Kathy’s parents were sitting in my office, shocked and devastated. Kathy had just been released from a two-week stay at a hospital two days before, where she had been sent to regain weight. Her pediatrician saw some warning signs had sent her there due to her elevated risk of heart failure as a result of her sudden weight loss.
Although she had been healthy all her life, she was facing major medical complications as the result of recent changes in her weight and eating habits. Her doctor discharged her from the hospital on the condition that she start intensive psychotherapy and that her weight be monitored on a weekly basis by her pediatrician.
Her parents were paralyzed by confusion. Kathy always set high standards for herself and excelled in all aspects of her life. Shortly after her fourteenth birthday, she joined her family on a mission to eat healthier. The entire family went on a diet in order to kick-start their new healthy lifestyle. Though Kathy’s sister and her parents returned to their normal eating patterns, Kathy decided to continue with her diet. She started skipping breakfast and went running every day after school for two hours.
Although Kathy lost 30 pounds in four months, Kathy’s mother didn’t suspect anything. Kathy said her new eating habits were part of the healthy lifestyle she was trying to adopt. Her mother was in denial about Kathy’s eating disorder until her pediatrician hospitalized her.
In my practice I have worked with many educated, well-rounded parents that were simply blindsided by their teens’ eating disorders. It can be difficult to spot an eating disorder, as most teenagers suffering with one do not want help. They often deny or underplay their symptoms. Lack of awareness of the presence of the disorder can delay treatment and may have life-threatening consequences. It is essential for parents to be conscious of the symptoms of eating disorders in order to prevent serious problems from occurring.
Below you will find some symptoms that can be indicators of eating disorders and/or disordered eating behaviors.
Skipping Meals and/or Fasting
Many teenagers begin on the path of eating disorders through dieting or fasting. Unfortunately, dieting can be an unhealthy eating pattern. Although not everyone who diets has an eating disorder, dieting is a risk factor for developing eating disorders among teens with genetic and environmental vulnerabilities. It is important to be mindful of your teen’s eating habits and discourage him or her from any diet talk. Although your teen may claim to eat lunch at school, you may hear otherwise from his or his friends and/or teachers. It is important to take such feedback seriously and follow up by taking appropriate action.
Many teens use unhealthy weight-control strategies to control their weight. Since they often experience guilt and shame about these behaviors, they may hide them from their parents. For this reason, it is important to be attentive to possible secretive behaviors, such as disappearing to the bathroom after each meal, and any evidence of laxative use. It is not always obvious that a teen is engaging in such behaviors, but several parents that I have worked with have found vomit residue in the bathroom or containers of vomit underneath the bed.
Refusal to Eat Non-Diet Food
We live in a culture that bombards our teens with messages about dieting and the importance of having “a beach body.” Combined with peer pressure at school, many teens become preoccupied with their food intake. Although it is normal to have food preferences, teens with eating disorders often become rigid about their food intake. In many cases, unless their parents provide them with a specific diet food, they may refuse to eat. For example, one of my clients ate the same frozen dinner for eight months, since she knew exactly how many calories were in it. It is important for parents not to give into these requests, so that diverse, healthy eating patterns can be fostered.
Although these warning signs are common symptoms of many eating disorders, an individual’s presentation may differ based on the stage of their development and their specific disorder. If you suspect an eating disorder or disordered eating behaviors, it is important to talk to your partner or spouse about it and book a consultation with an eating disorder specialist. Eating disorders are a serious, life-threatening condition, and early intervention is the key to successful recovery.
Dr. Nazanin Moali, Ph.D. is a clinical psychologist. She uses Family Based Treatment (Maudsely Approach) to effectively treat adolescents with eating disorders. Dr. Moali completed an APA-accredited postdoctoral fellowship at Kaiser Permanete where she received extensive supervision in providing psychotherapy to this population. She currently owns the Oasis 2 Care practice, in Torrance, California.