Eating Disorders Among Adolescents

Most people who have or have had an eating disorder were diagnosed in adolescence. Eating disorders are a serious and sometimes deadly mental health condition.

Eating Disorders in Adolescence Statistics

Here’s a few statistics and facts about eating disorders in adolescence:

• The average age for developing anorexia and bulimia is 18 and 21 for binge eating disorder
• Girls are more than two times as likely to struggle with eating disorders than boys
• Young people ages 15 to 24 were ten times more likely to die from an eating disorder compared to other people their age
• Teens who diet are five times more likely to develop an eating disorder compared to teens who don’t
• Black teenagers are 50% more likely to struggle with binging and purging
• Teens from low-income families are more likely to engage in self-induced vomiting and laxative abuse [1,2]

Types of Eating Disorders in Adolescence

There are several different types of eating disorders. This section will go over three eating disorders that are commonly seen in adolescents.

Anorexia in Adolescence

Anorexia is less common than bulimia and binge eating disorder (BED). However, anorexia is serious and has the highest mortality rate compared to other eating disorders [3]. Here are the signs and symptoms of anorexia:

• Extreme food restricting
• Extreme thinness
• Belief that they are overweight or fat despite being severely underweight
• Intense fear of gaining weight
• Self-esteem that is significantly linked with body shape or size
• Despite low body weight, continual desire to lose weight
• Inability to maintain a healthy weight [3]

Binge Eating Disorder (BED) in Adolescence

BED is an eating disorder that is given to someone who continually binge eats. A binge is when someone eats a large amount of food in a short period of time. The amount is so large that most people would not be able to or wouldn’t eat the same amount in the same time frame. There are a few other signs of BED. These are:

• Feeling unable to control or stop binging
• Feel disgusted, sad, or guilty after binging
• Creating food rituals or changing plans in order to binge
• Eating even if you’re full or not hungry
• Eating alone or in secret due to feeling embarrassed about the amount of food
• Rapid eating [3,4]

Bulimia Nervosa in Adolescence

Bulimia nervosa is another serious eating disorder. Bulimia is characterized by cycles of binge eating followed by a compensatory behavior. A compensatory behavior is something someone does in order to avoid gaining weight after binging such as purging, laxative abuse, fasting, or compulsive exercise after binging.

Here are other signs and symptoms of bulimia:

• Frequent trips to the bathroom after meals
• Drinking excessive amount of water
• Using excessive amounts of breath-freshening products
• Dental problems
• Calluses on the back of hands and knuckles from purging
• Extreme concern with body shape or size
• Evidence of binge eating, such as large amounts of food being gone or finding hidden food wrappers [4]

It’s important to know that people with bulimia can be underweight, at a normal weight, or overweight.

What are the Effects of Eating Disorders in Adolescence?

As mentioned earlier, eating disorders can have serious health effects. Some of these effects can be long-term or lifelong. These include:

• Bone thinning, such as osteopenia or osteoporosis
• Heart damage
• Brain damage
• Multiorgan failure
• Electrolyte imbalance which can lead to a stroke or heart attack
• Infertility [3]

Other possible health effects include:

• Severe dehydration
• Gastrointestinal issues
• Dental problems
• Dry skin
• Immune system impairment
• Abnormal labs
• Difficulty falling or staying asleep [3,4]

What Causes Eating Disorders in Adolescence?

There isn’t one single thing that can cause an eating disorder. Research shows that eating disorders are a result of a mix of genetic, biological, psychological, and social factors [3].

Psychological factors can include things about someone’s personality, such as perfectionism or rigid thinking patterns. Social factors could include family dynamics, such as families where talking about emotions isn’t allowed. Other social factors can include things like media influence or being bullied for your weight.

Understanding Food Phobias

A fear of certain foods may be a telltale sign of an eating disorder such as anorexia nervosa or bulimia nervosa. For example, high-fat foods may increase anxiety levels in some kids with eating disorders. By avoiding these foods, they learn they may temporarily keep their anxiety in check. This is known as “negative reinforcement.”

Eating disorders may deprive brain cells of needed energy and, eventually, change the way people process information. This change in brain chemistry is thought to contribute to food phobias and distorted thinking, especially in regard to one’s perceived body image.

Related Reading

• Teens
• Groups at Risk for Eating Disorders
• Athletes
• Women
• Women with PCOS

Adolescent Eating Disorder Treatment Program Options

There are several treatment options for adolescents that are shown to be helpful in recovering from an eating disorder. The severity of someone’s eating disorder will determine what level-of-care they need. The levels-of-care that are available are:

• Inpatient hospitalization
• Residential
• Intensive day programs
• Outpatient

When it comes to providers, eating disorder treatment typically includes support from a multidisciplinary team. Treatment is usually compromised of mental health counseling, medical care, medication, and nutritional counseling.

Mental Health Counseling

Therapy for an eating disorder can include individual, group, and family therapy. Therapy is a really important element in the recovery process. There are certain types of therapy that have shown to be helpful and effective in treating the underlying emotions and behaviors that fuel an eating disorder [3].

Recovery can also be emotionally difficult. Having support from a trained professional can help you navigate this process. Group therapy also provides adolescents with an opportunity to receive and give support to others who are going through something similar. This can be a powerful form of support.

Family involvement is critical

Families are an integral part of the treatment team. The chances that your loved one will recover from an eating disorder will be increased if the family is involved in supporting and treating the eating disordered individual develop and maintain coping strategies.  Children find it encouraging when family members are a part of their recovery efforts.

Family therapy also gives an adolescent’s family an opportunity to understand more deeply how to support their child during this process. Family therapy can also help family members work through any difficult feelings or communication issues that may serve as barriers to the recovery process.

Medical Care

While eating disorders are a mental health condition, they also have a large medical component. Treatment typically includes support from a doctor to make sure you are physically stable and healthy. The severity of the eating disorder will determine how much medical support someone needs.

A doctor or psychiatrist may also prescribe medication to help with any unresolved mental health issues that could be feeding into the eating disorder, such as anxiety or depression. There are certain medications that have been shown to help with these conditions and can make the recovery process more manageable [3].

Nutritional Counseling

Nutritional counseling is really important for the recovery process. A registered dietitian who has been trained to work with eating disorders can help significantly. Nutritional counseling can help someone figure out how to portion properly, resolve any illogical beliefs about food, and meet their unique nutritional needs.

Resources:

[1] National Eating Disorders Association. (n.d). Statistics and Research on Eating Disorders. Retrieved August 31st, 2021 from https://www.nationaleatingdisorders.org/statistics-research-eating-disorders

[2] National Institute of Mental Health. (n.d). Eating Disorders. Retrieved August 31st, 2021 from https://www.nimh.nih.gov/health/statistics/eating-disorders

[3] National Institute of Mental Health. (n.d). Eating Disorders. Retrieved August 31st, 2021 from https://www.nimh.nih.gov/health/topics/eating-disorders#part_2269

[4] National Eating Disorders Association. (n.d). Warning Signs and Symptoms. Retrieved August 31st, 2021 from https://www.nationaleatingdisorders.org/warning-signs-and-symptoms

Author: Samantha Bothwell, LMFT

Page last updated and reviewed on September 28, 2021 by Jacquelyn Ekern, MS, LPC
Published on EatingDisorderHope.com, Online Resource for Eating Disorders

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