The Truth About Eating Disorders: How Experts Say to Approach Your Teen Without Creating Shame

Being a parent is one of the toughest jobs in the world. The urge to protect your child is always at the forefront of everything you do. It's natural to want to shield them from things beyond their control, which often means difficult conversations. And conversations about their health, body image, and overall self-worth are some of the most challenging to navigate.

The sad reality is that eating disorders are more common than many parents realize. It's estimated that 28.8 to 30 million people will have an eating disorder in their lifetime. While this accounts for only about 9% of the population, teens and young adults are the largest demographic. It hits close to home for many, and the fear a parent feels knowing this can't be understated.

Shame is a common emotion surrounding teens and their bodies, and talking about this can be uncomfortable. To end the stigma, we speak with Francesca Emma, LMHC-D and Eating Disorder Specialist, who has spent more than 15 years helping families.

What Do Eating Disorders Look Like?

Eating disorders are not one-size-fits-all. They vary from case to case and look different depending on a teen's thoughts and feelings about themselves and food. The most commonly known eating disorders are anorexia and bulimia, but modern psychology now recognizes several other categories. Eating disorders include:

• Anorexia Nervosa: Using food avoidance and/or excessive exercise to control body weight.
• Bulimia: Purging food to lose or control weight.
• Binge-Eating Disorder: Overeating past the point of fullness.
• Other Specified Feeding or Eating Disorder (OSFED): Atypical anorexia, inconsistent bulimia, purging disorder, night eating syndrome, or another form of food restriction that does not fit typical eating disorder categories.
• Avoidant/Restrictive Food Intake Disorder (ARFID): Avoiding, restricting, or limiting certain foods.

Learning the signs of these can be scary, but this information is all necessary for parents who suspect an eating disorder. Knowledge is power, and the more a parent is armed, the better they can navigate uncomfortable conversations. While the most obvious signs of an eating disorder are sudden changes in weight or appearance, this can also vary from person to person. Symptoms of an eating disorder could be emotional or physical, and we speak with Emma to learn more.

What Are the Early Signs of an Eating Disorder?

It's essential to look out for the most common eating disorder symptoms, which include:

• Dramatic weight loss
• Skipping meals
• Overeating or excessive food portions
• Eating too quickly
• Excessive trips to the bathroom
• Food avoidance or not eating in social settings
• Exercising to the point of exhaustion
• Changes in appearance or clothing choice (i.e., wearing baggier clothes)
• Eating too slowly or not at all

In addition, Emma shares signs that parents might not realize are indicative of an issue. “Noticing physical changes often comes after some of the earlier signs. These include overcuriosity about food, increased comments regarding the body of self or others, dressing in baggy clothes, beginning to eat more meals alone, or opting out of social plans, moving food around the dish without actually finishing meals, bathroom use during meals, cutting out specific food groups, and labeling foods as healthy and unhealthy,” she says.

She also adds that sudden shifts in the foods that they normally love can be another symptom. For example, not eating their favorite takeout, skipping dessert, or skipping other meals altogether. Aside from physical changes, emotional changes such as irritability, isolation, difficulty focusing, severe anxiety, and drastic changes in habits can also be red flags.

The Cause of Eating Disorders Often Is Not About the Food

Emma shares that it's important for parents to know that eating disorders are not really about the food most of the time. “I explain [eating disorders] as a maladaptive coping skill, a bad way to cope with whatever is going on, and so the true work goes beyond what they are or are not eating, but how to manage stressors without using food/body as a means,” she says. Knowing this, parents can start examining what might be triggering their teens.

We asked Emma about the most common causes of eating disorders, and she explained that the answer is complex. “I think it's a combination of a lot of things. Home environments where children have been modeled poor body image are definitely a huge trigger. It is almost always done unconsciously, but parents who tend to make comments about their own bodies or constantly prioritize dieting are modeling a silent norm that children then carry with them,” she says.

“Social media is also another HUGE factor, especially these days with AI, filters, and a recurrence of the ‘skinny being in trend.' Children are constantly comparing themselves and feeling less than.”

While social media is a significant cause of low self-esteem among teens, parents can be a counteractive force. Emma shares that being mindful is often all it takes to reassure and build your teen's confidence. She says, “Stop saying things like ‘I am so fat,' ‘I can't eat that donut,' ‘I need to work out,' or ‘I ate like crap.' Even if you are saying it on the phone to a friend, children hear you. Model food-neutral and body-neutral language and eat meals together!”

Emma adds how critical being mindful is. “Most parents say they were not even aware of how their own stuff could affect their children. NO parent is perfect or expected to be, but increased awareness allows us to be accountable and make conscious efforts to improve our own self-talk and, in turn, our children's.”

How Can Parents Be Proactive About Their Teen's Body Image?

Similar to how eating disorders vary case by case, there's also no one-size-fits-all way for parents to address their concerns. There's always room to be proactive, especially when it comes to the language a parent uses with their teen. When asked about boosting confidence rather than adding to the shame a teen might already feel, Emma says reshaping your focus is key.

“Making sure to compliment children on their characteristics rather than their appearance is a big one!” she says. “We want to encourage them by teaching them that their personality characteristics are what matter. So before you say ‘you are so beautiful,' start by saying, ‘you are so funny, kind, empathetic, etcetera.' This can start young, so they learn to believe that their appearance is not the most interesting thing about themselves. They can then value themselves through a personality lens.”

Start Those Hard Conversations By Doing This

If being proactive and supporting your teen's self-worth beyond body image doesn't work, it's time for a serious conversation. Therapy and professional medical guidance are essential, but parents can also navigate this conversation at home. Many teens struggle with body dysmorphia and view themselves in an inaccurate or negative light. This can eventually lead to eating disorders or other negative beliefs, and Emma says it's crucial for parents to do one thing: Validate.

“We often try to cover things up and try to make it better, but if your child is coming to you with these thoughts, they are sharing something vulnerable,” she says. “Always start with validating comments like, ‘that is so hard, I'm sorry you are feeling that way right now, I have felt that before, too,' ‘it's not easy,' and so on.”

“Once you validate, you have to get curious about things like, is something else going on that might be making you feel bad? How often do you feel like this? When did this start? Open communication and curiosity allow our children to know we are their safe space and encourage them to listen to our support.”

What to Do If Your Teen Does Have An Eating Disorder

Let's say you've had the tough conversations and can now confirm that your teen is struggling with an eating disorder. The first step, according to Emma, is education. “It is such a hard concept to understand. I list a number of resources on my website, but Life without ED by Jenni Schaeffer is a great tool for both teens and parents to help bridge the gap in understanding. I also always suggest looking for external support from a therapist and a nutritionist.”

She also adds that sometimes, too much control from a parent can actually be a negative thing. “When a parent tries to handle it on their own, they end up being the ‘food police,' and it becomes a bad dynamic. The goal is to be there to support the child as they navigate the ins and outs with a professional. There are also free support groups online for parents, and I find that this is extremely helpful in gaining understanding. I always encourage these as well.”

The image featured at the top of this post is ©Brian / Getty Images