TeenThreads Health: Eating Disorders in Teens & Adolescents

A complete, teen‑friendly guide to understanding eating disorders – what they are, why they happen, how they show up in school, and how friends, family, and teachers can help.

What Are Eating Disorders?

According to the National Institute of Mental Health (NIMH), eating disorders are serious illnesses marked by severe disturbances in eating behaviors, often involving an intense focus on body weight, shape, or food control.
They are not choices, not phases, and not about vanity. They are medical and mental health conditions that affect the brain, body, emotions, and behavior.

Eating disorders can affect anyone—boys, girls, nonbinary teens, athletes, high achievers, quiet kids, outgoing kids, and everyone in between.

Common names teens may hear:

• “ED”
• “Ana” (anorexia)
• “Mia” (bulimia)
• “Binge eating”
• “ARFID”
• “Disordered eating”
• “Body dysmorphia”

Teen line:
“Eating disorders aren’t about food—they’re about feelings, control, and pain that’s hard to talk about.”

Types of Eating Disorders

Based on NIMH and KidsHealth information:

1. Anorexia Nervosa

• Extreme restriction of food
• Intense fear of gaining weight
• Distorted body image (“I feel fat” even when underweight)

2. Bulimia Nervosa

• Repeated episodes of binge eating
• Followed by purging (vomiting, laxatives, over-exercising)

3. Binge Eating Disorder

• Eating unusually large amounts of food
• Feeling out of control
• No purging afterward
• Often followed by guilt or shame

4. ARFID (Avoidant/Restrictive Food Intake Disorder)

• Not about weight or body image
• Avoiding food due to sensory issues, fear of choking, or lack of interest in eating

5. Other Specified Feeding or Eating Disorders (OSFED)

• Serious symptoms that don’t fit neatly into one category
• Still dangerous and still require treatment

Why Do Eating Disorders Happen? 

Eating disorders develop from a mix of biological, psychological, and environmental factors.

Biological Causes

• Genetics (family history increases risk)
• Brain chemistry differences
• Hormonal changes during puberty

Psychological Causes

• Perfectionism
• Low self-esteem
• Anxiety or depression
• Trauma or bullying

Environmental Causes

• Social media comparison
• Pressure to look a certain way
• Diet culture (“thin = better”)
• Comments about weight from peers or adults
• Sports emphasizing weight (dance, wrestling, gymnastics)

Teen analogy:
“Imagine your brain has a funhouse mirror. Eating disorders make you see your body in a way that doesn’t match reality.”

What’s Going On in the Brain & Body? 

Eating disorders affect:

The Brain

• Distorted body image
• Obsessive thoughts about food
• Anxiety around eating
• Reward pathways that make restriction or bingeing feel “relieving”

The Body

• Malnutrition
• Hormone imbalances
• Heart problems
• Stomach issues
• Weakness, dizziness, fainting

Eating disorders can become life-threatening if untreated.

Signs & Symptoms in Kids & Teens

Based on NIMH and Johns Hopkins findings.

Emotional Signs

• Fear of gaining weight
• Feeling “gross” after eating
• Obsession with calories, dieting, or body shape
• Anxiety around meals
• Depression or irritability

Behavioral Signs

• Skipping meals
• Eating tiny portions
• Going to the bathroom right after eating
• Exercising excessively
• Wearing baggy clothes to hide weight loss
• Avoiding social events involving food

Physical Signs

• Rapid weight loss or gain
• Dizziness or fainting
• Hair loss
• Stomach pain
• Feeling cold all the time
• Fatigue

Teen line:
“If your whole day revolves around food—avoiding it, controlling it, or obsessing over it—that’s not ‘discipline.’ That’s distress.”

How Eating Disorders Show Up in School Kids & Teens

Eating disorders often hide in plain sight.

In School:

• Falling grades
• Trouble concentrating
• Skipping lunch
• Avoiding PE or sports
• Sitting alone
• Bringing “safe foods” only
• Asking to go to the nurse often

In Friendships:

• Pulling away
• Irritability
• Canceling plans
• Comparing bodies
• Talking negatively about themselves

In Athletes:

• Overtraining
• Fear of weight checks
• Exercising even when injured

Diagnosis (How Professionals Figure It Out)

Diagnosis is done by:

• Pediatricians
• Child/adolescent psychiatrists
• Psychologists
• Licensed therapists

They use:

• Medical exams
• Growth charts
• Eating behavior assessments
• Mental health evaluations

NIMH emphasizes that eating disorders are serious illnesses requiring professional care.

Treatment Options

Eating disorders can be treated, and recovery is absolutely possible.

1. Therapy

• CBT‑E (Cognitive Behavioral Therapy for Eating Disorders)
• Family-Based Treatment (FBT) for kids/teens
• Dialectical Behavior Therapy (DBT)

2. Medical Monitoring

• Regular checkups
• Nutrition stabilization
• Monitoring heart rate, electrolytes, and weight

3. Nutrition Support

• Working with a dietitian
• Learning balanced eating
• Rebuilding a healthy relationship with food

4. Medication

Used when anxiety, depression, or OCD are also present.

5. Online Therapy Options

(Not for emergencies, but helpful for ongoing support)

• BetterHelp
• Talkspace
• Brightside

6. Mindfulness Tools

• Headspace
• Calm
• Insight Timer

What Happens If Eating Disorders Go Untreated?

Untreated eating disorders can lead to:

• Heart problems
• Organ damage
• Bone loss
• Fertility issues
• Severe depression
• Self-harm or suicidal thoughts
• Long-term health complications

Early treatment leads to much better outcomes.

The Role of Friends, Family, Teachers & Counselors

Friends

• Notice changes
• Avoid comments about weight
• Encourage help
• Be supportive, not judgmental

Parents & Family

• Create a safe, non-judgmental environment
• Avoid diet talk at home
• Seek professional help early
• Learn about eating disorders

Teachers

• Watch for warning signs
• Avoid body-shaming language
• Refer students to counselors
• Support accommodations

School Counselors

• Provide emotional support
• Connect families to treatment
• Monitor academic impact
• Help with crisis intervention

Lessons Teens Can Learn 

• Your body is not the enemy.
• You don’t have to “earn” food.
• You deserve to take up space.
• Recovery is not about weight—it’s about freedom.
• You can’t see someone’s struggle by looking at them.

Teen lines:

• “Food is fuel, not a moral test.”
• “Your worth isn’t measured in pounds or calories.”
• “Healing your relationship with food is healing your relationship with yourself.”

Support Groups & Helplines (With URLs)

These are information and support resources, not emergency services.

NAMI HelpLine

Free, confidential emotional support & resources.
Phone: 1‑800‑950‑NAMI (6264)
Text: “NAMI” to 62640
Website: https://www.nami.org/nami-helpline/ (nami.org in Bing)

NAMI Support Groups

Peer-led groups for individuals and families.
https://namiarizona.org/support-and-education/support-groups/ (namiarizona.org in Bing)

NIMH – Eating Disorders Information

https://www.nimh.nih.gov/health/topics/eating-disorders

Help & Hope for YOUth (Arizona)

Youth mental health support & stigma reduction.
https://www.azyp.org/help-hope-for-youth (azyp.org in Bing)

Quiz: Eating Disorders in Teens & Adolescents 

Understanding Eating Disorders (1–10)

1. Eating disorders are best described as:

1. A choice
2. Serious mental‑health conditions
3. A diet gone wrong
4. A phase

2. Eating disorders affect:

1. Only eating habits
2. Thoughts, emotions, and behaviors
3. Only weight
4. Only athletes

3. Eating disorders can develop due to:

1. Genetics
2. Stress or trauma
3. Social pressure
4. All of the above

4. Eating disorders are:

1. Rare
2. Common in kids and teens
3. Only found in adults
4. Not serious

5. A major risk factor for eating disorders is:

1. High confidence
2. Perfectionism
3. Low stress
4. Strong boundaries

6. Eating disorders can affect:

1. Physical health
2. Mental health
3. School performance
4. All of the above

7. Kids and teens with eating disorders often feel:

1. Proud
2. Ashamed or secretive
3. Relaxed
4. Unaffected

8. Eating disorders are treatable with:

1. Support and professional care
2. Ignoring the problem
3. More dieting
4. Willpower alone

9. Eating disorders can occur in:

1. Only girls
2. Only boys
3. Anyone
4. Only adults

10. Early intervention:

1. Makes recovery harder
2. Improves outcomes
3. Doesn’t matter
4. Is only for severe cases

Types of Eating Disorders (11–20)

11. Anorexia Nervosa involves:

1. Eating large amounts of food
2. Restricting food and intense fear of weight gain
3. Eating normally
4. No concern about weight

12. Bulimia Nervosa involves:

1. Restricting only
2. Bingeing and compensatory behaviors
3. Eating slowly
4. Avoiding all food

13. Binge Eating Disorder involves:

1. Eating very small meals
2. Eating large amounts of food with loss of control
3. Eating only healthy foods
4. Skipping meals

14. ARFID stands for:

1. Avoidant/Restrictive Food Intake Disorder
2. All‑Restricted Food Intake Disorder
3. Active Restriction for Ideal Diet
4. Avoiding Regular Food Intake Disorder

15. ARFID is different because:

1. It’s about body image
2. It’s not about weight or appearance
3. It’s a diet
4. It’s only in adults

16. Orthorexia involves:

1. Fear of eating healthy foods
2. Obsession with “clean” or “perfect” eating
3. Eating too fast
4. Eating only junk food

17. Purging behaviors can include:

1. Excessive exercise
2. Vomiting
3. Misusing laxatives
4. All of the above

18. A teen with anorexia may:

1. Feel cold often
2. Have low energy
3. Avoid eating with others
4. All of the above

19. A teen with bulimia may:

1. Hide food
2. Go to the bathroom after meals
3. Feel out of control
4. All of the above

20. Binge Eating Disorder can lead to:

1. Shame
2. Emotional distress
3. Physical health issues
4. All of the above

Warning Signs & Symptoms (21–30)

21. A sudden change in eating habits may be a sign of:

1. A new hobby
2. An eating disorder
3. A cold
4. A growth spurt

22. Teens with eating disorders may:

1. Avoid meals
2. Cut food into tiny pieces
3. Wear baggy clothes
4. All of the above

23. A teen who constantly talks about weight may be:

1. Confident
2. Struggling with body image
3. Unaffected
4. Just joking

24. Physical signs of eating disorders include:

1. Dizziness
2. Fatigue
3. Stomach pain
4. All of the above

25. Emotional signs include:

1. Irritability
2. Anxiety
3. Depression
4. All of the above

26. A teen who exercises excessively may be:

1. Training for fun
2. Using exercise to compensate for eating
3. Relaxing
4. Following doctor’s orders

27. A teen who avoids eating in public may be:

1. Shy
2. Hiding disordered eating
3. Busy
4. Not hungry

28. A teen who disappears after meals may be:

1. Cleaning up
2. Purging
3. Doing homework
4. Talking to friends

29. Eating disorders often involve:

1. Control
2. Shame
3. Fear
4. All of the above

30. A teen who denies being hungry often may be:

1. Forgetful
2. Restricting food
3. Hydrated
4. Distracted

Causes & Risk Factors (31–40)

31. Eating disorders can be triggered by:

1. Bullying
2. Trauma
3. Social media pressure
4. All of the above

32. Genetics can:

1. Play a role
2. Have no effect
3. Cause instant recovery
4. Prevent eating disorders

33. Teens with perfectionism are:

1. At higher risk
2. At lower risk
3. Immune
4. Unaffected

34. Family stress can:

1. Increase risk
2. Prevent eating disorders
3. Cure eating disorders
4. Have no impact

35. Diet culture teaches teens:

1. All bodies are good
2. Thinness equals worth
3. Food is neutral
4. Health is flexible

36. Social media can:

1. Improve body image
2. Increase comparison and pressure
3. Prevent eating disorders
4. Have no influence

37. Trauma can:

1. Increase vulnerability
2. Prevent eating disorders
3. Cure eating disorders
4. Have no effect

38. Low self‑esteem can:

1. Increase risk
2. Prevent eating disorders
3. Have no impact
4. Cure eating disorders

39. Kids with anxiety or depression:

1. Are at higher risk
2. Are immune
3. Never develop eating disorders
4. Always develop eating disorders

40. A major emotional trigger is:

1. Feeling supported
2. Feeling out of control
3. Feeling confident
4. Feeling relaxed

Treatment, Recovery & Support (41–50)

41. Eating disorders require:

1. Professional support
2. Ignoring the problem
3. More dieting
4. Willpower

42. Treatment may include:

1. Therapy
2. Nutrition support
3. Medical care
4. All of the above

43. Family support is:

1. Unnecessary
2. Critical for recovery
3. Harmful
4. Optional

44. A teen in recovery needs:

1. Patience
2. Understanding
3. Consistency
4. All of the above

45. Recovery from eating disorders is:

1. Impossible
2. A long‑term process
3. Instant
4. Only for adults

46. A supportive friend should:

1. Comment on weight
2. Encourage healthy habits
3. Pressure them to eat
4. Ignore the issue

47. A school can help by:

1. Shaming students
2. Providing a safe, supportive environment
3. Ignoring warning signs
4. Encouraging dieting

48. A teen who relapses:

1. Has failed
2. Needs more support
3. Should be punished
4. Is doing it on purpose

49. Recovery focuses on:

1. Weight only
2. Healing thoughts, emotions, and behaviors
3. Appearance
4. Dieting

50. The TeenThreads message about eating disorders is:

1. “You’re alone.”
2. “Your worth is not your weight.”
3. “You should hide your struggles.”
4. “Recovery is impossible.”

Answer Key

1‑B
2‑B
3‑D
4‑B
5‑B
6‑D
7‑B
8‑A
9‑C
10‑B
11‑B
12‑B
13‑B
14‑A
15‑B
16‑B
17‑D
18‑D
19‑D
20‑D
21‑B
22‑D
23‑B
24‑D
25‑D
26‑B
27‑B
28‑B
29‑D
30‑B
31‑D
32‑A
33‑A
34‑A
35‑B
36‑B
37‑A
38‑A
39‑A
40‑B
41‑A
42‑D
43‑B
44‑D
45‑B
46‑B
47‑B
48‑B
49‑B
50‑B