Tweens and Teenagers: Learning How To Take Care of Themselves - Disordered Eating Behaviours and Eating Disorders

“Let food be thy medicine and medicine be thy food.”

Hippocrates

Middle school years and teenage years are the years where our children learn to become self-sufficient adults. One of the aspects of becoming a self-sufficient adult is being able to take good care of themselves. This is a very big topic that varies from personal hygiene to drugs and alcohol consumption to self harm and suicidal thoughts… However, the most basic four pillars of self care are nutrition, exercise, sleep and hygiene and today I want to focus mainly on nutrition in terms of healthy eating, and disordered eating…

First of all, let’s look at the terminology. According to Amy Baker Dennis from National Eating Disorders Association:

“Disordered eating refers to a spectrum of problematic eating behaviors and distorted attitudes toward food, weight, shape and appearence. Often these behaviors include dieting, skipping meals, fasting, restricting food intake, eliminating specific food and food groups, binge eating, excessive use of diurectics, laxatives, weight loss medications. Disordered eating patterns can vary in severity but do not meet the frequency, duration and/or psychological criteria for diagnosable eating disorder” such as anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder and other specified feeding and eating disorder.

Disordered eating behaviors and eating disorders are on the rise in tweens and teenagers. The poster child for eating disorders is young white girls, yet recent reserch shows that this is highly misleading. Boys do develop eating disorders as unrealistic male body image exists. However, the language is different in boys than girls. Girls usually talk about being skinny and loosing weight, whilst boys talk about gaining weight, becoming more muscular or leaner and therefore, the diagnosis of eating disorders in boys can easily go unnoticed. Further rerseach clearly indicates that no socio-economic group, gender or race is immune to eating disorders. Furthermore, there is a social contagion aspect to it, which means our children could develop eating disorders and disordered eating behaviors by being socially exposed to them.

Eating disorders are extremely sneaky and very dangerous. It is sneaky, because at the beginning it starts like healthy eating behavior. What we usually hear from our kids that they want to eat well and become healthy…. And that’s something we all welcome. However, it can quickly take a turn on the wrong side and can get out of control very quickly. They are very dangerous, as they pose severe health consequences as well as psycological and social consequences. If they are left untreated they can be life threatening and in fact eating disorders have the second highest mortality rate amongts mental health disorders.

These are complex mental health conditions and there are several factors that can play a role in developing eating disorders. One risk factor is genetic and biological predisposition such as having Type 1 Diabetes, having a close relative with an eating disorder, self-oriented perfectionism (it is one of the strongest risk factors), personal history of mental health conditions, sensory issues around food (picky eaters), and genuine lack of interest in food. Genetic predisposition does not work alone in causing eating disorders. They work alongside some precipitating factors such as personal trauma, being teased, bullied or fat shamed, or developing body image dissatisfaction.

Disordered eating behaviors do develop mostly during the early adolescent years. During these years, children gain height and weight… a lot of weight! Although, this should not be alarming to us, as this is a normal part of development, it may cause body dissatisfaction (not liking a part of whole of one’s body) or in some cases body dysmorphia (fixation on external appearance, seeing faults that other people do not see) in our children. These can be early red flag for low self-esteem and eating disorders.

Cara Natterson and Vanessa Kroll Bennett suggest that we should be careful about disordered eating behaviors with our tweens and teenagers, but they also add that there are certain groups of kids that we need to be extra attentive about. These include ‘early bloomer females’ (those who become curvier before their friends), ‘athletes’ especially those who wear leotards and swimsuits, as well as certain sports where kids need to develop certain types of body muscles and finally ‘social media regulars’.

Social media plays a huge role in developing eating disorders in two ways. Our children are being exposed to highly photoshopped, unrealistic body image ideals day in day out through social media and that can easily cause body image dissatisfaction in them. Also, there is the issue of algorithms and norm shitfing. When our kids search or look for ‘healthy eating’ or ‘diet’ or even ‘exercising’, social media outlets start pouring images and written content on them about unattainable, unrealistic body images and sometimes even pro-anorexia videos, websites under the disguise of ‘dieting’ or ‘healthy eating’. When tweens and teenagers are being regulary exposed to this type of content, their understanding of norms shifts. They start normalising what they are digesting through social media.

What Are the Symptoms? What Do We Need to Be Looking For?

The most common sign of disordered eating behavior and eating disorders is preoccupation or even obsession with food, dieting, exercising, eating strategies, and calories. The feeling is different… We would feel that our child’s attitude towards their eating and exercising becomes more regimented, strict and no more fun! Food and exercise should be fun, so, if not, beware!

Others include,

-Unexpected, unexplained weight changes (not just losing weight but gaining weight as well)

-Eliminating a type of food or a whole food group

-Making excuses to miss mealtimes

-Developing new food rituals such as eating in certain order, excessive chewing, rearranging food on a plate

-Sneaking food (finding wrappers in bedroom)

-Binge eating

-Compensatory behaviors such as using laxatives or diuretics, compulsive exercising

-Withdrawing from friends; being secretive; avoiding social occasions that involve food and eating

-Extreme concern with body image

Issues around eating are part of one’s ability of taking care of themselves and being able to make decisions that will not harm them in the long run. This requires a lot of support, coaching, and monitoring from us during the tween and teenage years. In the following newsletter, I will focus on prevention and what we can do in our daily lives to support our children and reduce the risk of developing eating disorders. In addition, I will talk about what we should be doing if we think something is going wrong with our children’s eating habits.

“We define healthy eating as having a healthy balance of foods and having a healthy relationship with foods.”

Evelyn Tribole

If you wish to further read about this topic;

National Eating Disorders Association

Icard M., 14 Talks by Age 14, The Essential Conversations You Need To Have with Your Kids Before They Start High School, 2021, Random House, NY

Natterson C., Kroll Bennett V., This Is So Awkward, 2023, Random House, NY

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