Eating Disorders in Children and Teenagers: A Parent Guide to Recognition and Support

Understanding Eating Disorders in Young People

Eating disorders are serious mental health conditions that affect a person relationship with food, body image, and eating behaviour. They are not a lifestyle choice, a phase, or vanity. They are complex conditions with psychological, biological, and social dimensions, and they carry significant health risks, including the highest mortality rate of any mental health condition.

Contrary to persistent stereotypes, eating disorders affect people of all genders, body sizes, ethnicities, ages, and backgrounds. While the most well-known disorders, anorexia nervosa and bulimia nervosa, are more commonly diagnosed in teenage girls and young women, they also affect boys and men, younger children, and people across the gender spectrum. Boys and males in particular are significantly underdiagnosed, partly because eating disorders are perceived as a female issue.

Early identification and intervention are critical. Outcomes are substantially better when eating disorders are identified and treated early, before the behaviours become entrenched and the physical consequences become severe.

Types of Eating Disorders

Anorexia Nervosa

Anorexia is characterised by severe restriction of food intake driven by an intense fear of weight gain and a distorted perception of one body. A person with anorexia may believe themselves to be overweight when they are dangerously underweight. Physical consequences include malnutrition, bone density loss, hormonal disruption, heart problems, and in severe cases, organ failure.

Bulimia Nervosa

Bulimia involves cycles of binge eating followed by purging behaviours such as self-induced vomiting, excessive exercise, laxative use, or fasting. Unlike anorexia, people with bulimia may be of average or above-average weight, making it harder to identify visually. Physical consequences include damage to teeth from stomach acid, electrolyte imbalances, and gastrointestinal problems.

Binge Eating Disorder

Binge eating disorder involves recurrent episodes of eating large amounts of food in a short period, often in secret, accompanied by a sense of loss of control and significant distress. It is not followed by purging behaviours. It is the most common eating disorder in many countries and is significantly underdiagnosed.

ARFID (Avoidant/Restrictive Food Intake Disorder)

ARFID involves extreme selectivity about food driven by sensory sensitivity, fear of choking, or aversion to certain textures, colours, or types of food rather than by concerns about weight or body image. It is more common in younger children and in autistic individuals. ARFID can result in nutritional deficiencies if the range of accepted foods is very limited.

Warning Signs of Eating Disorders

These signs, particularly in combination and when they represent a change from previous behaviour, warrant attention:

• Significant changes in eating behaviour: skipping meals, cutting out entire food groups, eating much less than usual
• Preoccupation with food, calories, weight, or body shape
• Comments about being fat or needing to lose weight, particularly in a child who is clearly not overweight
• Negative comments about specific body parts with unusual intensity
• Wearing loose clothing to hide body shape
• Disappearing to the bathroom immediately after meals
• Evidence of laxative or diet pill use
• Eating secretly, hiding food, or denying having eaten when they have not
• Excessive or compulsive exercise, particularly when injured or unwell
• Physical signs: feeling cold all the time, hair loss, dizziness, fainting, swollen cheeks (a sign of purging), dental erosion
• Social withdrawal, particularly around food: avoiding meals with family, declining social events involving food

Social Media and Body Image

Research increasingly links heavy social media use, particularly exposure to appearance-focused content, with negative body image and disordered eating in young people. Fitspiration, thinspo content, extreme diet culture, and algorithm-driven exposure to idealised and often manipulated bodies create a constant source of unrealistic comparison for adolescents. This does not mean social media causes eating disorders, but for vulnerable young people it can be a significant contributing factor.

Talk with your teenager about the constructed nature of images online and help them develop a critical eye for content that makes them feel worse about their body. Monitoring which accounts they follow and supporting breaks from social media can also be protective.

How to Talk to Your Child

Starting the conversation is often the hardest part. Some guidance:

• Focus on behaviours and emotions rather than weight or appearance. Say I have noticed you seem really anxious around mealtimes lately and I am worried about you rather than you are not eating enough.
• Choose a calm, private moment, not during or immediately after a meal.
• Be prepared for denial. Most people with eating disorders are not ready to admit it, often because the disorder itself distorts their perception. Stay calm and keep the door open for future conversations.
• Express love and concern without ultimatums or threats.
• Do not make comments about weight, body shape, or food choices, for your child or yourself. Modelling a healthy, relaxed relationship with food and your own body is one of the most protective things you can do.

Seeking Professional Help

If you are concerned that your child may have an eating disorder, seek professional help promptly. Start with your family doctor or GP, who can carry out an initial assessment including physical checks and make a referral to specialist eating disorder services. Do not wait to see if it gets better on its own: eating disorders can deteriorate quickly and early intervention genuinely improves outcomes.

Be persistent. Waiting times for specialist services can be long in many countries. In the interim, keep in close contact with your family doctor and look for voluntary or charity-run support services in your country that can provide guidance and support while you wait for specialist appointments.