Many people believe that eating disorders are immediately recognizable – we picture an emaciated young girl with sallow skin who refuses to eat anything but salads.  If your child struggles with anorexia nervosa, Roots to Recovery can help, but you should know that eating disorders come in all shapes, sizes and genders. We all know the classic signs and symptoms of an eating disorder – dramatic weight loss, throwing up after meals and an obsession with counting calories, but most parents miss the less obvious signs. While many eating disorder patients are underweight, the majority are a normal weight or even overweight.  Some of the less obvious signs of eating disorders include:

  • An obsession or preoccupation with food
  • Eating large amounts of food
  • Eating even when full
  • Eating alone or hiding food
  • Hiding empty food containers
  • An obsession with weight or body image
  • Making excuses for missing food or stealing money for food
  • Habitually going to the bathroom after or during meals
  • Sores, scars or calluses on the knuckles or hands
  • Scratchy or raspy voice
  • Odd rituals surrounding food or a refusal to eat certain foods or types of food
  • A distorted self image (believing you are overweight when you are not)
  • Crash diets or yo-yo dieting
  • Excessive or compulsive exercising
  • Rapid weight loss or rapid weight gain

All of these are signs that your teen may be struggling with an eating disorder.  It’s important to understand that these are serious indicators that your child may need help.  Untreated eating disorders can lead to significant and lifelong medical problems.  The earlier you and your child get help, the better their prognosis will be.

The Diagnostic and Statistical Manual of Mental Disorders is the manual published by the American Psychiatric Association which lists all classifications of mental disorders.  Earlier versions of the DSM recognized only three (anorexia, bulimia and eating disorder NOS), but today it recognizes eight unique feeding and eating disorders. The most common eating disorders in teens include:

  1. Binge Eating Disorder

Binge Eating Disorder (BED) is a serious condition that often begins in childhood or the early teens years.  Sufferers of BED frequently consume unusually large amounts of food and eat past the point of satiation, sometimes until they become sick.  A teen with binge eating disorder is often unable to stop eating and feels that the behavior is out of control.  They may not want to overeat but they often feel powerless to stop.

Teens with binge eating disorder are often overweight, but some are normal weight.  They are often very good at hiding their behaviors by eating in secret, hiding empty food containers or stealing money for food.  Binge eating disorder often runs in families and if you are overweight, your teen is more likely to struggle with weight and food intake as well.

  1. Bulimia Nervosa

Bulimia nervosa (simply known as bulimia) is a serious condition where the sufferer eats large amounts of food at a time, similar to the binges observed in binge eating disorder, but attempts to compensate for the large intake of calories by engaging in purging behaviors.  Purging behaviors include self-induced vomiting, laxative abuse or abusing exercise.  Like teens with binge eating disorder, sufferers of bulimia are often very good at hiding their disorder.  Some of the less obvious signs include sores or calluses on the knuckles, spending too much time in the bathroom or stealing money for laxatives and diet pills.

Teens with bulimia are typically an average weight or overweight.  This is a result of the large amounts of calories they consume during a binge. Compensatory behaviors are usually not enough to erase the damage done by a binge.  This failure to achieve the intended goal is a source of stress for the teen, who gets stuck in a cycle of overeating and desperately trying to compensate.

  1. Anorexia Nervosa

Anorexia nervosa (also known as anorexia) is an extremely serious medical condition that often begins in adolescence.  Teens who struggle with anorexia nervosa are obsessed with food and weight and they go to great lengths to restrict food intake. The most obvious sign of anorexia is dramatic weight loss and a refusal to maintain a healthy body weight.

Teens with anorexia nervosa need immediate help.  They are at risk for a number of troubling side effects that could affect their long term health and well being.  If your child has recently lost a significant amount of weight or is noticeably underweight, seek help immediately.

  1. Other Specified Feeding or Eating Disorder (OSFED)

Other Specified Feeding or Eating Disorder, or OSFED, is a category of eating disorders that are clinically severe but do not fit neatly into the categories of anorexia, bulimia or binge eating.  Teens who suffer from OSFED display a number of symptoms, often from all three categories of eating disorders.  Types of OSFED include;

  • Atypical Anorexia Nervosa– The sufferer meets all of the criteria for anorexia with the exception that the individual’s weight remains within or above the normal range, despite significant weight loss.
  • Atypical Bulimia Nervosa – The sufferer meets all the criteria for bulimia but do not binge or purge as frequently as someone with Bulimia.
  • Purging Disorder – In purging disorder, purging behavior aimed to influence weight or shape is present but in the absence of binge eating.
  • Night Eating syndrome – Individuals who suffer from night eating syndrome have recurrent episodes of eating at night, such as waking up in the middle of the night and binging.

It is important to understand that teens who struggle with any of the above symptoms are in need of immediate help.

  1. Avoidant/Restrictive Food Intake Disorder (ARFID)

ARFID is a serious eating disorder wherein the patient limits their food intake based on food’s appearance, smell, taste, texture or a past negative experience with food.  Teens who suffer from ARFID sometimes struggle to keep weight on (or struggle to lose weight) and suffer from significant nutritional deficiencies.

Sufferers of ARFID are unable or unwilling to eat certain foods.  They may limit themselves to a small selection of “safe” foods.  In severe cases the sufferer may only be willing to eat one or two foods.  Teens with ARFID often exclude whole food groups such as fruits or vegetables.  Foods are excluded based on color, texture, temperature, appearance or other criteria.

Most sufferers of ARFID are able to maintain a healthy body weight yet they are nutritionally deficient as a result of the extreme limitations they place on their dietary habits.

It is important to understand that ARFID is not “picky eating”.  Teens who suffer from ARFID often experience extremely unpleasant effects if they are faced with the prospect of eating foods that they have deemed “unsafe”.  This includes retching, vomiting, gagging, gastrointestinal reactions and more.  Most sufferers of ARFID say they would change their eating habits if they could.

If after reading this you suspect that your child may be suffering from any of the above listed conditions, please call our kind and compassionate admissions counselors today.


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