Eating Disorders and Adolescence

Back to School Can Trigger Eating Disorders

Back to school means new classes, new clothes and new friends. While a fresh start can be exciting, all of that change can also cause stress, anxiety and self-doubt.

“The start of the school year is a time of transition. Kids are adjusting to new teachers, schedules and peers,” says Dena Cabrera, Psy.D., CEDS, clinical director of Rosewood Centers for Eating Disorders. “The stress of having to perform, measure up, be graded and fit in can be difficult, and this can lead some young people to turn to unhealthy and dangerous behaviors as a way to cope.”

Those behaviors may include an urge to restrict food intake, purge or engage in other behaviors symptomatic of anorexia, bulimia or binge eating disorder. Parents and teachers of children beginning middle school, high school or college this fall should be especially vigilant for early signs of eating disorders.

Eating Disorders During Adolescence

The teen years are a time of significant upheaval. Social pressure, academic demands and relationship worries, along with major changes in the body and brain development, can all contribute to emotional ups and downs and internal turmoil.

The teen years can also create a perfect storm for eating disorders. A 2012 study in the Journal of Nursing found that significant life changes, including changing schools and moving, were associated with the onset of eating disorders. (The study, which included interviews with adults who had been treated for eating disorders, also found that relationship break ups, family problems, the death of a loved one, illness or hospitalization and abuse, combined with a lack of support afterward, were also eating disorder triggers.)

While periods of transition can be a trigger, eating disorders have multiple causes. Biological, psychological and social factors are all known to contribute.

Eating Disorders Risk Factors

Biological risk factors include genetics and biochemical abnormalities in the brain that regulate appetite, mood, sleep and stress. Psychological factors include depression, anxiety and obsessive compulsive disorder, along with low self-esteem and perfectionism.

Social pressures also play a role – and teens, who are still trying to figure out who they are and their place in the world, may be especially vulnerable. At the start of the school year, new social cliques form. Many teens put a great deal of importance on fitting in and being “liked,” and worry that they won’t. In a society that celebrates unrealistic beauty standards, teens may see dieting and being thin as the path to popularity and acceptance.

Social media compounds the pressure, with teens comparing their own bodies and social lives to the filtered and carefully curated images they see on other’s social media feeds.

Many teens are also highly driven to excel in all aspects of their lives, from academics to athletics to their social lives. Demanding honors and AP courses, year-round competitive sports, pressure to participate in resume-building after school activities, standardized tests, the college application process – all can take a toll on teen’s mental health.

“It’s not easy being a teen these days,” Dr. Cabrera says. “With all of the pressure they’re facing, it’s imperative for kids to understand that who they are is good enough. It’s also important for kids to have balance and moderation in what they do. They need to practice self-care, self-love and self-compassion.”

What Parents, Teachers and Counselor Can Do To Help

The good news is there is much that parents, teachers and counselors can do to help teens deal with stress, anxiety and social pressures, Dr. Cabera says. Through actions and words, caring adults can make sure that teens feel they are receiving the love and support they need to successfully navigate these new situations.

Another important step is getting help. “If a teen is struggling with eating, get them help from eating disorder professionals, ideally a team that includes a physician, therapist and dietitian,” she adds.

How To Help Teens Cope With Life Transitions

1. Know the warning signs – Dramatic weight loss is one warning sign, but there are many others. Teens may dress in layers to hide their weight loss, abuse laxatives or diet pills, or make excuses to avoid eating, like claiming they ate before you got home. Other signs to watch out for include changes in mood, a drop in grades, social withdrawal and a loss of interest in activities they once enjoyed.

2. Be a role model – It may not always seem like it, but your teen is listening and watching. If you’re constantly dieting or making negative comments about your appearance, this will influence your teen’s attitudes. Also avoid commenting on your teen’s body or weight.

3. Spend time together – Eat meals together, play a board game, take a walk. It’s important for families to spend time with one another outside of performance-related activities.

4. Strive for moderation – It seems important today, but that extra AP class or tournament win isn’t going to make much difference in the long-term. Take a look at your teen’s schedule and make sure they’re not overscheduled and over-stressed.

5. Listen carefully – Teens may not tell you everything, but they may give you clues about what they’re feeling. According to recent research, depressed teens don’t often describe themselves as depressed. Instead, they use words such as “stressed out” or “sad.” Depression, anxiety and eating disorders are often linked.

6. Watch out for your athlete – Competitive athletes with a strong determination to win and the ability to push through physical discomfort may be at risk of developing eating disorders and over-exercising. Athletes in sports such as running, in which lower weight is believed to improve performance, are at high risk, as are athletes in “aesthetic” sports such as gymnastics, dance and competitive cheer. But boys and girls in any sport may be at risk of over-training and under-fueling their bodies.

7. Don’t hesitate to get help – The earlier eating disorders are identified and treated, the better the chances for a full and lasting recovery. If you’re worried, get a consultation with a trained professional, who can help you figure out your next steps.