Signs of disordered eating can be subtle, but early detection and intervention are key.
Disordered eating — irregular eating behaviors that may or may not lead to the diagnosis of an eating disorder — may show up in different ways. According to Dr. Todd Callahan, division director of adolescent and young adult health at Monroe Carell Jr. Children’s Hospital at Vanderbilt, childhood and adolescence is a particularly vulnerable time for disordered eating.
“The symptoms can be subtle and hard to notice,” Callahan said, “and oftentimes young people keep them secret.”
Some signs to look out for include calorie restriction, excluding certain foods and not others; binge eating or eating large amounts of food in a short amount of time; purging by using laxatives or vomiting; or a combination of these. Excessive exercise that is inconsistent with health or that interferes with responsibilities or daily life is also a concern.
“All these things should be talked about with the teen or evaluated further,” Callahan said.
The difference between disordered eating and eating disorders
Although they sound similar, disordered eating and eating disorders aren’t the same thing.
“A large percentage of adolescents and even children will display disordered eating,” Callahan said. “Not all of those patients will meet diagnostic criteria for an eating disorder.”
Why adolescence is a vulnerable time
“At the very time that adolescents need more nutrition than they’ve ever needed, they have less adult supervision during mealtimes than they’ve ever had before.”
Preteens and teens face some unique challenges regarding diet and body image compared to younger children or adults.
“Adolescents are at a stage in life where their nutritional needs are higher than they’ve ever been before and higher than they’re going to be when they are adults,” Callahan said. At the same time, they are growing, developing and going through puberty.
“Puberty may be accompanied by self-consciousness and body dissatisfaction,” he added, “because they may look at themselves and look at other people in their friend group or their classroom and feel like they don’t look like any of those people.”
Adolescents are also gaining new freedoms. “At the very time that adolescents need more nutrition than they’ve ever needed,” Callahan continued, “they have less adult supervision during mealtimes than they’ve ever had before.”
They may be eating many of their meals and snacks outside the home or away from parents and caregivers. This makes them more vulnerable to other influences, including their peers, social media and other social messages.
“These messages may have a lot to say about eating,” Callahan said, “most of which is not really applicable to adolescents and is not nuanced.”
What to do if you suspect disordered eating in your teen
Callahan recommends having a discussion with your teen to let them know in a nonjudgmental way that you’ve noticed a change in their behavior that’s concerning you.
Additionally, he recommends encouragement and modeling healthy eating practices. “When we talk about healthy nutrition with families, we don’t think about individual foods,” he explained. Instead, he considers these three factors:
- Are you eating the variety of foods your body needs, including fruits, vegetables, proteins, carbohydrates and fats?
- Are you eating enough?
- Do you have the flexibility to fuel your brain and body in all the different situations you find yourself in?
Part of modeling healthy behaviors and creating a nonjudgmental safe space for teens lies in how parents talk about diet, exercise and body image. “We should all just establish a zero-tolerance policy for weight-based teasing or negative comments,” Callahan said. “Some of the negative comments young people hear are often from parents talking about their own bodies. That sends a powerful statement to children and adolescents: ‘If Mom or Dad or Grandmother is dissatisfied with their own body, maybe I should be more critical of how I look.’ “
When should you talk to a health care provider?
“It’s never a bad idea to consult with your pediatric provider if you have concerns about your child or if your child is expressing concerns,” Callahan said. “But particularly if you see persistent, worrisome patterns of eating or exercise or if you have concerns about purging symptoms, those would be reasons we really encourage families to consult with their pediatric provider.”
Finding help
If your child is struggling, the next best step is to talk with your pediatrician, who can assess and make any needed referrals. Monroe Carell Jr. Children’s Hospital at Vanderbilt’s Pediatric Primary Care clinics ensure quality care for your child as close to home as possible, with locations throughout Middle Tennessee.
