How to recognise early signs of an eating disorder

It’s not always easy to spot the first signs of an eating disorder, but early identification and intervention can help to reduce its severity and duration. There are some indicators that can help you to recognise if your teen needs support.

This can help if:

• you’ve noticed a change in your teen’s eating habits and relationship to food

• you’re worried your teen has an eating disorder 

• you want to feel more prepared as your teen goes through adolescence. 

What is the difference between an eating disorder and disordered eating?

To be able to recognise the early signs of an eating disorder, it’s important to understand that an eating disorder is different from disordered eating.

Eating disorders are considered a mental illness that can be potentially life threatening, while the term ‘disordered eating’ refers to behaviours that are associated with eating disorders. It’s also helpful to keep in mind that not everyone who displays one or more of these behaviours has an eating disorder.

Disordered eating symptoms 

Symptoms of disordered eating include:

• fasting or skipping meals

• binge eating

• restrictive diets

• avoiding particular foods or food groups

• self-induced vomiting

• misusing laxatives, enemas or diuretics

• using diet pills, steroids or creatine.

If your teen is showing signs of disordered eating, it doesn't necessarily mean they will develop an eating disorder. But it’s still serious and harmful to their health and wellbeing and requires attention. Teens with disordered eating habits can often feel guilt and a sense of failure from cycles of binge eating, breaking a diet or gaining weight. These feelings can also lead to social isolation, where they avoid situations involving food, and may contribute to feelings of low self-esteem or emotional distress. 

Disordered eating behaviours can contribute to serious short- or longer-term health issues. Dieting is one of the most common forms of disordered eating, but severely restricting food intake can be dangerous or even fatal. Starvation, when the body and brain aren't getting enough nutrients to function properly, can cause a wide range of health problems, including death in serious cases. 

It's important to take these signs seriously if you notice them, but also to keep an open mind about what's going on for your teen.

What are the early signs of an eating disorder in a young person?

There are a range of risk factors associated with the development of an eating disorder, including genetic, psychological and sociocultural factors. Nearly one-third (27%) of people with an eating disorder are aged 19 years or younger. Early intervention can mean a quicker recovery journey and more positive outcomes over the long term. 

Because some of the behaviours that are symptomatic of eating disorders could also indicate other physical or mental health conditions, such as anxiety, it’s important not to draw immediate conclusions. If you notice one or more of the following signs, consider speaking to a health professional to better understand what could be going on for your teen.

Common early signs of eating disorders include:

• unusual behaviours, such as dieting, controlling portion size, or using the bathroom during or after meals

• avoidance of certain food groups or of eating in front of others

• obsessive behaviours when eating, such as cutting food into small pieces, wanting to eat at the same time every day, or eating very slowly

• focusing more on weight, or being sensitive to comments about weight 

• suddenly talking more about healthy/unhealthy food or being sensitive to comments about food

• excessive exercising, or experiencing distress when unable to exercise

• not sleeping well, or regularly having lower energy than is usual for them

• changing the way they dress, such as wearing baggy clothes to hide their body shape and size.

How to talk to your teen if you suspect they have an eating disorder

It’s normal to feel nervous about talking to your teen if you suspect they have an eating disorder. You don’t want to seem too nosy or confronting, but you do want to address the behaviours you’ve noticed in case  your teen is at risk. These conversations can be really hard for both of you to navigate, and your teen may react in ways that you aren’t prepared for. 

One of the most important things to remember when talking to your teen if you suspect they have an eating disorder is to really listen to them and to reassure them that you’re here to support them. Avoid trying to force them to change their food habits before they’re ready to do so. They can find this distressing and it could make the situation worse. It can be helpful to chat with a professional to prepare for talking to your teen. Here are some other things to consider as you prepare to talk to your teen.

Create a plan for the conversation. Think about what you’ll say and how you’ll respond to different scenarios that might occur. You can even practise what you’re going to say, to take the edge off any nerves.

Choose your setting. Pick a place that is safe and private, and where both you and your teen feel comfortable. Choose a time when neither of you has to rush off to do other things.

Focus on showing empathy. Try to understand your teen’s perspectives and habits. 

Try not to stigmatise them. Use ‘I’ statements, rather than ‘you’ statements. For example,  instead of saying, ‘You don’t finish your meals anymore’, try: ‘I’ve noticed that we’re throwing away more food after meals than usual.

Shift the focus away from food. Focus instead on behaviours you’ve noticed. For example: ‘I’ve noticed that we haven’t seen you much in the evenings lately. Is everything okay?’ 

Steer clear of commenting on their appearance. Whether it’s a positive or negative comment, don’t draw attention to their appearance. It might be a very sensitive topic for your teen and could reinforce disordered thinking or behaviours.

Ask open-ended questions. Don’t assume that your teen has an eating disorder. This conversation is an opportunity for you to learn more about what’s going on for them, not to diagnose them.

Practise active listening when your teen speaks. Remain open-minded about what’s going on for them, despite any assumptions you may have.

Respect and validate their experiences. Even if you have other thoughts or opinions, now isn’t the time to bring them up. It’s important to reassure your teen that you accept that what they’re feeling and experiencing is true for them.

Reassure them that you care. Demonstrate that you’re willing to listen and want to help them through any challenges they’re experiencing. This could be with words and with actions, such as showing that you respect their boundaries.

To get some more ideas on how to approach this conversation, you can watch this video of parents and teens who have recovered from eating disorders talking about what worked for them. If you’re concerned that your teen has an eating disorder and you need more support with deciding how to approach them, call the Butterfly National Helpline. This service provides specialised, free and confidential support for loved ones and carers, as well as for anyone experiencing an eating disorder or related concerns.

How to help someone with an eating disorder

Even after you notice the signs of an eating disorder in your teen and have had conversations with them about your concerns, it’s important to speak to a medical professional who is trained in treating eating disorders.

You can talk to a medical professional on your own, and with your teen if they consent. A GP or other health professional can provide early support options for your immediate concerns, while guiding you to find additional support depending on your teen’s recovery journey. You can also check out the Butterfly Foundation’s database to locate a professional near you who is experienced in treating eating disorders.

Helping your teen can look like the following:

• Be aware of the early signs of an eating disorder.

• Have conversations with your teen in an open and non-judgmental way.

• Ask your teen how they want to be supported, to avoid any misunderstandings.

• Respect your teen’s experience and boundaries.

• Acknowledge and understand the link between mental health and eating disorders.

• Accept that your teen might experience symptoms of an eating disorder or disordered eating again in the future, and support them if that happens.

• Book in to see relevant health professionals for guidance and treatment.

• Accompany your teen to appointments, with their consent.

• Implement any recommendations to support your teen’s recovery journey.

• Research to understand more about eating disorders.

• Role model a healthy relationship with food, body acceptance and self-esteem that is based on a variety of qualities and characteristics other than appearance.

• Talk openly as a family about social media and help your teen to take steps to mitigate its harmful effects, like developing media literacy and curating their social media feeds.

As a parent or caregiver, it might be tempting to blame yourself or to try and fix what you perceive as a problem, but that’s not a very helpful place to start. Instead, focus on getting your teen the kind of support they need and on reassuring them that they’re loved, accepted and safe. 

Caring for someone with an eating disorder is complex. Be sure to take care of yourself so that you can show up for your teen without burning out. This can include doing things like prioritising time for your own self-care and mental health support.