How to Tell if Your Child or Teen Has an Eating Disorder?

What are Eating Disorders?

Eat_or_diet_signsEating disorders (EDs) in children and adolescents are serious psychological conditions that cause changes in eating habits and can lead to serious or even life threatening health problems.

There are three main types of eating disorders:
1. Anorexia nervosa, a condition in which a child refuses to eat adequate calories out of an intense and irrational fear of becoming fat and subsequently becomes underweight
2. Bulimia nervosa, a condition in which a child eats large quantities of food (binge eating) and then purges the food by vomiting or using laxatives to prevent weight gain
3. Binge eating disorder, a condition in which a child engages in binge eating, but without purging

What are the Signs of an Eating Disorder in Children and Teens?

Eating disorders typically develop during adolescence or early adulthood. However, they can start in childhood too. They are much more common in girls, but do affect boys as well.
EDs are complex and have multiple causes, including genetic, personality, and social factors. We know that early detection and treatment leads to better outcomes.

How can you tell if your child has an eating disorder? Here are some things to look out for:

  • intense fear of becoming fat, even if underweight
  • excessive or compulsive exercising
  • menstruation that becomes infrequent or stops
  • rapid weight loss, which the child may try to conceal with loose clothing
  • strange eating habits, such as avoiding meals, eating in secret, monitoring every bite of food, or eating only certain foods in small amounts
  • abusing laxatives and other treatments to prevent weight gain
  • binge eating on large amounts of food
  • social withdrawal, reduced interest in activities your child used to enjoy
  • mood swings
  • overemphasis on physical appearance
  • regularly spending time in the bathroom after eating
  • scarring on knuckles from using fingers to induce vomiting
  • vomiting after eating
  • worried_teenage_girlIn addition, eating disorders often co-occur with other psychological problems, such as anxiety, depression, perfectionism, and drug or alcohol abuse. It is important to observe if you see any of these problems as well.

    What about Dieting?

    Many children and teens will try some type of diet at one point. With so much emphasis in our society on thinness, it is no wonder that dieting is so prevalent among children and adolescents. Research shows that dieting is almost always the precursor for developing an ED. While not every child or teen who diets will get an ED, those who have a pre-existing vulnerability and who diet can develop an ED. Therefore, if you notice your child beginning to diet, it can be a good idea to have a conversation with them about why they are dieting, and help them see that maybe there is no need for it.

    If I think My Child or Teen has an ED, what Can I Do?

    So what can I do if I suspect my child or teen has or is developing an ED? The first step would be to talk to them. When talking to your child about the ED, it can help to:

  • Stay calm.
  • Don’t blame or judge.
  • Concentrate on how they are feeling.
  • Emphasize that no matter what, you love them and will always be there for them.
  • Try not to feel hurt if they don’t open up right away, and don’t resent them for being secretive. This is due to their illness, not their relationship with you.
  • Ask them what you can do to help.
  • Be patient and listen to what they are trying to say, as the feelings behind the eating disorder may be really difficult for them to express.

  • The next, and very important step, is to take your child or teen to see their pediatrician. Your pediatrician can perform a more thorough assessment to determine whether your child’s eating behaviours are of concern and warrant treatment with a mental health professional. With early detection and treatment, your child or teen has a better chance of recovering from an ED.

    Lea Thaler, Ph.D., is a clinical psychologist who specializes in eating disorders, obesity and body image. She works at the Eating Disorders Program at the Douglas University Institute, and is an Assistant Professor in the department of Psychiatry at McGill University. In addition to her clinical work, Dr. Thaler does research examining the genetic basis of eating disorders, and on treatment outcome for eating disorders. She is currently on maternity leave and will return to work in March 2015.

    Image at top left courtesy of Stuart Miles as
    Image at right courtesy of marin at