Since the start of the pandemic, hospitalizations for in adolescent populations have skyrocketed. In one study, the number of admissions has doubled. At Walden’s Center for Recovery, we have seen a dramatic increase in the number of adolescents admitted to our units over the last two years.
Although this is worrisome for parents, being aware of common signs and symptoms of anorexia in teens can help you get your child into the right treatment.
1. Falling off their growth curve (not due to a medical issue)
It’s important to be aware of your child’s growth trends throughout their development and make sure they’re continuing on their normal growth trajectory. In normal adolescent development, we should see a steady increase in weight every year, so a sudden drop in weight is often a cause for concern. For many adolescents, Anorexia Nervosa is diagnosed after significant weight loss, however, weight stagnation—that is, weight not increasing year over year—can also be a sign of a shift in normal eating patterns and a warning sign of anorexia.
2. Diet and exercise
Eating disorders often start with good intentions.
“I wanted to eat healthy, exercise, and lose a couple pounds.” Who hasn’t heard (or said) that before?
The problem for those with a predisposition to develop an eating disorder is that diet and exercise can quickly spiral out of control. A warning sign of anorexia in teens can show up as dieting turning into not eating foods they once enjoyed and exercising changing from a pleasurable activity to something compulsive. While moderation in eating and developing a healthy relationship to movement are important to learn in adolescence, parents need to be aware if they start to get out of control.
3. Eliminating or limiting certain food groups
Another common sign of anorexia in adolescents is gradually (or suddenly) cutting out specific foods or entire food groups. These are often items that were eaten regularly or could even have been favorite foods. We hear things like, “I don’t like that anymore,” “I want to eat clean,” or taking a hardline stance against animal cruelty by becoming vegetarian or vegan as reasons to justify anorexia-imposed food limitations.
What’s really happening is that these limitations are caused by anxiety, which leads to avoidance of “challenging foods,” or food that make someone anxious and are often calorie-dense and a reliance on “safe” foods or foods that do not cause as much anxiety and are often low-calorie.
4. “Body Image” issues
Struggling with body image is a hallmark symptom of anorexia in teens and is usually what’s fueling anxiety around food. It is a combination of an intense fear of weight gain and distortion in one’s perception of their body, also known as body dysmorphia. Sometimes, adolescents will focus on a specific part of their body such as their hips, stomach, or thighs and ‘body-check’ by pinching at their body or weighing themselves obsessively. These symptoms tend to worsen as adolescents continue to lose weight. You may hear, “All I need to do is get to my [eating disorder’s] ‘goal weight’ and then I’ll feel better.” Usually once a goal is hit, another (lower) goal is set in its place.
5. Personality changes, relational issues, poor performance at school
The examples above are many ways anorexia impacts one’s health, but it’s important to know that another sign of anorexia in adolescents is changes with temperament, concentration, and increased irritability, which can then affect relationships and performance in school.
Parents of teens with anorexia will often tell me, “It’s like they’re a completely different kid since the ED started.”
They may seem easily frustrated or even become explosive. “I feel like I have to walk on eggshells,” is something I often hear from concerned parents.
Conversations at the dinner table, once enjoyable, are now tense and involve constant arguments about food and how it’s prepared. We also see performance issues at school, however slipping grades aren’t a great indicator since many kids will continue to earn high marks. You may notice that your child is spending all of their spare time studying to keep earning good grades or complaining of concentration issues.
When warning signs of anorexia in adolescents go unchecked
An eating disorder is likely to start in adolescence and can have enduring, devastating consequences if left untreated. Early identification and yield the most effective results. Although anorexia can make parents feel powerless and hopeless, it’s important to remember that you are the key to your adolescent’s recovery.
Walden’s approach to treating adolescents with eating disorders
Walden uses evidenced-based practices to treat all eating disorders in adolescents. We incorporate key aspects of Family-Based Treatment (FBT), the most strongly supported method of care for adolescents with eating disorders, as part of our curriculum at each of level. FBT views the family as a critical resource in the treatment process.
We know finding anorexia treatment can be tough. Walden is here for you. If you are concerned that you, or a loved one, may have an eating disorder, please reach out by completing the form on this page or email us at firstname.lastname@example.org.
Kameron Mendes, LMHC, is the Program Director for the Adolescent and Young Inpatient Unit at Walden’s Center for Recovery. Mr. Mendes has worked in various roles at every level of care in the Walden continuum and maintains a small private practice. Through that work, he has gained extensive training and experience working with eating disorders at all phases of recovery. Mr. Mendes uses a strengths-based, client-centered approach while also employing Family-Based Treatment and components of Dialectical Behavior Therapy and Cognitive Behavior Therapy in his work with eating disorders. He received his master’s degree from William James College, formerly MSPP.
Otto, A K, et al. (2021) Medical Admissions Among Adolescents With Eating Disorders During the COVID-19 Pandemic. Pediatrics, DOI: 10.1542/peds.2021-052201
*This blog post does not necessarily represent the views of Walden Behavioral Care and its management. The Walden Blog is meant to represent a broad variety of opinions relating to eating disorders and their treatment.