My daughter's* eating doesn't seem normal. How do I know when to get help?

A lot of teenagers experiment with weight loss, dieting, excessive exercise and other non-healthy weight related behaviors, so how do I know when it’s become a problem. At what point do I step in and at what point do I need professional help?

These are really important questions, because these types of behaviors are so common. While actually having a diagnose-able eating disorders is rare, but rising in incidence, disordered eating is rampant, especially in this age group (roughly ages 13-20).

What is disordered eating? It’s a way of eating that resembles the symptoms of eating disorders but doesn’t meet all criteria to be officially diagnosed as an eating disorder. It is fairly common for teenagers especially to exhibit some symptoms of disordered eating, but once your teenager is exhibiting even just one, that is a sign to YOU to be on alert. It’s so important to try to “catch it” while it’s still symptomatic but not an eating disorder, because people with eating disorders, unlike other illnesses, are not incentivized to get better. They would like their life to return to “normal,” but they don’t want to stop the behaviors, whether that is starving themselves, purging, using laxatives, etc., and they will lie and do whatever it takes to keep doing them.

There are many different type of symptoms of disordered eating, and if your child displays any, you are in good company, but if you notice too many of these or they seem like they are getting extreme, that’s when I would get some professional help or make sure you are talking to your child and trying to assess the situation so that the symptoms don’t get more severe or multiply.

Symptoms of disordered eating:That might mean, occasionally binging on food (eating vast quantities of food in a short time period, until the point where you feel sick). It might mean severely dieting: switching to a vegan diet, eating super healthy all the time, avoiding gluten without being allergic, intermittent fasting or any of other trendy diet you hear about. Again, it doesn’t mean that your child is developing an eating disorder just because he/she is doing any of these things, but it does mean that these behaviors should raise a red flag in your mind, and you should begin to pay close attention to their eating/restricting behaviors.

Another thing to look out for is excessive exercise. Exercise is extremely healthy and I recommend it to all my clients. It raises your endorphins and it’s healthy to move your body. But at what point does it become excessive? What if your child is an athlete and they train for 4 hours a day? Of course that makes perfect sense, but it’s still a red flag. Athletes are more statistically prone to developing eating disorders, so if this is the case, you should be on alert. But if they are not training for anything in particular, and just want to lose weight, how much is too much? Sometimes in these instances the best thing to do is get a feel for their motivation. Are they making up for all the guilty-pleasure eating they just did? (In which case this is a type of purging). Are they feeling “disgusted” with how they look and are trying to make a change? Try to understand their motivation and that may help you determine whether it’s psychologically healthy or not.

Another indication is how they eat: If you notice that your child is hardly eating at family meals or doesn’t want to go out to eat, that should raise a red flag. If your child is picking at her food, or moving food around the plate without eating it, that should raise a red flag. If your child has developed a sudden interest in feeding everyone in the family, and is becoming obsessed with food, that should raise a red flag. If you notice a lot of food wrappers, or a lot of food missing from the pantry or fridge, if your child is spending too long in the bathroom, especially after meals, that should raise a red flag.

Drastic weight gain or loss: If you notice serious weight fluctuation, that should raise a red flag. Again, it doesn’t mean she has an eating disorder but you should investigate weight gain or weight loss. Both are delicate, but weight gain, even a significant amount during puberty is very normal. Girl’s bodies are transitioning to a woman’s body that needs to be able to carry children, and weight gain is often a necessary component of that process. Its natural to carry extra fat. But that change is often uncomfortable for many girls. It’s a huge adjustment to their self-image, and it affects the way other people relate to them. Your job is to notice and be there for them during this time, and if you are concerned, ask a professional eating disorder specialist on your own first. Sometimes a doctor's visit at this time, with a doctor recommending weight loss, can be detrimental, so proceed with caution when/if you take this step.

Behavioral Changes: Lastly, is she spending less time with family and friends, and does she seem withdrawn? These are also red flags for more than just eating disorders,

Most importantly, often eating disorders have a genetic component to them, so if you are worried about your child, it is possible that some of these red flag items described you. If that is the case you need to get yourself some help first, because while we love our children and truly want the best for them, sometimes our limiting beliefs about weight and attractiveness can affect our children’s views and this can be very damaging.

And I always recommend that parents try to impact their daughter's body image for the positive. See below, I have included some very helpful article on how to do that.

For gentle advice on how mother's can improve their daughter's body image - https://www.healthyimagetherapy.com/post/how-mothers-can-improve-their-daughter-s-body-image

For gentle advice on how father's can improve their daughter's body image - https://www.healthyimagetherapy.com/post/how-dads-can-encourage-their-daughters-healthy-body-image

* daughter here can be interchanged with son, but for the purpose of ubiquity and simplicity, I wrote this article using the female.