Eating Disorders and Youth

Eating disorders are marked by a variety of emotional, physical, and behavioral changes. While some of the behaviors may appear to be typical teenage dieting and body dissatisfaction, they might indicate something more serious and even life-threatening – an eating disorder. The average age of onset for eating disorders is 12 to 13 years old, with eating disorder specialists reporting an increase in the diagnosis of children, some as young as 5 or 6.

It's important for parents, relatives, and school personnel to be aware of risk factors and symptoms of eating disorders so they can take steps to address these issues early to ensure the best possible outcomes for the young person.

Social Media and Eating Disorders

Social media can help individuals with eating disorders by providing them with access to peer support, treatment options, and other information. However, it has also been shown to increase the exposure of messages that promote disordered eating. “Pro-eating disorder” content has been on the internet as early as 2001 when Yahoo removed 113 pro-anorexia websites from its servers. The trends continued on Tumblr when there was an increase of “thinspiration” blogs. Now pro-eating disorder content, dangerous diet culture trends, and unrealistic body image expectations can be found all over the internet on YouTube, Instagram, TikTok, Discord, and Snapchat.

Additionally, “pro-ana” (pro-anorexia) and “pro-mia” (pro-bulimia) websites have found a global platform through social media websites such as Facebook, Twitter, Tumblr, Instagram, and Pinterest. Using these websites, users support each other’s self-harming behaviors and promote the notion that an eating disorder is a lifestyle choice rather than a serious mental illness.

There is also growing concern around “fitspo” or “fitspiration.” This includes content that often focuses on “clean eating” and fitness programs. While this movement was initially thought to be a healthy alternative to the pro-anorexia and pro-bulimia content, they may also overvalue and reinforce obsessive thoughts and behaviors around food and exercise, even if they may appear to or claim to promote health.

In reality, social media makes it easy for individuals with eating disorders to seek and gain approval of their actions, and it amplifies behaviors associated with these disorders – obsessions, comparisons, and competition. In response to this, social media sites have made attempts to censor content that encourages eating disorders, but it can be difficult to prevent all of the content from getting through.

Tips for Parents and Relatives

Do:

Notice: Pay attention to warning signs of eating disorders, including changes in behaviors around food, physical changes, types of social media use, and conversations about food or body image.
Listen: Listen openly, reflectively, and without judgment. If you do not understand, ask how your child is feeling and how you can best support them. Validate their feelings instead of immediately offering solutions.
Learn: Learn more about eating disorders and recovery, including facts and myths. Reading about or speaking with other parents who have supported their children in recovery is also helpful and is often a part of treatment programs.
Support: Remind them that you are there to support them and just want them to be well. Focus on positive personality traits and emotional health instead of exclusively focusing on food-related behavior. Model recovery in your own relationship with food, weight, and exercise, and work to create an environment where the whole family is promoting healthy behaviors and alternatives.

If your child denies having a problem, simply and calmly:

Repeat what you have observed, i.e., evidence that there is a problem
Repeat your concern about their health and well-being
Repeat your conviction that the circumstance at least be evaluated by a counsellor or therapist
End the conversation if it is going nowhere or if either of you become too upset
Leave the door open for further conversation

Do Not:

Judge: When your child is struggling or discusses something personal, do not express judgment, make jokes, or be dismissive of their thoughts, feelings, or behaviors. They may feel confused, ashamed, or frustrated and are trusting you for support.
Argue: While it is painful to watch someone you love struggle, avoid expressing anger and frustration. Confronting your child with a group of people, making accusations, or getting into arguments will likely make communication and support more difficult and may lead them to feel more isolated.
Lecture: Do not oversimplify the problem or focus on giving advice on things like appearance, weight, or exercise. While there may be times when your child is looking to you for specific answers, make sure the focus is on what they want and need in that moment.
Ignore: Do not dismiss warning signs at any stage as simply a “phase.” Eating disorders have the highest mortality rate of all mental health disorders so it is crucial to get treatment and support as early as possible. If the person is throwing up several times a day, passing out, complaining of chest pain, or is suicidal, get professional help immediately.

Tips for School Personnel

If a student consistently shows one or more of the signs or symptoms listed below, it is cause for concern, and a student's parents or guardians should be contacted

Emotional

Perfectionism: The student may have an intolerance for imperfections in academics, eating, social life, etc. and may overvalue self-sufficiency, creating a reluctance to ask for help. Other signs of perfectionism related to disordered eating include: expressing body image complaints/concerns like being too fat regardless of weight; being unable to accept compliments; having moods affected by thoughts about appearance; constantly comparing self to others; self-disparaging remarks; referring to self as fat, gross, or ugly; overestimating body size; seeking constant outside reassurance about looks; and striving to create a “perfect” image.
Withdraw: The student may appear withdrawn across different areas of their life. This includes changes in attitude/academic performance; flattened or absent emotions; and increased time spent alone or pulling away from friends. They may appear sad, depressed, anxious, ashamed, or embarrassed, or express feelings of worthlessness.
Changes in thoughts or conversations about food: They may display rigid or obsessive thinking about food, eating, and exercise (e.g., label foods as good/bad or on/off limits; appears uncomfortable or unwilling to share food; inflexible about diet without reason). There may be incessant talk about food, weight, shape, exercise, cooking, etc. The student may also appear obsessed with maintaining unhealthy eating habits to enhance performance in sports, dance, acting, or modelling.

Behavioral

Mealtime rules or rituals: You may observe rigid dietary rules or chaotic food intake, including skipping meals, carefully calculating food intake, hoarding food, or refusing to eat food prepared by others or without knowing exact ingredients. The student may also make frequent trips to the bathroom, particularly around mealtimes.
Avoidance: The student may avoid the cafeteria, work through lunch, or eat alone. They may also wear very baggy clothes to hide a very thin body (anorexia) or weight gain (binge eating disorder) or to hide their body because of concerns about body shape/size. If asked, the student may deny difficulty with food or body image despite evidence that it is an area of concern.
Compulsivity: The individual may show some type of compulsive behavior like compulsive handwashing, hoarding, repetitive movements/speech, or a need for constant reassurance. This may also look like exercising for long periods with an obsessional attitude or exercising excessively every day. The student may have difficulty sitting still and may hover over a chair instead of sitting, constantly jiggle legs, get up from their desk as every opportunity, or offer to run errands.