a sudden interest in “healthy eating,” or spending extra time at the gym, can seem harmless initially. But if your teen becomes more and more anxious about these new routines, this could signal that something serious is going on.
Eating disorders are serious conditions that can significantly impact a teen’s physical and emotional health. Plus, the longer unhealthy thinking and eating patterns continue, the harder they are to address. Therefore, you don’t need to wait for things to get “bad enough” to speak to your teen and seek help.
Professional support is advised to ensure timely treatment and healing. This makes recognizing the signs of eating disorders in teenagers all the more important. This guide can help you better understand what eating disorders in teens are, as well as their signs, by covering:
- The age at which eating disorders are most likely to start
- Signs of the different types of eating disorders
- When to seek help for an eating disorder
- Types of treatment for an eating disorder
At What Age Do Eating Disorders Start?
Around 3 out of every 100 adolescents between the ages of 13 and 18 have been diagnosed with an eating disorder at some point in their lives.³
Eating disorders can appear at all ages, but the highest risk is typically during the adolescent school years. To break findings down, anorexia often begins in the mid-teens, around the middle and high school years (ages 14–18).² Bulimia tends to show up later in high school, while binge eating disorder often develops in older teens and young adults (though it can occur in younger teens too).
The reasons why adolescents may be at higher risk of disordered eating may come down to how this stage of development is filled with challenges. Puberty, body changes, shifts in friendships, interests, studies, and the pressures of social media – all often happening at the same time.
Parents can’t shield their teens from these challenges, but you can keep an eye on anxieties about appearance and eating habits. It can also help to begin conversations about mental health early, before unhealthy ways of thinking and eating begin to form.
The stats around rates of eating disorders in teens are daunting, but it also means you and your teen are not alone. There are professionals, experts, and resources to help you understand these conditions and where to get help.
Who Can Have an Eating Disorder?
Though eating disorders are often shown as an issue that affects girls, teens of all genders can be living with one. In fact, in the United States alone, eating disorders will affect 6.6 million males at some point in their lives.⁶
However, because of the stigma around eating disorders and lack of representation in the media, boys are less likely to talk about their struggles with eating or weight. This makes it even more important to recognize the signs and ask the right questions early.
The same principles apply in talking to your teen, regardless of gender. Look for persistent physical, behavioral, and emotional red flags, ask them what’s on their mind, listen actively, and don’t minimize or dismiss their worries.
How to Tell the Difference Between Dieting vs. Eating Disorders
Parents often ask about signs of dieting versus eating disorders in teens so as not to overreact. It can be hard to know sometimes, especially when it comes to certain eating disorders. However, if in doubt, it might help to ask for professional advice.
In general…
- Dieting is usually motivated by health or sports, openly discussed, and flexible when guided by experts
- Eating disorders involve secrecy, extreme anxiety if rules are broken, inability to talk about food rationally, and behaviors that disrupt their daily life – including sleep, studies, socializing, and hobbies.
When food choices start to cause distress or isolation, something more serious may be going on. The following signs of eating disorders can help clarify the difference between dieting vs. eating disorders further.
Signs of Eating Disorders in Teens
Eating disorders don’t just come out of the blue; they typically develop gradually over weeks and months.² However, it’s important to note that the signs of eating disorders can vary from condition to condition. We break down the signs of the most common eating disorders in teens below to help raise awareness.
Seeing a number of these patterns may be a sign that your teen isn’t just going through a phase or trying a diet. They may be struggling with something that goes much deeper than food and calories, and might need professional support.
Signs of Anorexia in Teens
Anorexia causes extreme restriction of food, which leads to a significantly low body weight. It can weaken bones, strain the heart, and disrupt hormonal balance in your teen.
Unfortunately, anorexia has the highest risk of health complications of any mental health disorder, taking far too many young lives each year (around 1 every 52 minutes).⁴ This is why recognizing it early and getting your teen the right support is essential.
With support such as family-based therapy (FBT), cognitive behavioral therapy (CBT), and working with trained experts and nutritionists, your teen can make a full recovery.
There is a range of physical, behavioral, and emotional symptoms of anorexia in teens, which we detail below.
Physical Symptoms of Anorexia:
- Noticeable weight loss or a drop off in your teen’s growth curve
- Skipped or irregular periods in girls
- Fainting, dizziness, or fatigue
- Fine body hair (lanugo) around the face, chin, or other unexpected areas
- Changes in sleep patterns
Behavioral Symptoms of Anorexia:
- Avoiding entire food groups (like carbs or fats)
- Strict food rituals, like cutting food into tiny pieces, eating very slowly, chewing ice cubes, counting/measuring food, or eating only at specific times
- Exercising excessively, even when they feel tired or get injured
Emotional Symptoms of Anorexia:
- An intense focus on perfectionism and high self-criticism when it comes to how they look
- Intense anxiety about weight or body shape
- Distorted body image (seeing themselves as overweight even when they’re underweight)
- Distress about clothes and how they fit
- Low mood and depression
- Self-harm and suicidal thoughts
Signs of Bulimia in Teens
Bulimia can cause serious health problems, including electrolyte imbalance, affecting the heart, weakening bones, damaging teeth, and straining the digestive system.⁵ Regardless of gender, bulimia habits can include binge–purge cycles, extreme exercise or fasting to “make up” for purging, pressures about appearance and identity, and constant body-checking.
Bulimia often responds well to therapy, especially CBT, when recognized and managed early. Working with the right professionals who understand the way your teen needs support can help unlearn unhealthy thinking patterns and coping tactics that fuel bulimia.
As bulimia often doesn’t cause extreme changes to weight, it can be difficult to detect. Keeping an eye out for the following signs could help.
Physical Symptoms of Bulimia:
- Stomach aches and pains due to digestive issues
- Dehydration and electrolyte imbalance
- Swollen cheeks from swollen salivary glands
- Dental issues like enamel erosion or increased cavities
- Sore throat
- Scarred knuckles from induced vomiting (Russell’s sign)
Behavioral Symptoms of Bulimia:
- Cycles of binge eating followed by purging (vomiting, using laxatives, or working out excessively)
- Frequent bathroom trips after meals, often with water running
- Secret eating, hiding food, or hiding evidence of eating
- Swinging between strict dieting and episodes of binge eating
- Complaints of stomach pain or acid reflux
Emotional Symptoms of Bulimia:
- Intense guilt or shame about eating
- Low self-esteem around body image
- Relating weight to self-worth
- Meltdowns
- Panic attacks
- Signs of self-harm
Signs of Binge Eating Disorder in Teens
Binge Eating Disorder (BED) is the most common eating disorder among U.S. teens. It’s important to recognize that it is not “just overeating,” but a recognized mental health condition. Therefore, it can have serious health effects for your teen if they don’t get the right support early on.
The impacts of BED include digestive and gastrointestinal issues, fatigue, excessive weight changes, and a higher risk of type 2 diabetes.⁶ CBT and working with dietitians trained in eating disorders in teens – especially when started early – can help teens start to break unhealthy patterns and move towards recovery.
The following physical, behavioral, and emotional signs of BED could help you spot if this is something your teen is struggling with.
Physical Symptoms of BED:
- Excessive tiredness
- Loss of sleep
- Digestive issues
- Weight changes (often an increase)
- Cardiovascular issues
Behavioral Symptoms of BED:
- Eating unusually large amounts of food in a short period of time, without purging or exercising excessively
- Consuming food when not physically hungry
- Eating very quickly or until uncomfortably full
- Eating alone or in secret, often followed by guilt
- Hidden food wrappers or large amounts of food vanishing quickly
- Difficulty stopping once a binge begins
- Choosing clothes that hide the body
Emotional Symptoms of BED:
- Shame or frustration after binging
- Preoccupation with food and body shape
- Extreme sensitivity to comments about weight or food intake
- Body dysmorphia
- Low self-esteem and self-worth
- Depression and anxiety
Signs of Avoidant/Restrictive Food Intake Disorder (ARFID) in Teens
Avoidant/restrictive food intake disorder (ARFID) is a relatively new category of eating disorder characterized by extremely selective eating and little interest in food. It can lead to nutrient deficiencies, constipation, slowed growth, reduced bone density, and energy. Additionally, ARFID can affect social life as it can lead to avoiding events involving food.⁵
ARFID affects boys, girls, and gender-diverse teens and young people of all ages and can…⁵
- Be mistaken for “just being a picky eater”
- Overlap with anxiety, sensory sensitivities, and identity crises
- Commonly be seen in children as young as 7 and 8, especially in those with neurodiversity
Noticing the signs of ARFID early can prevent long-term emotional and physical health challenges. These include the following.
Physical Symptoms of ARFID:
- Lacking adequate vitamins, minerals, and proteins required for growth
- Slow growth
- Delayed puberty
- Dehydration
- Slow pulse
- Low blood pressure
- Absence of periods
- Muscle and bone density loss
- Reliance on supplements or nutritional shakes for calories
Behavioral Symptoms of BED:
- Avoiding specific foods or entire food groups due to texture, taste, or smell sensitivities
- Specific fear of choking, vomiting, or getting sick from food
- Very limited range of preferred “safe” foods
- Low appetite or lack of interest in eating, unrelated to weight or body image
- Extreme pickiness that goes beyond the typical childhood habits
- Eating very slowly or refusing to try new foods
- Distress at mealtimes if preferred foods aren’t available
Emotional Symptoms of BED:
- Fears around food, such as choking
- Social and home life problems due to restricted eating habits
- Anxiety or obsessive-compulsive disorder
- Sensory issues relating to neurodivergence
Other Specified Feeding or Eating Disorder (OSFED) in Teens
Other specified feeding or eating disorder (OSFED) is just as serious as other eating disorders, as it comes with its own medical and emotional risks.³
Yet, teens with OSFED often feel overlooked or misunderstood, as their symptoms can vary and don’t fit a single diagnosis, which can delay treatment. This can be frustrating and damaging for a teen as they may be struggling with unhealthy thinking and eating patterns, and need professional support. OSFED can show up in your teen as a blend of anorexia and bulimia traits, and they may restrict or over-exercise without obvious weight loss.
Evidence-based therapies like CBT and FBT can be very effective in the treatment of OSFED. However, recognizing the signs of OSFED is the first step towards seeking treatment.
Physical Symptoms of OSFED:
- Changes in weight, such as fluctuations or significant loss or gain
- Lowered immune system
- Changes to the menstrual cycle
- Low blood pressure
- Swollen cheeks
- Dental issues
Behavioral Symptoms of OSFED:
- Binging and purging behaviors that don’t fit the full criteria of the other diagnoses listed above
- Strong preoccupation with food and body, despite not meeting a “classic” profile of someone with an eating disorder
- A mix of symptoms from different eating disorders (for example, bingeing without purging, or restricting without being underweight)
- Ongoing signs of distress about food, body image, or timings and quantity of food
- Significant eating concerns that don’t fit neatly into anorexia, bulimia, BED, or ARFID
- Secret eating
- Hiding food
- Rituals around food
- Obsessions around body shape and image
- Social withdrawal
Emotional Symptoms of OSFED:
- Preoccupation with food and body image
- Shame around eating habits
- Anxiety around food and meal times
- Extreme sensitivity to comments about eating habits or weight
- Body dysmorphia
- Low mood and depression
- Self-harm and suicidal thoughts
When to Seek Help for Eating Disorders in Teens
The right time to seek help is when you notice persistent weight changes, social withdrawal, purging, bingeing, or physical symptoms such as fainting or digestive issues in your teen.
The most appropriate form of treatment for eating disorders involves a medical and psychological approach to target physical symptoms and their underlying causes. For instance, a doctor might check blood pressure, heart rate, and other vital signs. However, a mental health professional may target issues such as childhood trauma or perfectionism. The right therapeutic approach will likely come down to a teen’s specific circumstances and condition.
Additionally, a healthcare provider may use one of the following screening tools to assess for eating disorders. They’re also an option for self-screening.
Eating Disorder Screening Tools for Teenagers:
One of the most common tools is the SCOFF questionnaire,¹ which asks yes-or-no questions about eating behaviors. Two or more “yes” answers suggest the need for professional evaluation.
Keep in mind that screening tools are not diagnostic and don’t replace a professional evaluation. However, they can help you understand the changes you are noticing in your teen and guide you towards getting the right help.
Mental Health Treatment Options for Teen Eating Disorders:
The following are some evidence-based treatment options for treating eating disorders in teens:
- Family-Based Therapy (FBT): This form of therapy temporarily gives control of eating habits to parents, before gradually giving it back to a teen
- Cognitive behavioral therapy (CBT): Teens can learn to express underlying worries and work to replace negative thoughts and unhealthy habits that drive their disordered eating
- Nutritional counseling: Working on meal plans with a counselor to build balanced, sustainable eating habits
- Medical Monitoring: Ensuring physical health safety by keeping an eye on vitals and addressing health issues before they get bigger
If more structured and intensive support is needed for your teen, residential or intensive outpatient programs may be worth looking into. Additionally, while medications don’t treat the symptoms of eating disorders, they may be used to manage emotional symptoms that can perpetuate them.
With care that keeps a teen at the centre and professionals who understand what they need, your teen may not just recover physically but could regain their self-worth and quality of life.
Mission Prep: Professional Support for Teenage Mental Health
At MissionPrep, we understand the health risks that come with eating disorders in teens. While we don’t directly target these conditions, we can help families overcome the issues that often lead to them. Whether your child is struggling with trauma, depression, or anxiety, our personalized programs can set them on the right track to recovery.
We can also provide flexible care that meets teens where they are, including outpatient, intensive outpatient, residential, and telehealth options. If you’re interested in hearing more about how we can help your teen on the path to recovery, reach out to our team today.
- Emergency: Call 911 if your teen faints, has chest pain, or shows signs of suicidal behavior.
- NEDA Helpline: 1-800-931-2237 or text “NEDA” to 741741 for crisis support.
- SAMHSA Treatment Locator: Visit findtreatment.gov for residential and outpatient eating disorder programs near you.10
References
- Morgan, J. F., Reid, F., & Lacey, J. H. (1999, December 4). The SCOFF questionnaire: Assessment of a new screening tool for eating disorders. BMJ, 319(7223), 1467–1468. https://www.bmj.com/content/319/7223/1467
- Swanson, S. A., Crow, S. J., Le Grange, D., Swendsen, J., & Merikangas, K. R. (2011). Prevalence and correlates of eating disorders in adolescents. Archives of General Psychiatry, 68(7), 714–723. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1107211
- National Association of Anorexia Nervosa and Associated Disorders. (n.d.). Eating disorder statistics. https://anad.org/eating-disorder-statistic/
- Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724–731. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1107207
- National Institute of Mental Health. (n.d.). Eating disorders. U.S. Department of Health & Human Services. https://www.nimh.nih.gov/health/topics/eating-disorders
- Norris, M. L., Spettigue, W. J., & Katzman, D. K. (2016). Update on eating disorders: Current perspectives on avoidant/restrictive food intake disorder in children and youth. Neuropsychiatric Disease and Treatment, 12, 213–218. https://www.dovepress.com/update-on-eating-disorders-current-perspectives-on-avoidantrestrictive-peer-reviewed-fulltext-article-NDT
- Deloitte Access Economics. (2020). The social and economic cost of eating disorders in the United States of America: A report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders. Harvard T.H. Chan School of Public Health. https://hsph.harvard.edu/research/eating-disorders-striped/research-reports/economic-costs-eating-disorders/
