Spotting the signs of disordered eating in youth: Tips for parents and caregivers

This is concerning, since there are already very long wait times for eating disorder programs.

Impact of eating disorders

Individuals with eating disorders experience a problematic relationship with food, often accompanied by significant distress about their weight, shape and size. Many experience body image dissatisfaction and restrictive eating.

Eating disorders do not discriminate. They can occur in people of any race/ethnicity, age, socioeconomic class or gender. Youth who do not “fit” the stereotype of an eating disorder, especially those from Black, Indigenous and racialized backgrounds, may face delayed recognition and diagnosis.

Eating disorders impact every aspect of an individual’s life and contribute to significant distress for the affected individual and their family, including their siblings. They can have serious and life-threatening complications, such as bradycardia (heart beating too slowly), osteoporosis (bone weakening) and anemia (low red blood cell count). Eating disorders are also associated with a high rate of premature death.

As clinicians and researchers, we have studied and worked with youth and their families struggling with eating disorders or “disordered eating” (the spectrum of unhealthy eating behaviour and patterns). Below we offer a guide for parents and other supportive adults on recognizing the signs of disordered eating in youth and offer practical resources and tips to support them effectively.

Signs of disordered eating

Considering the growing concern about the rise in eating disorder behaviour in youth, and the importance of timely recognition and action, the following signs and symptoms of disordered eating are important to look out for:

Behaviours related to disordered eating:

• Excessive exercise to reduce weight or change body shape — going to the bathroom immediately after eating;

• Eating in secret;

• Restricting foods, such as a specific food group;

• A preoccupation with losing weight or maintaining a low body weight;

• Frequently weighing themselves because of body image dissatisfaction;

• Unusual behaviour around food such as weighing/measuring food or cutting food into tiny pieces, or large consumption of liquids at mealtimes (for calorie dilution and a sensation of fullness),

Physical signs of disordered eating:

• Unexplained weight loss or weight fluctuations (up or down);

• Delayed puberty or amenorrhea (missed periods);

• Sensitive or damaged teeth;

• Dizziness or fainting;

• Feeling cold;

• Stomach pain.

Social and psychological signs of disordered eating:

• Personality changes, such as social withdrawal and increased irritability;

• Depression or anxiety;

• Fighting with others about food, eating and weight;

• Avoidance of food-related social activities like birthdays or sleepovers.

General recommendations for all parents and caregivers

• Be on the lookout for sudden or drastic changes in your child’s eating habits, such as extreme dieting, avoiding certain foods, preoccupation with weight, and fears about losing control of overeating. Also, keep an eye out for frequent fluctuations in meal patterns.

• Pay attention to any physical changes you notice in your child, such as unexplained weight loss or gain, persistent fatigue, or changes in mood. These could be signs of underlying issues related to disordered eating.

• Be mindful of withdrawal from social situations that centre on food, such as avoiding gatherings where meals are involved.

• In addition to social media use, parent role modelling can shape children’s attitudes and behaviour toward food and body image. As a result, we recommend that parents ditch the weight-based talk. It is best to avoid commenting on people’s physical appearances, weight, shape and body sizes, including your own and others in your life. Rather, we recommend parents focus on health rather than appearances and empower youth to develop a positive relationship with food and their bodies.

The importance of early identification and intervention

If you notice some of the signs and symptoms of disordered eating, it is essential to talk with your child. Invite them to share their experiences and listen without judgment. Express compassion, kindness and concern about their health and well-being.

If you believe your child’s health is at risk, warmly but firmly tell them that you are worried about them and organize contact with a health-care professional. Make an appointment with your primary care provider and come to your appointment prepared to discuss the type of behaviour you have been seeing.

Previous research suggests that quickly seeking help may support better recovery from an eating disorder. This awareness motivates both providers and family members into action to quickly identify eating disorder behaviour in youth and to advocate for them to receive comprehensive care from a diverse health-care team including psychologists, physicians, dieticians and social workers.

If you experience a long wait for targeted support in your area, consider also exploring reputable organizations in your geographical location.

It is important for parents and caregivers to recognize that negative body talk does not mean that your child has an eating disorder. It is, however, something to be mindful of, especially when coupled with the signs of eating disorders provided above.

The National Eating Disorders Information Centre helpline and live chat are available seven days a week. For the helpline, call 1-866-NEDIC-20 (toll-free) or live chat at nedic.ca.