Understanding Eating Disorders in Teens: Causes, Signs, and Support

Research shows that 12.5% of 17 to 19 year olds in England are living with an Eating Disorder, and the numbers only seem to be getting higher. Eating Disorders in teens  are complex and multifaceted, requiring careful observation and sensitive handling. In this week’s session, we spoke with Dr Nihara Krause, award-winning Consultant Clinical Psychologist and CEO of teen mental health charity, Stem4, who share valuable insights into recognising and addressing these issues. 

Signs of Eating Disorders in Teenagers

Nihara explained that eating disorders can manifest in various ways, usually categorised in four main areas:

Physical Signs

  • Weight Variability: Significant weight loss (anorexia), variable weight (bulimia), or weight gain (binge eating disorder).

  • Frequent Illnesses: Increased susceptibility to illnesses.

  • Menstrual Changes: Irregular menstrual cycles in girls.

  • Skin Problems: Increased sensitivity to cold and various skin issues.

Behavioural Changes

  • Eating Habits: Sudden changes in eating habits, preoccupation with food, calories, weight, or body shape.

  • Secretive Eating: Avoiding eating with others, making own meals secretly.

  • Extreme Healthy Eating: Adopting extreme dietary restrictions, often under the guise of vegetarianism or other diets.

Emotional and Thought-Based Changes

  • Body Dissatisfaction: Negative comments about one's body and appearance.

  • Perfectionism: A clinical feature of anorexia nervosa, often leading to relentless self-criticism and dissatisfaction.

Social Changes

  • Avoidance of Social Eating: Avoiding social situations involving food.

  • Secret Eating: Eating in secret or cooking for others but not eating themself.

Gender Differences and Neurodiversity

Nihara talked about the different ways Eating Disorders can present and how we should be mindful of these differences when spotting the signs:

  • Gender Differences: While the diagnostic characteristics are similar, social ideals differ. Girls often pursue thinness, while boys may focus on muscle mass or leanness.

  • Neurodiversity: Eating disorders in neurodiverse individuals may present differently, often involving routine and control, sensory difficulties, and social communication challenges.

Addressing the Secrecy and Sensitivity

Teenagers often become secretive as part of their development, seeking independence. However, secrecy related to eating disorders can be dangerous. Understanding the underlying reasons for this secrecy is crucial. For instance, a teenager might value their eating disorder because it boosts their confidence or gives them a sense of control. Open, curious questions and providing choices can help teenagers feel safe to open up.

Approaching Teenagers About Eating Concerns

  • Focus on Emotions: Ask about their feelings rather than their eating habits or weight.

  • Open-Ended Questions: Encourage them to share their thoughts and feelings without feeling judged.

  • Provide Choices: Allow them to feel in control of the conversation and their decisions.

What else can you do to help?

  • Model Healthy Behavior: Avoid making comments about weight or shape and focus on health.

  • Media Literacy: Help teenagers understand and critically evaluate the media they consume.

  • Open Conversations: Discuss the unrealistic standards set by shows like "Love Island" and encourage viewing them as entertainment rather than reality.

Professional Support and Resources

  • Medical Evaluation: Seek a medical evaluation to check for physical health issues.

  • Specialist Support: Engage with specialists who understand eating disorders, especially if there is a neurodiverse overlay.

  • Family-Based Treatment: Family-based treatment has shown better recovery rates for anorexia nervosa.

Eating disorders are not just about food; they are deeply connected to issues of confidence, self-worth, and emotional regulation. Understanding and addressing these underlying issues can help in effectively supporting teenagers struggling with eating disorders.

For more information and resources, visit Dr. Nihara’s website HERE and seek professional help if you need to.

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Neurodiversity: A Parent’s Guide

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Teenage Friendships: Insights and Strategies for Parents