I wanted to figure out how parents can get better at recognizing whether a child has an eating disorder. Here’s what I found …
Most people assume that people who have eating disorders are underweight, but it’s not that simple. In fact, your child’s body weight can hide an eating disorder in plain sight. The three signs of an eating disorder are a change in appearance, changes in eating habits, and changes in relationships.
You may think these are not specific enough. But if you know what to look for, they will tell you everything you need to know about whether your child should be evaluated for an eating disorder.
Here’s some more information:
1. Changes in appearance
Almost all of us assume that the clearest sign of an eating disorder like anorexia or bulimia is weight loss. We also assume the sign of binge eating disorder is weight gain. These assumptions can be really dangerous, because often weight does not change significantly with an eating disorder.
It’s important to understand that eating disorders are psychological and emotional in nature. Except in a very small number of cases, they are not medically recognizable. We miss the majority of eating disorders if we use weight and blood tests.
Weight loss or gain may occur, but many times it is not a massive change. If your child is living in a larger body, you may mistake eating disorder weight loss as positive. You may think that they are getting “healthy.”
This is why it’s important to pay attention to appearance in more ways than weight. People who have eating disorders are uncomfortable with their bodies. This means that you may notice a change in the way they dress.
They may begin to wear baggy clothing and multiple layers of clothing to hide their bodies. Some kids will change style abruptly to something darker. You may think they’re going through a simple “goth” phase. But it could also be that they are trying to show how dark they feel on the inside. Dressing in dark, strange clothing may be a signal.
Other kids will show off their bodies. But constantly adjust their hemlines, spaghetti straps, low-cut tops, and bikini bottoms gives away discomfort. They may feel uncomfortable with themselves even as they appear to flaunt their bodies.
Your child may also hold themselves differently. You may notice that they tend to hold their elbow with the opposite hand. This is a classic sign of self-protection. When it takes place in a way that literally blocks the view of their stomach, it may be an indication of a lack of comfort with their body.
Look for body language that indicates discomfort with the self, including slumped shoulders, lack of eye contact, and increased fidgeting. If you get the sense that your child is falling in on themselves or jumping out of their skin, it’s worth trying to understand what’s going on.
They may also talk about their bodily discomfort and use phrases like “I’m so fat,” and “I’m so ugly.” Some level of body dissatisfaction is unfortunately a part of living in our culture. But consistent statements about appearance may be a sign of something more serious.
2. Changes in eating habits
The common assumption is that eating disorders are easily identified by either a drastic increase or decrease in food consumption. While this may occur, changes in eating habits are often more subtle. A small percentage of kids who have eating disorders refuse to eat. The majority of kids who have eating disorders use culturally-accepted methods of restricting food.
There are many diet programs that claim that health, not weight loss, is the goal. Clean eating, Keto diets, Whole 30, Noom, Intermittent Fasting, and Weight Watchers are all excellent ways to get started with an eating disorder. About 25% of teens who go on a diet will develop an eating disorder. So any form of dietary restriction – for any reason – is cause for concern for a parent.
Popular hiding places
A popular hiding place for eating disorders today is vegetarian and vegan diets, which have become trendy among young kids. Children and teens frequently cite animal cruelty as the reason behind these dietary choices. But they are often a way to restrict food and attempt to achieve “goodness” through food choices.
Eating disorder treatment centers frequently report that the majority of their patients are vegetarian/vegan.
I love animals, but I strongly recommend against vegetarian and vegan diets. Instead, I propose that concerned children become involved in animal rights activities that don’t begin and end on their plate. We want to avoid a child’s identity being linked to what they do or do not eat.
Monitor change in your child’s eating habits. This may include:
- Eliminating favorite foods
- Following a trend-based diet
- Signing up for a weight loss program
- Tracking their intake using an app like My Fitness Pal
Also pay attention to any “disappearing” food. Many people who restrict all day find themselves taking food from the pantry at night in binge eating episodes. This is a perfectly natural response to food restriction. Don’t shame your child for any binge eating. Do pay attention to disappearing food and seek professional support if you notice it consistently.
3. Changes in relationships
A sense of belonging is critical to our health. But it is rarely focused on when we talk about parenting children. When a child feels disconnected and lonely, they are more likely to have trouble. Eating disorders, self harm, suicidality, addiction, and other troubling mental conditions all stem from loneliness. Eating disorders often occur in people who feel disconnected and lonely. Healing begins when they feel they belong and are understood.
Most parents assume that teenagers will naturally distance themselves from their families during adolescence. It’s true that some distancing is perfectly normal and healthy. However, if you or any member of your family are unable to have a conversation with your child, it could be a sign of more serious disconnection in your family.
Family is a safe place
Family is the place where a child should be able to rest as part of a loving group. Broken ties in the family relationships are dangerous for any child. Children are biologically driven to connect with their parents and families. It is not natural or healthy for them to ignore family members or be unable to relax around family members. This extends all the way into their early twenties, at which time the child will begin to form their own “chosen families,” and the original family ties may loosen naturally.
But a child who distances themselves from family at any time is in pain. When combined with other symptoms mentioned in this article, family distance is reason for concern.
Children and teens who have eating disorders frequently block out their parents and family members. They may stop communicating in a meaningful way with their loved ones. Kids will often also have friendship difficulties. They may fall into groups of other people who seem either aggressively “popular” or “weird.” Abrupt social changes may be a sign that your child is seeking belonging so they can feel safe and as if they belong.
What should I do if I think my child has an eating disorder?
There is no possible way that a web article can diagnose an eating disorder. If you’re reading this and your “spidey sense” is going off, it may be a good idea to do some more research and get some help.
Many websites recommend that you take your child to a doctor if you believe they may have an eating disorder. However, I only make this recommendation if your child is medically underweight and/or having medical complications.
In most eating disorder cases, there are few if any medical symptoms. Our physicians have not been trained to identify and manage mental health conditions. In fact, well-intentioned doctors can make uninformed and harmful comments. They are not trained in the subtleties of eating disorders. Nor do most know how best to approach a child or teen who insists they are “fine” even when they are not.
This is why I recommend that if you think your child has an eating disorder you identify a trained nutritionist or psychotherapist who has experience with eating disorder treatment. A nutritionist or psychotherapist who has experience with eating disorders will be able to recognize the symptoms of an eating disorder. They can help you identify the best path forward.
Look for experience
Beware of working with any professional who does not have direct experience with eating disorders. There is so much misinformation about eating disorders. Parents need to be really careful about well-meaning but uninformed professionals who can do more harm than good.
We have a directory of RDs and therapists who can help. Most will set up a phone consultation if you can’t find someone local. The NEDA hotline is available Monday-Thursday from 9AM to 9PM ET, and Friday from 9AM to 5PM ET @ (800) 931-2237
Ginny Jones is the editor of More-Love.org. She writes about parenting, body image, disordered eating, and eating disorders.
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