Chances are you’ve known someone with an eating disorder, whether you were aware or not. About 1 in 10 people in the U.S. has an eating disorder, and since the start of the COVID-19 pandemic, those numbers have increased. The National Eating Disorders Association estimates nearly 29 million Americans will suffer from an eating disorder at some point in their lives.
It’s important to know how to offer help to someone with an eating disorder. If these mental and physical health conditions are not treated properly, they can lead to long-term health problems. Laura Kester Prakash, an adolescent medicine physician at UC Davis Children’s Hospital, offers advice for anyone who may believe someone they know may have an eating disorder.
What is an eating disorder?
Eating disorders are serious, life-threatening conditions. If not properly treated, eating disorders can lead to major short- and long-term complications. People can develop eating disorders because of genetic, physical, mental, and social factors.
There are three common eating disorders:
Anorexia nervosa (typically called anorexia)
Anorexia involves people who have a lower body weight than is normal for their age and height. Many people with anorexia have an intense fear of gaining weight and a distorted body image.
Bulimia nervosa (typically called bulimia)
Bulimia involves eating a large amount of food (binge) and then making up for what they ate soon after. This is often done by causing oneself to vomit, take laxatives, or excessively exercise.
People with this binge-eating disorder eat a lot of food at one time (binge). The American Psychiatric Association says people with binge-eating disorder often feel they don’t have control and will binge at least once a week for three months.
How are eating disorders identified?
The diagnosis of an eating disorder is based on identifying an energy imbalance. A person experiences energy deficiency when the energy needed for their development and physical activity is more than what they eat.
However, eating disorders can involve more than nutrition. They can also include excessive exercise and improper use of medications that can affect a person’s metabolism. Over time, if eating disorders persist, they can result in substantial harm to a person’s physical, biological, and social health and functioning.
What are the signs and symptoms of an eating disorder?
There is a spectrum of eating disorders. This means that a person with one type of eating disorder behavior can evolve or change to other eating disorder behaviors over time. Signs and symptoms of an eating disorder include:
- Introduction of strict “healthier” dietary changes to lose weight. This could include switching to vegetarian, vegan, or low-fat diets that result in a large decrease in nutritional intake.
- Paying very close attention to ingredient labels.
- Starting precise calorie counting.
- Weighing oneself several times a day.
- Eating smaller portions or taking a long time to eat. These behaviors may start in unobserved places like school before they happen at home or with family around.
- Secretive eating behaviors. These can include hiding food during social meals or not eating around family or friends.
- Exercising too much.
- Going to the bathroom numerous times after meals.
- Wearing multiple layers of clothes or changing the style of clothing.
How common are eating disorders?
Historically, about 10% of the general population suffers from some type of eating disorder over their lifetime. However, during the COVID-19 pandemic, hospitals across the country saw a large uptick in the number of patients with eating disorders.
In addition, physicians have seen patients with eating disorder behaviors as young as 12 years old. Unfortunately, only a small number of patients with eating disorders will be identified or seek treatment. Children and young people with eating disorders who go untreated can become adults with chronic and disabling eating-related medical problems. Those issues can be life-threatening.
What are the risk factors for an eating disorder?
There are a variety of risk factors for eating disorders. They include:
- Being a female
- Being age 15-19 (Some studies show a much younger onset for eating disorders.)
- Having a family history of an eating disorder
- Having previously dieted or shown concerns about weight
- Having a history of other mental health concerns, like anxiety and obsessive-compulsive disorder (OCD)
- Knowing a family member is trying to diet or lose weight
- Going through a transition such as changing schools or moving to a new house
- Participating in elite or individual sports (Team sports tend to be more protective.)
- Needing to have everything perfect
- Struggling with coping skills (Better developed coping skills can be protective.)
- Differing from peers, particularly early in life
- Using food-tracking apps that place a large focus on calorie counting
- Feeling neglected, having overprotective relationships, family conflict, or lots of conversations about weight or shape
Supportive and close relationships can help prevent eating disorders.
What should parents look for if they believe their child has an eating disorder?
For parents of teenagers, eating disorders can often be hard to recognize because many teens can have unusual eating patterns. Parents should look for abnormal eating habits, including:
- missed or skipped meals
- excessive eating, whether consistently or every once in a while
- becoming sick after eating
- not eating certain types of food or food groups
What should parents do if they think their child has an eating disorder?
If you suspect that your child has an eating disorder, talk with them in a non-judgmental and supportive way. Avoid specific questions that introduce ideas or ways to have an eating disorder.
Questions that you can ask include:
- How do you feel about your weight, body shape or body size?
- Does your weight affect the way you feel about yourself?
- Are you worried that you are overweight or in danger of becoming overweight?
- Are you doing anything to try to change your body shape?
Eating disorders are best addressed, diagnosed, and treated by medical professionals experienced with these conditions.
If you have a concern or suspicion that your child has an eating disorder, bring your child to their primary care provider to be evaluated. Specialists can also provide additional evaluation and medical treatment and support.
Additionally, the National Eating Disorders Association has resources for parents.
The UC Davis Adolescent and Young Adult Clinic for Eating Disorders and Nutritional Imbalances evaluates, diagnoses and treats children and adolescents suffering from an eating disorder. The team works to ensure that patients and their families have the tools they need for a successful recovery.