Teen Eating Disorders
Eating disorders are serious illnesses that can affect a teenager’s physical health, emotional well-being, and development. They include anorexia nervosa, bulimia nervosa, binge-eating disorder, ARFID, and atypical anorexia.
Eating disorders are not simply about food, weight, or appearance. Genetics, biology, psychological factors, and social and cultural influences can all play a role. They can affect teenagers of different body sizes and backgrounds, and the problem may not always be obvious.
Early recognition and treatment are important, and recovery is possible.
This section brings together research and practical information to help parents and families recognize possible signs of an eating disorder, understand the major treatment approaches, and know where to turn for help.
Nothing on this site should be considered medical advice. Medical decisions should be discussed with appropriate healthcare professionals.
Roger Streit
Understanding Eating Disorders in Teenagers
Eating disorders are serious illnesses involving persistent disturbances in eating behavior. They often begin during adolescence and can affect physical health, growth, emotional well-being, and family life. They occur in boys as well as girls and in teenagers of all body sizes and backgrounds.
Anorexia Nervosa
Anorexia nervosa involves severe restriction of food intake, an intense fear of gaining weight or behaviors that interfere with weight gain, and a distorted perception of body weight or shape. Some teenagers also exercise excessively. In adolescents, inadequate nutrition can interfere with normal growth and development as well as cause potentially serious medical complications.
Atypical Anorexia
A teenager with atypical anorexia can have the restrictive eating, significant weight loss, fear of gaining weight, and other features of anorexia without being underweight. This is particularly important because parents—and sometimes healthcare providers—may overlook a serious eating disorder when a teenager appears to be at a “normal” or higher weight.
Bulimia Nervosa
Bulimia nervosa involves repeated episodes of binge eating accompanied by a feeling of losing control, followed by attempts to compensate for the food consumed. These may include self-induced vomiting, fasting, misuse of laxatives or other medications, or excessive exercise. Because weight may remain within an expected range, bulimia can be difficult for families to recognize.
Binge-Eating Disorder
With binge-eating disorder, a person repeatedly consumes unusually large amounts of food while feeling unable to control the eating. Unlike bulimia, the episodes are not regularly followed by vomiting or other behaviors intended to compensate for the food eaten. Binge eating is often accompanied by distress, embarrassment, or guilt.
ARFID
Avoidant/Restrictive Food Intake Disorder (ARFID) is different because concerns about weight or body shape are not the primary reason for restricting food. A teenager may eat very little or avoid many foods because of sensory sensitivities, lack of interest in eating, or fear of consequences such as choking or vomiting. ARFID can lead to inadequate nutrition, impaired growth, or significant disruption of everyday life.
An Important Point
Eating disorders do not always look the way families expect. A teenager does not have to look extremely thin to have a serious eating disorder. Significant changes in eating behavior, weight or growth, exercise, or attitudes toward food and body image deserve attention.
Early evaluation by healthcare professionals experienced with adolescent eating disorders can help determine what is happening and what level of treatment may be needed.
Recognizing the Warning Signs
Food & Eating
Watch for skipping meals, avoiding family meals, eliminating foods or food groups, rigid rules about eating, secretive binge eating, frequent bathroom trips after meals, or increasing concern with calories, weight, or “clean” eating.
Weight & Exercise
Significant weight loss or unexpected changes in normal growth can be warning signs. So can excessive or compulsive exercise, particularly exercising despite illness, injury, or exhaustion.
Physical & Behavioral Changes
Possible signs include dizziness, weakness, fatigue, feeling unusually cold, difficulty concentrating, changes in menstrual periods, anxiety, irritability, secrecy, or social withdrawal.
A pattern of changes in eating, weight or growth, exercise, mood, or behavior deserves attention, even when a teenager appears healthy.
When to Seek Help — What Parents Should Do
If a teenager shows a pattern of restrictive eating, significant weight loss, binge eating, vomiting, compulsive exercise, or increasing preoccupation with food and weight, it is better to seek help early rather than wait for the problem to become severe.
Start With a Medical Evaluation
A pediatrician or other healthcare professional can assess weight and growth patterns, heart rate and blood pressure, nutrition, and other signs of medical problems. When possible, seek someone with experience treating adolescents with eating disorders.
How to Talk With a Teenager
Choose a calm time and focus on specific changes you have noticed rather than appearance or weight. Express concern without blame or criticism. A teenager may deny that anything is wrong or resist getting help; that does not necessarily mean that evaluation should be postponed.
Parents Have an Important Role
Parents should not assume that the teenager must become motivated to recover before treatment can begin. With adolescents, active family involvement is often an important part of treatment.
When It May Be Urgent
Fainting, severe weakness or dehydration, a very slow heart rate, chest pain, difficulty breathing, confusion, repeated vomiting, refusal or inability to eat or drink, or concern about suicide or self-harm requires prompt medical evaluation.
Eating disorders can become medically serious even when a teenager does not appear extremely thin. When in doubt, getting an evaluation is safer than waiting.
Family-Based Treatment (FBT)
Family-Based Treatment (FBT) is one of the best-supported treatments for adolescents with anorexia nervosa and is also used for some other eating disorders. Sometimes called the Maudsley approach, it treats parents as an important part of the solution rather than as the cause of the eating disorder.
Early in treatment, parents take an active role in helping their teenager eat enough and restore healthy nutrition and growth. As recovery progresses, responsibility for eating is gradually returned to the teenager.
FBT is not appropriate for every teenager or family, but when it is suitable, parents can play a central role in recovery. Treatment does not have to wait until the teenager is motivated to recover.
Nutrition & Weight Restoration
For teenagers with restrictive eating disorders, restoring adequate nutrition is a central part of treatment. Insufficient nutrition during adolescence can affect the heart, bones, hormones, brain, mood, and normal growth and development.
Undernutrition can also increase anxiety, irritability, rigid thinking, and preoccupation with food, making recovery more difficult.
Treatment should consider the teenager’s previous growth pattern, stage of development, medical health, and nutritional needs, not simply a number on the scale. Serious nutritional problems can occur even when a teenager’s weight appears to be within a “normal” range.
Nutrition and weight restoration should be guided by healthcare professionals experienced with adolescent eating disorders.
Eating Disorders & the Brain
Eating disorders involve both the body and the brain. Anxiety, depression, obsessive-compulsive traits, perfectionism, and rigid thinking are common and may exist before the eating disorder, develop alongside it, or worsen with inadequate nutrition.
Undernutrition can affect concentration, mood, judgment, and flexibility of thinking and increase preoccupation with food. This can create a difficult cycle in which restrictive eating makes eating normally and accepting treatment even harder.
Improving nutrition can help reverse some of these effects, while coexisting problems such as anxiety, depression, or obsessive-compulsive disorder may require treatment of their own.
Athletes, Exercise & Eating Disorders
Sports can provide teenagers with exercise, friendships, confidence, and a sense of accomplishment. But some young athletes are at increased risk of inadequate nutrition, disordered eating, and eating disorders, particularly in sports that emphasize leanness, weight, endurance, or appearance.
When Exercise Becomes a Warning Sign
A teenager may become increasingly rigid about workouts, exercise despite injury or illness, become distressed when unable to exercise, or add substantial exercise outside normal training.
These behaviors can be mistaken for dedication. Compulsive exercise can be part of an eating disorder.
RED-S
Relative Energy Deficiency in Sport (RED-S) occurs when an athlete does not consume enough energy to support both normal body functions and training.
Inadequate energy can affect growth, bone health, hormones, immunity, mood, and athletic performance. Boys as well as girls can develop RED-S.
Performance Can Eventually Suffer
Over time, inadequate nutrition can contribute to fatigue, injuries, slower recovery, impaired concentration, and declining performance.
Adequate nutrition is part of athletic training, not an obstacle to it.
Social Media, Body Image & Diet Culture
Teenagers encounter a constant stream of messages about appearance, weight, dieting, fitness, and food. Social media can intensify these pressures through edited images, unrealistic body ideals, and constant comparison.
Eating disorders are complex illnesses influenced by genetics, biology, psychological factors, and environment. Social media does not by itself cause an eating disorder, but for some vulnerable teenagers, weight-loss content, extreme fitness advice, or idealized bodies may increase body dissatisfaction and reinforce restrictive eating or excessive exercise.
“Healthy Eating” Can Become Rigid
An interest in nutrition is not necessarily a problem. Parents should pay attention when eating becomes increasingly restrictive or a teenager develops rigid rules about foods being “good,” “bad,” “clean,” or “unhealthy.”
What Parents Can Do
Parents can help teenagers understand how online content is selected, edited, and promoted and encourage interests and activities that emphasize abilities, relationships, and well-being rather than appearance.
Treatment, Medications & New Approaches
Treatment depends on the type of eating disorder, medical condition, age, and individual circumstances and often combines nutritional rehabilitation, psychological treatment, medical monitoring, and family involvement.
For adolescents with anorexia nervosa, Family-Based Treatment (FBT) is one of the best-supported approaches. Other forms of psychotherapy may be useful for bulimia, binge-eating disorder, ARFID, and accompanying anxiety or depression.
Medications
Medication is generally not the primary treatment for anorexia nervosa, although it may sometimes be used for accompanying psychiatric conditions. Certain medications can be helpful for other eating disorders but require careful medical supervision in teenagers.
When More Intensive Care Is Needed
Some teenagers require day treatment, residential care, or hospitalization because of significant medical or psychiatric risks.
New Approaches
Researchers continue to study new treatments. Promising or experimental approaches should be distinguished from treatments already supported by good evidence in adolescents.
Resources for Parents & Families
These organizations provide reliable information, practical guidance, and support for families dealing with eating disorders.
The American Academy of Pediatrics (AAP) provides medical guidance on recognizing and treating eating disorders in children and adolescents, including early detection, medical complications, growth and nutrition, and treatment.
This July 2026 AAP publication specifically addresses anorexia, bulimia, ARFID, binge-eating disorder, atypical anorexia, medical evaluation, and treatment.
F.E.A.S.T. — Families Empowered and Supporting Treatment of Eating Disorders
F.E.A.S.T. is an international nonprofit for parents and caregivers of people with eating disorders. It emphasizes evidence-based treatment and the important role families can play in recovery, with free guides, education, webinars, and support.
National Eating Disorders Association (NEDA)
NEDA provides information about eating disorders, warning signs, treatment, and recovery, along with resources to help families find professional support.
The free Parent Toolkit covers warning signs, talking with a young person, medical risks, treatment, mealtime support, working with schools and treatment teams, and questions to ask healthcare providers.
NEDA also provides resources to help families locate eating-disorder treatment and professional support.
Academy for Eating Disorders (AED)
The Academy for Eating Disorders (AED) is an international professional organization for eating-disorder clinicians and researchers. It provides evidence-based information about eating disorders, medical complications, and treatment.
Lauren Muhlheim, Psy.D. — Eating Disorder Therapy LA
Lauren Muhlheim, Psy.D. is a psychologist specializing in eating disorders and certified in Family-Based Treatment (FBT). She is the author of When Your Teen Has an Eating Disorder and provides practical guidance for parents on FBT, meal support, ARFID, exercise, and recovery.
Muhlheim explains Family-Based Treatment (FBT), one of the best-supported treatments for adolescents with eating disorders. Parents take an active role in restoring nutrition and interrupting eating-disorder behaviors, with responsibility gradually returning to the teenager as recovery progresses. She also explains the principles behind FBT and when a higher level of care may be necessary.
Muhlheim’s book is a practical guide for parents based largely on Family-Based Treatment (FBT). It explains how parents can help restore adequate nutrition, manage difficult meals, normalize eating, gradually return independence to the teenager, and help prevent relapse.
Muhlheim explains how exercise fits into recovery for teenagers receiving Family-Based Treatment (FBT). She discusses why exercise may need to be restricted during recovery and how it can gradually be reintroduced as nutrition and medical stability improve.
Finding Treatment
Look for professionals with experience treating adolescent eating disorders. Parents may want to begin with their teenager’s pediatrician and ask specifically about experience with eating disorders and Family-Based Treatment (FBT).
Search for eating-disorder treatment providers and programs throughout the United States.