The COVID-19 pandemic has been associated with a deterioration in mental health among teenagers, including an increasing number of patients with eating disorders. Research even indicates that the number of teens with eating disorders at least doubled during the pandemic.
This is especially concerning given eating disorders are among the most deadly of all mental health diagnoses, and teens with eating disorders are among them higher risk of suicide than the general population.
While experts don’t know exactly why eating disorders arise, studies do show it body dissatisfaction and desire for weight loss are major contributors. This can make conversations about weight and healthy behavior especially tricky with teens and young adults.
like a pediatrician doctor specializing in eating disorders, I have seen firsthand the increase in eating disorder patients, as well as the detrimental effects of stereotypes about eating disorders. I regularly work with families to help teens develop a positive relationship with body image, eating and exercise.
It is important to understand the signs of a possible eating disorder, as studies suggest timely diagnosis and treatment leads to it better long-term results and better chances of full recovery.
Eating disorders defined
Eating disorders, what often begin during pubertyInvolving anorexia nervosa, bulimia nervosa, binge syndrome, other specified feeding and eating disorders And avoidant restrictive food intake disorder. Each eating disorder has specific criteria that must be met in order to receive a diagnosis, which is made by a professional with eating disorder expertise.
Research suggests that up to 10% of people will develop it an eating disorder in their life. Medical complications of eating disorders, such as low heart rate and electrolyte abnormalities, can be dangerous and result in hospitalizationand malnutrition can affect growth and development. Many of the patients I see in the clinic show signs of interrupted puberty and delayed growth, which can affect bone health, adult height and other health issues if not addressed quickly.
Teens are also at risk for disordered eating behaviors such as intentional vomiting, calorie restriction, binge eating, excessive exercise, use of weight loss supplements, and abuse of laxatives.
A recent study estimated that 1 in 5 teens could do this struggling with disordered eating behavior. While these behaviors alone do not qualify as an eating disorder, they can predict the eating disorder development of eating disorders later.
Treatment methods for eating disorders are varied and dependent on several factorsincluding a patient’s medical stability, family preferences and needs, local resources, and insurance coverage.
Treatment may involve a team consisting of a medical provider, nutritionist, and therapist, or may involve the use of a specialized eating disorder program. Referral to any of these treatment approaches may come from a pediatrician or a specialist eating disorder provider.
Eliminate misconceptions and stereotypes
Traditional ideas and stereotypes about eating disorders have led many people to believe that it is mainly thin, white, affluent women who develop eating disorders. However, research shows that anyone can get these conditions, regardless of age, race, body size, gender identity, sexual orientation or social economical status.
Unfortunately, there are stereotypes and assumptions about eating disorders contributed to health inequalities in screening, diagnosis and treatment. Studies have documented negative experiences with eating disorder treatment transgender and gender diverse individuals, Black and native people and those with greater body length. Some contributors to these negative experiences include a lack of diversity and training among practitioners, treatment plans without cultural or economic dietary considerations, and differential treatment when a patient is not visibly underweight.
Contrary to popular belief, studies show that teenage boys are also at risk for eating disorders. These often go unnoticed and can be disguised as a desire to gain muscle. However, eating disorders are just as dangerous for boys as they are for girls.
Parents and loved ones can play a role in helping to dispel these stereotypes by advocating for their child with the pediatrician when concerns arise and by recognizing red flags for eating disorders and eating disorder behaviors.
Warning signs
Given how common disordered eating and eating disorders are in teens, it’s important to understand this some possible characters of these worrying behaviors and what to do about it.
Problematic behaviors can include eating alone or in secret and a hyperfocus on “healthy” foods and anxiety when those foods are not readily available. Other warning signs include significantly reduced portion sizes, skipped meals, arguing during meals, using the bathroom immediately after eating, and weight loss.
Because this behavior often feels secretive and embarrassing, it can be difficult to bring it up with teens. Taking a warm but direct approach when the teen is calm can be helpful while letting them know you’ve noticed the behavior and are there to support them without judgment or blame. I always make sure to let my patients know that my job is to be on their team, rather than just telling them what to do.
Teens may not be immediately open about their own concerns, but if this type of behavior is present, don’t hesitate to show them at their pediatrician’s office. Follow up on patients who have shown signs of an eating disorder and immediately refer to a specialist who can further evaluate the patient are crucial to getting teens the help they need. Resources for families can be useful navigating the fear and uncertainty that can come with being diagnosed with an eating disorder.
Focus on health, not size
Research shows that bad body image And body dissatisfaction can put teens at risk for disordered eating and eating disorders.
Parents play an important role in the development of teens’ self-esteem, and research shows that negative comments from parents about weight, body size, and eating are associated with eating disorder-type thoughts in teens. Therefore, when you talk to teenagers, it is can be beneficial to take a weight neutral approach, what focuses more on overall health rather than weight or size. Unfortunately, I have had many patients with eating disorders who have been berated or teased about their weight by family members; this can be really harmful in the long run.
A helpful strategy is to include a lot of variety in a teen’s diet. If feasible, trying new foods as a family can encourage your teen to try something they haven’t done before. Try to avoid terms like “junk” or “guilt” when discussing food. Teaching teens to appreciate many different foods in their diet can help them develop a healthy, knowledgeable relationship with food. If you feel stuck, you can ask your pediatrician to see a dietician.
It’s important to remember that teens need this lots of nutrition to support growth and development, often more than adults, and eating regularly helps prevent extreme hunger that can lead to overeating. Getting teens to listen to their bodies and learn their own hunger and fullness signals will help them eat in a healthy way and create long-term healthy habits.
In my experience, teens are more likely to exercise consistently when they find an activity that they enjoy. Exercise doesn’t have to mean lifting weights at the gym; teens can get their bodies moving by taking a walk in nature, moving to music in their room, or playing a game of basketball or soccer with a friend or sibling.
Focus on the positive things exercise can do for the body, such as improvements in mood and energy can help prevent movement from feeling compulsive or forced. When teens can find exercise they enjoy, it can help them appreciate their body for all it can do.
