Eating Disorders in Teens: Addressing Disorders and Body Image Concerns

Eating disorders are a type of mental health condition in which a person has unhealthy and extreme thoughts and/or behaviors related to food, eating, and body image. These disorders may impact a person both physically and emotionally and may have severe health consequences. Treating eating disorders typically involves a team of medical and mental health professionals with expertise in addressing disordered eating. Here, we’ll explore some common signs of eating disorders in teens along with treatment options.

Common types of eating disorders in teens

Eating disorders can take several different forms, each with distinct characteristics and challenges. Understanding the common types of eating disorders can help with early identification and intervention or treatment. Keep in mind that anyone of any gender, sexual orientation, body size, or body shape can experience an eating disorder. Some common types of eating disorders include the following. 

Anorexia nervosa

Anorexia nervosa is a mental health condition characterized by a fear of gaining weight and a distorted body image, which may lead a person to restrict their food intake and/or exercise excessively. Individuals with anorexia may see themselves as overweight and may skip meals or otherwise drastically reduce their food intake in an attempt to lose weight. This restrictive eating may cause malnutrition, weakened bones, and heart problems, potentially leading to death in some cases. It may also cause mental health concerns such as anxiety, depression, and social withdrawal.

Bulimia nervosa

Individuals with bulimia nervosa may cycle between binge-eating food and purging to avoid weight gain. During a period of binging, a person may consume large amounts of food and may feel unable to control their eating, even if they feel full. After binging, a person living with bulimia may use a method to purge the food, such as vomiting, taking laxatives, or exercising excessively. It can be more challenging for loved ones to detect bulimia because the person living with this condition may maintain a consistent body weight. 

Binge eating disorder

Binge eating disorder (BED) is an eating disorder that involves recurrent episodes of eating large quantities of food quickly or to the point of discomfort. The binge portion of this eating disorder is similar to bulimia; however, with BED, there are no purging behaviors that happen after the binge. This can lead to obesity and related physical health conditions such as type two diabetes, high blood pressure, and heart disease. Individuals living with binge eating disorder may also experience psychological impacts, such as low self-esteem, depression, and anxiety. 

Other eating disorders

While the three above are some of the most common in teens and adults, they’re not the only eating disorders per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). For example, avoidant/restrictive food intake disorder (ARFID) is an eating disorder that shares characteristics with anorexia but without the accompanying body image concerns. A person with ARFID may avoid eating food due to texture, lack of appetite, or fear, which may cause malnutrition and weight loss. 

Or, when a person has symptoms of an eating disorder that impact daily life but do not meet the clinical diagnosis criteria for an eating disorder, they may be diagnosed with other specified feeding or eating disorders (OSFED). Some common examples of OSFED include purging without binging, excessive nighttime eating, or anorexia in which the person's weight stays in a certain range. 

Common signs and symptoms of an eating disorder

The warning signs of eating disorders may vary based on the individual and the specific type of eating disorder they may be experiencing. In general, however, some broad symptoms of an eating disorder may be divided into physical, behavioral, and emotional or psychological signs, including the following:

• Physical signs. A person may show noticeable weight gains or losses and may be fatigued, dizzy, or faint. Eating disorders may also cause gastrointestinal issues such as stomach pain or constipation. Changes in the strength and appearance of hair, nails, or skin may also be a physical sign that a person might be living with an eating disorder. 
• Behavioral signs. Avoiding meals or eating food in secret can be an indicator of an eating disorder. A person may also have an obsession with food, dieting, or body image that can make it hard for them to focus on other things. Excessive exercise and withdrawal from social events that involve food may also be behavioral signs of an eating disorder. 
• Psychological signs. Disordered eating may cause a person to have mood swings or be more irritable than normal. They may experience depression or anxiety as a result of their eating habits or body image, which may also lead to low self-esteem or feelings of shame. A person with an eating disorder may feel guilty after eating as well. 

Causes of anorexia nervosa and other eating disorders

Eating disorders are thought to be caused by a complex interaction of factors rather than one alone. First, it’s currently believed that there may be a genetic component to eating disorders. Other biological factors—such as hormone imbalances, which can impact appetite and mood—may also play a role in developing an eating disorder.

In addition, there may be psychological elements that influence whether a person develops an eating disorder. An individual who has low self-esteem or perfectionist tendencies may be more likely to develop this type of condition. Additionally, comorbid mental health disorders such as an anxiety disorder or depression may play a role in the development of eating disorders. 

Outside of biological and psychological factors, a person’s environment may influence the development of an eating disorder too. Traditional media, social media, and societal pressures can contribute to eating disorders in some, as can peer pressure or bullying. It is also possible for a person to be raised with family dynamics or attitudes towards food and body image that may contribute to their development of disordered eating.  

Potential impacts of eating disorders

Eating disorders can impact a person both mentally and physically. While the physical impact can sometimes be easier to see, the mental impact can also be significant. Here are some examples of how an eating disorder might impact a person and their quality of life. 

Body image and other mental health impacts

In many cases, an eating disorder may directly impact a person’s body image. Individuals living with anorexia or bulimia may believe they need to continuously monitor food intake and their weight to maintain a certain body image. This can mean that a person with one of these disorders may never perceive that they’ve reached a point where they’re satisfied with how their body looks. In addition, individuals living with these illnesses or binge eating disorder may feel shame or guilt about their body after eating. 

In addition to challenges with body image, eating disorders may impact mental health in other ways. They may be linked to an increase in rates of depression or anxiety as well as social withdrawal. In teens, these impacts can make it challenging to build and maintain new friendships and interpersonal relationships. 

Physical health impacts

A person living with an eating disorder may also experience a variety of physical health impacts. One primary example is gaining or losing weight rapidly, which can affect overall health. Binge eating disorder may cause obesity, which can impact joint health and heart health and may cause high blood pressure. Anorexia and bulimia may cause gastrointestinal issues such as constipation or stomach pain. Particularly when left untreated over the long term, anorexia can also cause problems with bone density and circulation, seizures, a weakened immune system, trouble with cognitive function, and even heart failure.

Treating eating disorders in teens

Treating eating disorders in teens and adults may involve a multifaceted approach aimed at managing and improving physical health concerns while addressing the underlying psychological causes and symptoms. For teens, working with a mental health professional such as an adolescent psychiatrist or therapist may be a good place to start. 

A therapist may use a variety of techniques for treating eating disorders. One common example is cognitive behavioral therapy (CBT) strategies, which aim to help an individual identify negative thought patterns and replace them with more realistic and productive thoughts. In addition to working with a mental health professional, effectively treating an eating disorder may also involve medical doctors and dieticians to help manage the physical impacts of the illness. These professionals may provide meal planning and develop strategies for healthily managing weight. 

Improving body image through long-term support strategies

Improving body image for individuals living with eating disorders is often an important component of the recovery process. A positive body image may help foster self-acceptance, reduce the urge to engage in disordered eating behaviors, and promote overall mental well-being. Here are some strategies to help improve body image for people with eating disorders, which may be more effective with therapist guidance and support: 

• Challenge negative thoughts. Keeping a thought journal or other record of your thoughts over time can be a way to note and challenge negative cognition patterns by analyzing where they originated and how to healthily respond to them.
• Focus on health and body function. Rather than focusing on appearance, it may be beneficial to focus on caring for your body so that it’s functional and healthy. Exploring the concept of body neutrality could be helpful to this end.
• Practice self-compassion. Practices that foster self-compassion could also help a person develop more realistic expectations for themselves. Examples include mindfulness meditation, writing self-compassionate letters, and engaging in positive self-talk.

Seeking therapy for an eating disorder

For individuals living with an eating disorder, it’s usually important to seek support in the form of therapy to help address underlying causes and reduce symptoms. That said, some people with an eating disorder may not have specialized providers in their area or may prefer to receive treatment from the comfort of home. In cases like these, online therapy through a platform like BetterHelp for adults or TeenCounseling for those aged 13–19 can be a potentially effective format to consider. 

While it’s not appropriate in every case, such as when a person is experiencing acute symptoms and may need immediate medical treatment, online therapy can be a helpful way to receive virtual talk therapy treatment for an eating disorder. You can attend remote sessions with a licensed therapist from anywhere you have an internet connection at times that are convenient for you. Research suggests that online therapy may be an effective treatment method for addressing certain symptoms of eating disorders in some cases.