What Is an Eating Disorder?
An eating disorder is a serious mental health disorder that affects around 20 million women and 10 million men in the United States, according to the National Eating Disorders Association (NEDA). People with eating disorders have unhealthy relationships with food, weight, and their appearance.
Additionally, teens with eating disorders often have an unrealistic view of their body weight, size, and shape—what’s known as body dysmorphia. Because they can no longer conceptualize what a normal body weight looks like, they begin to implement overly restrictive diets and obsess about calories and food intake.
Eating disorders are complex and often occur alongside other mental health conditions, such as depression, anxiety, and obsessive-compulsive disorder (OCD). And they can be deadly if left untreated. At least one person loses the battle to the disease every hour, and research confirms that anorexia nervosa has the highest mortality rate of any psychiatric disorder. People with anorexia nervosa are at severe risk of dying from health complications caused by starvation. Moreover, they have a high risk of attempting suicide.
In addition to diagnosable eating disorders, a large percentage of teens worldwide struggle with disordered eating behaviors. The National Eating Disorder Association (NEDA) reports that almost a quarter of children and adolescents worldwide (22 percent) show disordered eating—distorted eating behaviors and attitudes towards food, weight, shape, and appearance.
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Clinically reviewed by Kara Becker, LMFT, CEDs, National Director of Eating Disorder Programs
Table of Contents
Causes of Eating Disorders and Disordered Eating in Adolescence
There is no one single cause of eating disorders in adolescence. Rather, genetics, environment, and social factors each play a role.
Some research indicates that eating disorders can run in families. A teen with a parent or sibling (especially a twin) who has an eating disorder is more likely to develop one, too.
Furthermore, social media and other cultural pressures expose teens to unrealistic, unattainable, and often filtered images. Teens associate these thin, “perfect” bodies with popularity and acceptance, and feel they can’t measure up. Research by the American Psychological Association found that reducing social media use by 50 percent for just a few weeks helped some teens improve how they felt about their weight and their overall appearance.
As a result, social influences contribute to poor self-image and feelings of shame, anxiety, and self-consciousness. Consequently, teens think obsessively about their food intake and eating behaviors. They also exercise to unhealthy levels in an attempt to attain the societal standards for body acceptance.
Furthermore, eating disorders are more prevalent in teens who have experienced childhood trauma, depression, and anxiety. Therefore, effective eating disorder treatment addresses the underlying causes of eating disorders as well as the symptoms.
How Many Teens Have an Eating Disorder?
Teens and young adults are more likely than any other age group to experience an eating disorder. In fact, 1 in 7 men and 1 in 5 women experiences an eating disorder by age 40. And 95 percent of people with eating disorders are between the ages of 12 and 25, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
In addition, many more teens have disordered eating symptoms. Disordered eating behaviors are not as severe as a full-fledged eating disorder. However, they set the stage for a diagnosable condition. If left untreated, disordered eating can progress into a life-threatening eating disorder.
Eating Disorders in Teenage Males
There is a common misconception that eating disorders only occur with young girls or women. While eating disorders twice as likely to occur in females, the rate of eating disorders in teenage males is increasing. Research published in JAMA Pediatrics found that 17 percent of boys have disordered eating behaviors.
According to the National Eating Disorders Collaboration, males account for approximately 20 percent of those with anorexia nervosa, 30 percent of those with bulimia nervosa, 43 percent of those with binge eating disorder, 55–77 percent of people with other specified feeding or eating disorder, and 67 percent of people with Avoidant/restrictive food intake disorder.
Another common eating disorder in teen males is bigorexia, or muscle dysmorphia. Boys with this disorder believe they are small and skinny despite their muscular physique. Therefore, they become obsessive about their diet and working out to build muscle. This type of male eating disorder typically requires treatment.
Signs and Symptoms of Teen Eating Disorders
Behavioral Signs of Teen Eating Disorders
- Making excuses to avoid eating
- Over-exercising; obsessed with exercise to lose weight or gain muscle
- Secretly storing food or eating alone, particularly at night
- A distorted body image; body dysmorphia (an obsessive focus on a perceived flaw in one’s appearance)
- Compulsive use of laxatives, diet pills, and weight-loss aids
- An intense, obsessive focus on calories and caloric intake
- An unwillingness to discuss weight gains or weight losses
- Resistance to social situations where eating is expected
- Extended bathroom use during or right after meals
Physical Symptoms of Teen Eating Disorders
- Sudden or extreme loss or gain of weight
- Repeated weight cycling, going up and down within a short period of time
- Constipation or vomiting
- Skin rashes or dry skin
- Erosion of tooth enamel; dental cavities
- Loss of hair and/or poor nail health
- Obvious signs of exhaustion, insomnia
- Irregular menstruation or absence of menstruation
- Easily bruised; more prone to physical injury
- Cold sensitivity; inability to tolerate cold
- Feeling tired
- Cardiovascular issues
- Stunted growth due to poor nutrition, such as with anorexia.
- Electrolyte imbalances
Psychological Eating Disorder Symptoms
- Feeling distressed or ashamed about eating
- Depression
- Anxiety
- Obsessed about one’s appearance and others’ perceptions
- Expressing guilt about eating
- Intense mood swings
- Panic attacks
- Self-harm
- Suicidal thoughts
Signs and Symptoms of the Most Common Eating Disorders
The three most common eating disorders in adolescents are anorexia nervosa, bulimia nervosa, and binge-eating disorder. Avoidant/restrictive food intake disorder (ARFID) is a newer eating disorder in children, more commonly found in boys.
Teen Anorexia Symptoms
Teens with anorexia nervosa are obsessed with food and calorie intake in an effort to lose weight, which can result in self-starvation. Adolescent anorexia is extremely dangerous and leads to more deaths than any other psychiatric disorder.
Signs and symptoms of teen anorexia include:
- Severe dieting or extremely restrictive eating habits
- Obsessive fear of putting on weight
- Low self-esteem tied to body dysmorphia
- Lethargy and general exhaustion
- Muscle wasting and extreme thinness
- Problems concentrating, combined with extreme sensitivity
Adolescent Bulimia Symptoms
Bulimia nervosa, also called binge-purge syndrome, is characterized by binging a large amount of food, followed by forced purging through vomiting or using laxatives, diuretics, or diet pills.
Signs and symptoms of teen bulimia include:
- Repeated binge eating, particularly of junk foods and sweets
- Constant trips to the bathroom during and after meals
- Excessive buying and use of laxatives, diuretics, and/or diet pills
- A sore throat for no obvious health reason, with swollen salivary glands in the neck and the jaw
- Indigestion, acid reflux, and gastrointestinal problems
- Gum disease, bad teeth, bleeding gums
Teen Binge-Eating Disorder Symptoms
Teens who have a binge-eating disorder engage in compulsory eating behaviors. That is, they eat large amounts of food in a short period of time. However, with teen binge eating disorder, bingeing is not followed by a forced purge. Instead, they eat to the point of being uncomfortably full, which triggers feelings of shame, regret, guilt, and/or depression.
Signs and symptoms of teen binge-eating disorder include:
- Repeated binge-eating episodes
- Eating more rapidly and aggressively than normal
- Claiming to be full, but continuing to eat
- Expressions of disgust or regret after binge-eating
- Weight cycling or weight gain
- High cholesterol and high blood pressure
Signs and Symptoms of ARFID
Children with AFRID symptoms fall into three categories:
- Selective/picky eaters who react strongly to smells, tastes, and/or textures of food
- Children who are uninterested in eating. They have a low appetite and will say they are not hungry.
- Those who avoid food for fear it may result in choking, pain, or an upset stomach
Children with ARFID are at risk of vitamin, mineral, and protein deficiencies, delayed puberty, and overall poor growth. In the worst cases, children require tube feeding and nutrition supplements.
Why Adolescent and Teen Eating Disorder Treatment Is Important
Without treatment, eating disorders can cause serious health problems, such as kidney disease, liver disease, and heart disease. Young girls can experience stopped menstrual cycles, which can lead to early bone loss and painful fractures. Young males with anorexia nervosa typically have low levels of testosterone and vitamin D, and they have a high risk of osteopenia and osteoporosis.
Moreover, restrictive eating disorders impact linear growth and development. Many of the effects of malnutrition can be treated and reversed, however stunted growth could be irreversible. Adolescents can achieve “catch-up” growth with early and aggressive weight restoration, however they may never achieve their projected adult height.
Additionally, studies show that eating disorders nearly always co-exist with other mental health issues. A National Institute of Mental Health study of teens with eating disorders revealed that up to 90 percent of the 10,000 participating teens reported mental health problems, such as anxiety and depression. In addition, teens with eating disorders are also at greater risk for substance use disorder and self-harming behavior.
Above all, eating disorders can be life threatening. If you suspect your teen has an eating disorder, early intervention is key to prevent long-term mental and physical complications.
Treating Teen Eating Disorders at Newport Academy
The caring staff at Newport Academy is ready to help your teen overcome their eating disorder with a tailored eating disorder treatment plan that includes dietary and clinical care. At Newport, we recognize that mental health conditions such as anxiety, depression, and obsessive-compulsive disorder are often linked to struggles with food and body image. Our integrated care creates sustainable healing by addressing teen eating disorder symptoms while treating primary mental health conditions.
Each teen’s tailored eating disorder treatment plan includes:
- Psychiatric and medical care, including medication management, as needed, for underlying mental health issues such as anxiety and depression
- Initial dietary screening, followed by ongoing individual check-ins and groups with board-registered dietitians
- Tailored dietary and relapse prevention plan to take home upon discharge, so teens can maintain and build on gains made in treatment
- Individual therapy to process underlying trauma and build self-knowledge and healthy coping skills
- Body image groups and eating disorder–specific homework using Cognitive Behavioral Therapy and Dialectical Behavioral Therapy skills
- Family therapy to restore connection and trust, so teens with eating and mental health disorders feel safe turning to parents for support
- Experiential therapy, such as rock climbing, kayaking, and yoga, that allows teens to build a positive connection with their body and its abilities
- Strength-based academic component to keep teens on track with educational and career goals while receiving the treatment they need
Contact us today to learn more about how our teen and adolescent eating disorder treatment program can help your child on that path to long-term recovery.
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Frequently Asked Questions
Do males have eating disorders?
Yes. There’s a common misconception that only young girls and women have eating disorders. Around 1 in 3 people struggling with an eating disorder are male. Eating disorders will affect around 6. 6 million men at some point in their lives.
Which are common eating disorders in adolescence?
Common eating disorders in adolescence include anorexia nervosa, in which teens experience a fear of gaining weight that results in starvation, and bulimia, which involves bingeing and purging food by vomiting or abusing laxatives, diuretics, or diet pills. Binge-eating disorder, compulsive overeating without purging, is another common eating disorder in adolescents.
What is an eating disorder that usually occurs in adolescent girls?
Anorexia nervosa is a common eating disorder among adolescent girls and has the highest mortality rate of any psychiatric disorder. It is critical to seek help for a teen girl who shows signs and symptoms of teen anorexia.
When do 90 percent of all eating disorders begin?
A full 90 percent of all eating disorder cases are diagnosed before the age of 20.
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