The Guidance Center is shining a spotlight on eating disorders in this month’s blog as part of National Eating Disorders Awareness Week. It is our hope that by joining this conversation, we can raise awareness, dispel myths and misunderstandings and promote compassion for those impacted by eating disorders.
What are eating disorders?
Eating disorders are characterized by severe disturbances in eating behaviors as a result of preoccupation with food, weight and body size and shape. The most common, diagnosable eating disorders are: Anorexia Nervosa, Bulimia Nervosa and Binge-Eating Disorder. However, it is just as important to be aware of eating habits, exercise behaviors and body ideals that do not meet full diagnostic criteria. These symptoms can be just as impairing and often lead to a greater risk of developing a diagnosable eating disorder later on. Early detection of symptoms and engagement in treatment significantly improve the chances of recovery from an eating disorder.
The following are general descriptions of the most common eating disorders:
Anorexia Nervosa: Restricting or severely limiting food intake that leads to a body weight that is significantly lower than is expected, and an intense fear of gaining weight or being overweight.
Bulimia Nervosa: Eating a large amount of food (more than most people) in one sitting, feeling out of control while eating and continually using behaviors that prevent weight gain (vomiting, laxatives, exercise, fasting).
Binge-Eating: Eating a large amount of food (more than most people) in one sitting, feeling out of control over food and eating and engaging in eating that is rapid and causes uncomfortable fullness, embarrassment or leads to guilt or disgust.
Who do eating disorders typically affect?
Children and adolescents, particularly those in junior high and high school, are at the greatest risk for developing eating disorders. It is estimated that 90 percent of those who have eating disorders are between the ages of 12 and 25 (SAMHSA). Adolescence is a challenging time; there is an increased desire for acceptance from friends and peers, teens become more aware of how they compare to others their age and, with the onset of puberty, there are a number of physical changes (weight gain, breast development, acne, hair growth, etc.).
Eating Disorders do not discriminate against gender, sexual orientation, cultural background, socioeconomic status or age. There is a common misconception that eating disorders primarily impact affluent, Caucasian females. However, People of Color, LGBTQ individuals, males and athletes are also at-risk groups due to factors such as chronic environmental stressors, acculturation, stigma, a focus on physical shape and barriers to seeking treatment.
What are some signs and symptoms of eating disorders?
Warning signs are more immediate signs of concern and may indicate the need for follow up with a physician or mental health provider. Common signs of an eating disorder include:
- Changes in weight (both increases and decreases)
- Frequent complaints of being dizzy or lightheaded
- Feeling cold frequently
- Cuts, redness or scarring on the tops of fingers (from induced vomiting)
- Recent dental issues
- Thinning hair and nails
- Facial swelling around mouth and jaw
- Frequently sick/poor immune functioning
- For girls: missing or stopping periods/menstrual cycles
Emotions and Behaviors
- Increased concerns or attitudes about dieting, losing weight or controlling food/eating
- Extreme concerns about body size and weight
- Changes in mood (anger, depression, anxiety)
- Cutting out entire food groups (no sugar, no carbs, no dairy) or constant dieting
- Strict eating practices (food cannot touch, excessive chewing, cutting food into small pieces)
- Skipping meals or only eating small portions at meals
- Frequent bathroom use immediately following meals
- Spending less time with friends and family
- Victim of bullying or weight teasing
- Eating alone or appearing uncomfortable while eating with others
Risk factors are unchangeable features that increase a person’s risk for developing an eating disorder. For children and teens, these include being female, having a close relative with an eating disorder, perfectionism or unrealistic expectations for self, acculturation, limited social support and a history of trauma or abuse.
Protective factors are features of the individual or their environment that can reduce the effects of stress and risk of developing an eating disorder such as: family connectedness, parental support, social supports, parental conversations around healthy eating and positive self-esteem.
What should I do if I have concerns about a child or teen?
Children and teens with eating disorders may demonstrate several symptoms that were noted above, but their behaviors might also look different. It is also important to know that even if a child has one or a few symptoms, they may not have an eating disorder. If there are concerns about a child or teen, it is important for parents to speak with their pediatrician. Physicians can refer children to a psychologist, nutritionist, psychiatrist or other specialists who can assess for eating disorders and provide appropriate treatment options.
How can parents, educators and providers help prevent eating disorders in children and teens?
Modeling behaviors and language that promote wellness, positivity and inclusion is important for all children and teens. Some strategies to create supportive environments for children and teens include:
- Avoid use of body or food shaming language (labeling food as good or bad, using words such as fat or skinny to describe bodies, promoting “dieting”)
- Offer praise and acknowledgement of characteristics or attributes that are not related to physical appearance
- Encourage “balanced” meals and snacks, exercise and sleep as important aspects of health and wellness
- Eat together as a family whenever possible as this encourages healthy food choices, promotes sharing and bonding, and provides an opportunity to model appropriate food behaviors
- Monitor social media exposure and have open conversations about unrealistic photos and body expectations
- Promote size diversity and body positivity
- Model gratefulness for body functions and health
- Providers, schools and agencies can feature diverse bodies in photos, brochures and advertisements
- Discourage or re-frame comments by children and teens that are body shaming to self or others
Where can I get more information about eating disorders?
- National Eating Disorder Association (NEDA)
- National Institute of Mental Health (NIMH)
- International Association of Eating Disorders Professionals
- Contact your child’s pediatrician if you have concerns or would like additional support
- Contact your insurance provider or dial 2-1-1 for LA County mental health resources
Brittany Jondle, Psy.D., is a Licensed Psychologist in The Guidance Center’s The Whole Child Program where she helps address the emotional and behavioral needs of children and families with complex medical conditions. She is especially passionate about mental health advocacy and the provision of integrated care for children and teens. Before joining The Guidance Center team in 2017, Dr. Jondle worked as a Postdoctoral Fellow in the Division of Adolescent and Young Adult Medicine at Children’s Hospital Los Angeles. Dr. Jondle earned a Doctorate in Clinical Psychology at Azusa Pacific University.