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What Are the Causes and Signs of Eating Disorders in Young Adults?

While eating disorders can affect people at any age, they most commonly begin in adolescence. Individuals as young as 10 have shown symptoms of the disorder. Many contributing factors can spur the development of eating disorders early in adolescence. One of the most obvious is the incidence of puberty, which results in dramatic changes to the body and how individuals feel about it. Combined with peer pressure and societal influence to be “skinny,” puberty can drive body image dissatisfaction and possible disordered eating behaviors like anorexia nervosa, bulimia nervosa, orthorexia, and others.

During this time, many teenagers begin to experiment with various kinds of diets, from fad diets like Atkins or keto to caloric restriction, which can be a precursor to disordered eating. This can be exacerbated by activities like wrestling or ballet that make weight a foregrounded issue. All these factors in combination, or alone, can spark anorexia nervosa.

Other things that contribute to the development of common eating disorders in adolescence include:

  • Genetics: Children with one or both parents having an eating disorder are many times more likely to develop one themselves. This can’t be completely reduced to behavioral examples absorbed by the child;research also shows the development of eating disorders is common in twins, indicating there are genetic factors that influence a person’s likelihood to develop an eating disorder.Some studies indicate people whose parent has anorexia nervosa are 7 to 12 times as likely to develop the disorder themselves; although no specific gene has been found that causes eating disorders, this tendency shows that there is some genetic factor involved in their development.
  • Trauma: PTSD including the response to sexual or physical abuse but not limited to them, is a common trigger for the development of eating disorders. It is common for survivors of trauma to experience feelings of shame, guilt, a lack of self-control, and low self-esteem. To counteract *these feelings, disordered eating behaviors including restriction might begin. Studies show as many as 50 percent of people with an eating disorder also experience clear signs of PTSD. Because of the frequency of PTSD in people with an eating disorder, most treatment centers centralize trauma-informed care as part of their programs. This may take the form of Cognitive Processing Therapy (a technique designed specifically to treat PTSD) or trauma-informed movement classes.
  • Society and the Media: For decades, if not centuries, young people have been subjected to constant exposure to the media’s presentation of “perfect,” “beautiful” bodies. The increased access to television, movies and YouTube videoshas also helped to further skew perceptions relating to attainable beauty standards. While these platforms don’t necessarily cause eating disorders, they may set an unattainable standard of slimness or weight loss that acts as a prime cause of eating disorders like anorexia nervosa. Many of the people featured in these media are professional models or actors who devote most of their time to working out and spend thousands on unhealthy meal planning and diets. Not to mention, many of the images are Photoshopped or computer-altered, which furthers the unattainable nature of the imagery.
  • Social Media: There is certainly overlap between traditional media and social media; for example, both have significant “diet industry” presences and advertising from fitness and weight-loss companies. The videos and imagery that influence negative body image and help promote disordered eating are similar as well. Social media, however, might be even more pervasive than older forms of media. On social media platforms like Twitter, Instagram, or TikTok, people can not only observe the idealized images but interact with the models or personalities they wish to emulate. This intimacy makes the unattainable seem more possible, even though these images are manipulated just as often as in traditional media. Social media can have such a negative effect on self-image and self-esteem that it’s been investigated by Congress.

Common Signs of Eating Disorders

  • Body Dysmorphia: A sense of dissatisfaction with one’s body that often manifests as a feeling of being overweight or “flawed,” even if there is no evidence to support this. People with eating disorders may complain and worry about being “fat” or wanting to lose weight, or frequently compare their bodies to others.
  •  Nervousness Around Food or Fear of Eating: As a way to hide how little they are eating, many adolescents avoid situations where they need to eat in front of others or in public. They might choose to take their meals in their rooms, as well, eschewing the family dinner table.
  • Fad Dieting: An obsession with food and counting calories is virtually always present in cases of anorexia nervosa. They may go from diet to diet or cut out entire food groups in an effort to lose weight. Some eating disorders, like bulimia nervosa or binge eating disorder, often involve dieting but since the individual frequently binge eats, they do not lose significant amounts of weight.
  • Changes in Appearance: One of the main symptoms of anorexia nervosa is extreme weight loss, although atypical anorexia nervosa sufferers may not lose a noticeable amount of weight. ARFID and orthorexia nervosa may also cause significant weight loss. As mentioned earlier, other forms of eating disorders may not cause weight loss, although fluctuations are common. Parents may also notice hair loss, emaciation, swollen salivary glands, and dry hair or skin.
  • Isolation: Concerns over their physical appearance and an obsession with food can cause many teens to withdraw from their usual activities and social engagements. There might also be increased moodiness or mood swings, irritation, and sleep difficulties. People with eating disorders often feel distressed when eating meals with other people; they may choose to eat alone or eat only sparingly around them. Binge eating episodes usually happen when a person is alone as well.
  • Excessive Exercise: While a commitment to staying physically fit through regular exercise is a good habit to adopt, excessive exercise can be an indication of disordered eating behaviors in adolescents. Parents should look out for an obsession with exercise that doesn’t stop for injuries, illness, inclement weather, or other important commitments. Excessive exercise is common enough in people with eating disorders that most treatment centers have specialized treatment to counteract it.

Other Risk Factors

  • Sexual Preference and Gender Identity: LGBTQ people suffer from eating disorders at a much higher rate than other people. This has been confirmed in many studies; one such found that 54% of LGBTQ adolescents had been diagnosed with an eating disorder. It’s important to note that nothing intrinsic to an LBGTQ identity causes eating disorders. Instead, the stress and discrimination faced by these individuals can trigger a variety of mental health disorders. Eating disorder treatment sensitive to gay and transgender needs is becoming more common at treatment centers.

 Eating Disorder Recovery Is an Achievable Goal

If you notice these symptoms and risk factors in yourself or a loved one, don’t lose hope – eating disorders are treatable. The first step is to face the situation with compassion and an action plan. It’s often difficult to discuss mental health problems, but a non-judgmental approach and education about the health risks can ease the conversation.

After talking to your loved one, the next step is to reach out to a mental health professional, preferably one that specialized in eating disorders. You can also reach out directly to an eating disorder treatment center. Either option can help make a formal diagnosis and design an appropriate treatment plan. The key to a successful, long-term recovery is acting early and sticking to the treatment plan.

  • Other Kinds of Mental Health Disorders: In psychological circles, a dual diagnosis or co-occurring disorder is the presence of two or more mental health illnesses in the same person. It’s common in people with distinct cases of most eating disorders. Body image is linked with self-esteem, and low self-esteem is linked with depression, for example. Various forms of anxiety, most especially social anxiety disorder and PTSD are also linked with eating disorders. Some research concludes that the compulsive behaviors associated with bulimia nervosa are similar to those found in obsessive-compulsive disorder (OCD). These psychiatric and psychological disorders also typically begin in adolescence or young adulthood – just like most eating disorders. A diagnosis of depression or anxiety is not a guarantee that a person will develop an eating disorder, but it’s a strong indicator that they’re at risk.
  • Biological Factors: The preeminent myth about eating disorders is that only women can experience them. This is categorically untrue, and the stigma about seeking help for a “women’s disease” has caused underreporting for men suffering from eating disorders. In recent years, more eating disorder treatment facilities have created male-friendly programs to help this situation. However, in general, women are more likely to develop an eating disorder. Anorexia nervosa and bulimia nervosa are more frequent in women than men by a relatively large margin (still taking into account that men are less likely to report them). Other disorders, like excessive exercise and binge eating disorder, are more likely to affect men – the gender split is nearly even with those disorders.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.
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