As social media’s influence has grown, so has the prevalence of eating disorders among teens. In New Jersey alone, nearly 800,000 people—about 9 percent of the population—will experience an eating disorder in their lifetime, according to Harvard University’s Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED). Nationwide, the impact is even greater, with approximately 30 million children, adolescents and adults affected, according to RWJBarnabas Health. If you’re worried your child is struggling with an eating disorder, how can you address it? What’s the best way to start the conversation? And where can you turn for help? We asked experts to share their insights on identifying the signs, offering support, and finding the right resources.
SPOTTING THE SIGNS
Parents are often unaware of how much their kids are eating or what they’re eating, especially during the teen years, says Susan Brill Goldberg, MD, Chief of Adolescent Medicine at The Children’s Hospital at Saint Peter’s University Hospital in New Brunswick. Denial about eating disorders is common, and there are many misconceptions, too.
Many people mistakenly assume kids with eating disorders are underweight. “We know that in binge eating disorder or bulimia, kids are often of normal weight or are overweight,” Brill Goldberg says. “Even teens with anorexia nervosa may be of normal weight. Teens who start out overweight and lose weight quickly often use unhealthy eating practices to do so but are mistakenly complimented on their appearance or weight loss by family members or even medical caregivers.”
Another overlooked reality is that boys can have eating disorders, too, though their behaviors may be masked by a desire to “gain muscle” or “get in shape,” which parents and coaches often encourage. “It’s also important to recognize that an eating disorder differs from a diet in that it is a complex biopsychosocial disorder, not a lifestyle choice or preference,” Brill Goldberg adds.
Beyond weight loss or weight gain, parents should watch for changes in mood, such as a noticeable increase in stress or self-criticism, says Patricia Behrens, M.S.W., volunteer/outreach coordinator at 2NDFLOOR, a free youth helpline and app that provide 24/7 support, 365 days a year, to New Jersey youth ages 10- 24. Frequent trips to the bathroom after meals, cutting food into tiny pieces, or hiding food can also be warning signs, Behrens says. If something feels off, trust your instincts and start a conversation.
More early warning signs include:
- Changes in eating habits: Counting calories obsessively, avoiding meals, binge eating, or excessive exercise after eating.
- Physical symptoms: Fatigue, dizziness, fainting, thinning hair, and feeling cold even in normal temperatures.
- Behavioral shifts: Increased anxiety, perfectionism, mood swings, or social withdrawal.
- Clothing choices: Wearing oversized clothing to hide their body.
- Weight fluctuations: Sudden weight loss or gain, frequent use of the scale, or reliance on diet pills or laxatives.
WHAT TO SAY—AND WHAT NOT TO SAY
Bringing up concerns about eating habits can be difficult, but how you approach it makes all the difference. Instead of saying, “You’ve lost weight, what’s going on?” try: “I’ve noticed that you seem more stressed. I’ve noticed these behavior changes, and I’m concerned,” Behrens suggests. From there, it’s important to just listen and encourage the start of a conversation without judgment, she adds. Don’t raise concerns at the dinner table, and make sure there’s privacy when you bring it up.
SUPPORT AND TREATMENT
Recovering from an eating disorder is a process that involves both medical treatment and emotional support. Behrens suggests starting with your child’s school counselor, who can recommend resources and programs to help. Next, have your child evaluated by a healthcare professional familiar with eating disorders, such as a pediatrician, an adolescent medicine specialist, and/or a psychiatrist.
“Usually, patients can be best treated by a team of clinicians at home in an outpatient setting. This team should include a registered dietitian skilled in working with children with eating disorders, along with a mental health professional such as a psychologist or licensed clinical social worker to allow for clinical support and counseling as treatment is initiated,” Goldberg says. A board-certified psychiatrist should also be involved, she adds. Some patients require more long-term treatment in residential programs.
Parents play an important role throughout treatment, including participating in therapy. “Family-based therapy requires parents to plate all meals and enforce completion of meals for those children who have restrictive-type eating disorders,” Goldberg says, adding that siblings may also need therapeutic support.
Early intervention can help prevent long-term health consequences, says Behrens, and teaching healthy habits now will go a long way toward boosting your child’s physical and mental health.
WHERE TO GET HELP
2NDFLOOR
New Jersey’s youth helpline and app 24/7 anonymous free support
Call or text: 888-222-2228
THE NATIONAL ASSOCIATION OF EATING DISORDERS
THE RENFREW CENTER
Paramus and Mount Laurel
GENPSYCH EATING DISORDER PROGRAM
Various NJ locations
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