Does My Teenager Have An Eating Disorder?

Today’s guest post is a two-part series on teens and Eating Disorders written by Michelle Horton, MA. Michelle is a biblical counselor with Heart Song Counseling in Tampa, FL. Michelle counsels on a variety of issues including PTSD, survivors of sexual abuse, eating disorders, addictions and emotional issues. In her spare time she enjoys running, spending long days at the beach and Clemson football.

Does my teenager have an eating disorder?

Maybe you started asking this question when you noticed your teen’s eating habits changing. Or maybe it was seeing their normally healthy, vibrant body deteriorating. Maybe you heard the sounds of vomiting in the bathroom. Or you found a stash of food in your teen’s bedroom. Maybe it was the comments he/she is making about their appearance. Or maybe, in the most fortunate of situations, your teen actually came to you directly and asked for help. So now what?

My intention in writing this article is to serve as a practical way to assist you in answering this question by providing you with a basic understanding of the issue at hand along with what practical and spiritual steps you need to take in caring for your teen.

What exactly is an eating disorder?

Here’s the most common definition as presented by the Mayo Clinic:

Eating disorders are serious conditions related to persistent eating behaviors that negatively impact health, emotions and the ability to function in important areas of life. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.

There are three important things to note as we examine the nature of an eating disorder (ED). First, eating disorders are not limited to females. Statistics show that 1 in 4 men have struggled with an eating disorder at some point in their life. Secondly, your teen does not have to be underweight or overweight to fit the criteria for an ED. Finally, it’s important to understand that there is a difference between someone who is struggling with disordered eating (emotional eating, bad food choices, etc) versus an actual eating disorder. Key elements of the above definition will help you to determine just how serious the problem may be.

What are the warning signs that I need to look for per the Mayo Clinic?

  • Skipping meals, making excuses for not eating or eating in secret
  • Excessive focus on food and healthy eating
  • Persistent worry or complaining about being fat and talk of losing weight
  • Frequent checking in the mirror for perceived flaws
  • Repeatedly eating large amounts of sweets or high-fat foods
  • Use of dietary supplements, laxatives or herbal products for weight loss
  • Excessive exercise
  • Regularly going to the bathroom after eating
  • Eating much more food in a meal or snack than is considered normal
  • Expressing depression, disgust, shame or guilt about eating habits
  • Intense fear of getting fat
  • Emotional outbursts when confronted about food choices
  • Making a rigid list of allowable foods.

If the answer to any of the above questions is “yes,” then it’s time to look a little more closely and get specific by determining what type of eating disorder your teen may have. Your teen does not have to exhibit all of the above behaviors to be diagnosed with an ED. As we have seen in examining the different types of disorders, many of these behaviors would conflict with one another as each struggle has a different focus and different goals. As presented by the Mayo Clinic, we see that there are three major categories of eating disorders–anorexia nervosa, bulimia nervosa and binge-eating disorder. But there is a fourth category that I would like to add. One that I am seeing more and more these days–orthorexia.

Anorexia nervosa: characterized by abnormally low body weight, intense fear of/obsession regarding gaining weight along with a distorted perception of body weight.

Bulimia nervosa: characterized by secretive binges — eating large amounts of food followed by purging–trying to get rid of extra calories in an unhealthy way (vomiting, laxatives, fasting or over-exercising).

Binge-eating disorder: characterized by eating unhealthy amounts of food (often to the point of physical pain) and a feeling of being unable to stop. Includes compulsive eating where a person feels unable to control food choices or quantities.

Orthorexia nervosa: characterized by an obsession with a set of rigid dietary practices or rules related to food. Usually includes a list of numerous foods that are “off limits” with only a very small number of foods allowed.

So as you are reading this and you realize, “I think my kid is struggling with an eating disorder!” Pause and take a deep breath. The Lord knows your heart is heavy and scared. He knows your desire to see your child get well. As you can see, the consequences involved can vary and even be life-threatening. In our next post we will examine the medical and spiritual components involved in the over all care of helping your teen.