Understanding Eating Disorders In Children And Adolescents

Research suggests that 28.8 million people in the United States will experience an eating disorder during their lifetime. Eating disorders can affect anyone, and they are now on the rise, with the prevalence nearly doubling since the year 2000 and affecting more and more children and adolescents. In this article, we’ll look at what is driving the increase in eating disorders in kids and teens, what parents should know about identifying symptoms, and how they can help.

Types of eating disorders

Many types of eating disorders can affect children and teens. The following are a few common eating disorders among this age group:

Anorexia nervosa

People with anorexia nervosa try to lose weight by severely restricting their food intake or engaging in excessive exercise. Anorexia typically stems from a skewed perception of the body; children and teens with this disorder may believe they are overweight or obese, even though they may be underweight. Anorexia can result in severe and persistent malnutrition, which can cause significant damage to a person’s physical health.

Children and teens may also experience atypical anorexia, which occurs when someone has the symptoms of anorexia while having a normal weight (as determined by doctors). The mental and physical health effects of atypical anorexia can be equally as severe as with typical anorexia.

Bulimia nervosa

Bulimia nervosa is typically characterized by repetitive cycles of binging and purging. When binging, people usually consume excessive amounts of food in a short period, and they typically feel that they are unable to control this behavior. Then, they tend to purge, which can take the form of self-induced vomiting, use of laxatives, or excessive exercise.

Binge eating disorder

Avoidant/restrictive food intake disorder (ARFID)

Avoidant/restrictive food intake disorder (ARFID) is an irregular eating pattern that causes someone to have a disinterest in eating. The person may avoid certain foods due to factors like texture or color or worry about choking or vomiting as a result of eating. In ARFID, food restrictions can be so severe that the person may experience malnutrition, significant weight loss, or failure to hit growth milestones, and it can affect psychosocial development as well. 

Night eating syndrome

Night eating syndrome is an eating disorder that can occur alongside insomnia or other forms of interrupted sleep. This disorder typically causes people to wake during the night to eat, often more than once. People with this disorder may feel that they won’t be able to fall asleep until they eat, and they may feel that they cannot control the urge to eat when they wake up in the middle of the night.

Prevalence of eating disorders in children and adolescents

Research shows that eating disorders in children and teens have risen significantly over the past two decades, with cases more than doubling worldwide between 2000 and 2018. In the United States, the number of healthcare visits for all eating disorders among people under age 17 has increased by 107.4%, going from around 50,000 in 2018 to more than 100,000 in 2022. 

Contributing factors 

Experts believe that there are several factors that may have contributed to this increase. Social media and the pandemic are two such factors. 

Social media

Some researchers speculate that misuse of social media may be a contributing factor to the increase in eating disorders, particularly in adolescents. Studies show that over 90% of teens have at least one social media account, and that, in the United States, 93% of adolescents and young adults between ages 14 and 22 use social media; 81% use it on a daily basis. 

Studies have identified multiple reasons why social media can contribute to the development of eating disorders. For example, celebrities, models, and influencers can promote unrealistic beauty standards and affect an individual’s body image. 

Some social media users may post content that promotes disordered eating. One study that looked exclusively at TikTok use among children and teens diagnosed with eating disorders found that participants reported finding anorexia and bulimia content (termed Pro-ana and Pro-mia on the platform, respectively) without actively searching for it. In another study, 96% of participants reported learning new purging or weight loss techniques from pro-eating disorders content.

COVID-19

The COVID-19 pandemic had significant mental health repercussions and may have contributed to the increase in symptoms of eating disorders in children and adolescents over the last few years. Since the beginning of the pandemic, the number of eating disorder diagnoses in this age group has increased, which may be due to a number of factors, including isolation, disruptions to normal schedules and routines, and unhealthy ways of attempting to assert control in a situation filled with uncertainty.

Symptoms to look for

If you are concerned that your child or teen may have an eating disorder, there are several signs you might watch for. Below are some possible physical and behavioral signs:

Physical signs

Physical signs of eating disorders may include significant weight loss or rapid weight changes, inability to concentrate, lethargy or sleepiness, and an increased sensitivity to cold. In people who menstruate, periods may become irregular or stop altogether. Children may not meet growth and weight milestones, and puberty may be delayed or interrupted.

Behavioral signs

You may also notice some changes in behavior, particularly around food and exercise. For example, children or teens with an eating disorder may meticulously track calories, avoid certain foods, exercise excessively, make excuses for skipping meals, weigh themselves frequently, or express fear about gaining weight. They may also begin to exhibit unusual and new behaviors around food, such as cutting food up into small pieces, and they may make frequent trips to the bathroom or shower after eating.

What parents can do

If your child has been diagnosed with an eating disorder or if you suspect they are exhibiting symptoms of one, there are some ways that you can help.

• Talk about it. Talking about what they’re experiencing can be key to recovery, but it can be difficult to do. Some children and teens may become moody or withdrawn or respond with anger, but it may help to keep trying. You might try to stay calm and focus on how they’re feeling without judgment or blame. Also, it may be best to avoid talking about their appearance, even if you’re being complimentary, and you might try not to take it personally if they are being secretive or aren’t ready to talk. 
• Cope with meal times. If your child is in treatment, you can ask a doctor or therapist for advice about how to handle meal times. It may be best to avoid talking about portion sizes and calories, and you might try to stay away from foods marked “low calorie” or “diet.” It may also help to keep the dinner conversation light. Finally, planning a family activity for after the meal may also help distract your child from wanting to purge or exercise. 
• Give them love and support. It may help to learn as much as you can about your child’s specific eating disorder so that you can understand more about what they’re experiencing and what you can expect. You can also let them know that you love them and will support them. Finally, you might try to be a good role model by eating a nutritious diet and getting an appropriate amount of exercise.

Getting help for conditions like anorexia nervosa and binge eating disorder

If you think that your teen or child is experiencing symptoms of an eating disorder or has weight or shape concerns, getting them treatment as soon as possible can be beneficial for their recovery. 

Treatment varies depending on the eating disorder, the severity, and any co-occurring physical and mental health challenges. In some cases, people with eating disorders may need to be admitted to a hospital or inpatient facility for refeeding, and this may require a feeding tube or IV nutrition. Malnutrition caused by an eating disorder can lead to electrolyte imbalances and other deficiencies, and close monitoring may be necessary. 

Nutritional counseling is also typically a part of a treatment plan for eating disorders. It includes correcting any nutrition problems or damage caused to the body. A significant focus of nutritional therapy may be learning what foods and beverages are necessary to maintain health, how the body uses nutrients, how to choose foods to meet recovery goals, and how thoughts, fears, and food are connected.

Psychotherapy is also usually a part of treatment for an eating disorder and can be an important part of long-term recovery. A qualified therapist may be able to help your child or teen make connections between their thoughts and disordered eating behaviors and learn how to overcome unhealthy coping mechanisms. Therapy may also help manage any mental health disorders that contribute to their eating disorder, like anxiety or depression.

Support for parents

If you have a teen or child with an eating disorder, it can be challenging to navigate. Being there to offer love and support can be key to their recovery, but you may be experiencing your own feelings of guilt, anger, stress, or anxiety. 

Caring for your own mental health can help you work through these challenges so that you can support your child better. However, finding a local therapist with available appointments can be challenging, and long commutes can eat up essential family time. Online therapy can be a flexible and convenient way to get help.

Eating disorders are complex conditions

Get support from an online therapist

Online therapy for parents of teens with eating disorders

With an online therapy platform, you can work with a therapist from the comfort of your home or anywhere you have an internet connection. Most people are matched with a therapist within 48 hours of signing up, and you can change providers at any time for no fee until you find someone who feels like the right fit for you.

Research shows that online therapy is an effective way to treat a number of mental health conditions. For example, one review found that online therapy was effective for depression, social anxiety, adjustment disorder, and substance use disorder. Also, you don’t have to have a diagnosable disorder to benefit from online therapy. It can be a valuable way to receive support no matter what you’re experiencing. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.