The crucial role of early therapy in long-term success overcoming adolescent eating disorders and the role social media plays in body image issues in teenagers.
By Ana Brown B.A Psychology (she/her). Reviewed by Dr. Pascale Piron, Psy.D., M.A., LCPC (she/her).
I was at a friend’s house having dinner while her young daughter watched a princess movie. Her daughter came to the dinning room a few times and chatted with us about things that only a 6- year- old could imagine. Until she became increasingly quieter and more focused on her TV screen. Right before I left, she approached me and asked if I thought she was as pretty as the princess in the movie and if she could eat the last piece of cake on the table, because she was afraid that eating cake “would not make her as pretty as the princess”. She was already becoming aware of her body image and the pressure to look a certain way. Sometimes even an apparent innocent princess movie on tv, comments heard in their household and school, or social media send wrong messages to young children who may be negatively impacted way into their adolescence. An important and vulnerable time for children who become highly influenced by the extensive use of unsupervised social media and other communication platforms.
Although the onset of eating disorders is more common in mid- to-late adolescence , there has been an alarming shift to as early as 9- year- old girls been diagnosed with some form of eating disorder.
Eating disorders in boys have generally been under reported. The American Psychological Association stated “boys have historically been excluded from research studies and the diagnostic criteria on eating disorders. A host of research from the past decade is now suggesting that these disorders, along with related mental health conditions such as body dysmorphia and subclinical disordered eating behaviors, don’t discriminate based on gender.”
According to the The National Eating Disorders Association eating disorders can be defined as follows:
Eating disorders are complex mental illnesses that are characterized by persistent disturbances in eating behaviors and impairment in psychological functioning.”
POSSIBLE CAUSES OF EATING DISORDERS:
The Cleveland Clinic lists some of the possible causes of eating disorders although the exact cause is still unknown. But studies show that many possible factors are considered in the diagnosis:
- Genetics: Our family genetic traits can directly impact our chances of developing eating disorders. Research shows that anorexia nervosa, bulimia nervosa and being eating disorder run in families.
- Brain Biology: Studies show that two chemical messengers and neurotransmitters, dopamine and serotonin are activated during certain eating behaviors. These chemicals are associated with pleasure, reward, motivation(dopamine) and mood regulation, sleep, appetite, digestion and learning(serotonin).
- Cultural and social ideals: One of the most common causes in adolescence eating disorder is the pressure to “fit in” in a society regulated now by the digital era. The unrealistic goals set by social media, TV and film industry can negatively influence anyone’s self-esteem.
- Undiagnosed mental health conditions: Many underlying mental health conditions such as trauma, anxiety and depression can trigger unhealthy eating habits that if left untreated could lead to an eating disorder.
WARNING SIGNS YOUR TEENAGER MAY DEVELOP AN EATING DISORDER:
As with any condition, we all experience symptoms in different ways, and a teenager may have one or more of these warning signs. It is important for parents and care givers to stay alert for any significant change in behaviors. The Uchicago Medicine lists some of the most common warning signs:
- Skipping meals or food groups
- Rigid rules at meal times
- Significant weight loss
- Avoiding social occasions involving food
- Hyperfocused on counting calories
- Excessive exercise
- Cutting out caloric foods
- Taking medication to suppress appetite
- Self-medicating using laxatives
- Weighing themselves multiple times a day
- Secretive eating
PHYSICAL SYMPTOMS THAT CAN BE ASSOCIATED WITH EATING DISORDERS:
The changes in eating behaviors can lead to the physical symptoms below :
- Digestive issues
- Lack of concentration
- Low energy and fatigue
- Increased anxiety
- Stress fractures
- Bone loss
- Teeth damage and calluses on knuckles from provoking vomiting.
- Swelling of arms and legs.
- Extreme weigh loss
- Dizziness or fainting.
- Constipation
- Issues with temperature regulation
There has been an alarming rise of eating disorders in younger children and teenagers in the last 20 years. Reports by The Journal of Pediatrics show that “In the US, from 2018 to 2022, health visits related to eating disorders more than doubled among people under the age of 17, and visits for all eating disorders among this age group increased by 107.4%, from approximately 50 000 visits in early 2018 to >1000 000 in 2022.” As a parent, these numbers are not only a huge concern but the confirmation that we as caregivers must be vigilant at all times and seek professional help as soon as warning signs are noticed.
TYPES OF EATING DISORDERS:
The The American Psychiatric Association outlines the following as the most common eating disorders:
- Anorexia Nervosa: Driven by an intense fear of gaining weight, this disorder is characterized by self-starvation resulting in extreme low weight for the person’s height and age. There are 2 subtypes of anorexia nervosa, the restrictive type (individual lose weight by dieting,fasting and excessively exercising) and binge-eating (intermittent binge eating and/or purging behaviors).
- Bulimia Nervosa: the ingestion of large number of foods in a short period of time, followed by guilt and shame, leading to self-inducing vomiting , intake of diuretics and laxatives in order to prevent weight gain. People suffering from bulimia nervosa is not necessarily underweight, and often recognizes there is an issue.
- Binge Eating: Someone suffering from binge eating may have recurrent episodes of ingesting really large amounts of food associated with a lack of control. The person may eat whether they are hungry or not. There is no compensatory behaviors with this type of eating disorder.
- Avoidant and Restrictive Food Intake Disorder (ARFID): Individuals suffering from ARFID significantly limit the volume and/or variety of foods they eat, leading to drastic weight loss, malnutrition and psychosocial issues. The difference between ARFID and anorexia nervosa and bulimia, is that the root cause is not body image but instead difficulties with sensory characteristics of food (appearance, smell, texture or taste), in addition to sensory characteristics an executive dysfunction such as fears of choking or vomiting may occur.
In a society that promotes restriction eating and dieting behaviors not only in adults but also in children, it is crucial that we support our youth in becoming aware of any warning signs and seeking professional help as soon as possible.
Therapy is one of the most important resources families can use to support their teenagers in coping with eating disorders. Whether it was triggered by biological traits or social media pressure, the focus should be on getting help and creating a treatment plan to get your child healthy again.
HOW CAN THERAPY HELP YOUR TEENAGER COPE WITH EATING DISORDER SYMPTOMS:
The importance of therapy for teenagers suffering from eating disorders can be explained here by psychotherapist Julia Levy-Brown, M.A., LCPC from Emerge Psychology Group based in Chicago, IL:
Eating disorders can begin impacting people the moment our intuitive instincts with food and movement are influenced by our environment. Early intervention and recognition, especially in adolescence, can significantly influence treatment success. Therapists can improve recognition of disordered eating and body image concerns in adolescence by curiously engaging in conversation surrounding the following topics:
- Client’s perception of the value food holds.
- Client’s perception of the value body size/shape holds.
- The messaging a client receives regarding expectations around food, movement, and bodies.”
If you are experiencing a mental health crisis, always seek professional help immediately. Please call 911 or the suicide prevention lifeline at 988, or go to your local emergency room for immediate medical attention.
TYPES OF THERAPY FOR TEENAGERS DIAGNOSED WITH AN EATING DISORDER:
- Psychotherapy: It creates a safe environment for discussion around body image , stress, teenager friendships, and family dynamics. It helps clients develop tools, or strategies as well as coping mechanisms by dispelling myths and false information dispensed by social media.
- Cognitive Behavioral Therapy (CBT): This type of therapy has two components.The first one is to address and help clients change their thinking about food, and the second is to help client improve their behavior or reaction to that situation.
- Family therapy: often recommended for children and teenagers, family therapy involves the whole family in supporting the child or teenager struggling with an eating disorder. Family members are encouraged to realize no one is to blame but rather should work together as a team, minimizing stress with improved communication, and helping their child or teenager develop a healthier relationship with food.
The path to healing from an eating disorder requires a lot support and adolescence is already such a vulnerable time for teenagers. It’s a period that includes so many significant changes that combined with the challenges of an eating disorder can be extremely overwhelming. It’s a time that can impact the mental health of our children with long lasting effects.
It does take a village to raise a child. I certainly could not have done it alone. Don’t wait to get help if you notice your teenager is struggling with body image, self-esteem, depression or anxiety and has shown concerning changes in their eating habits. We are parents, not super heroes. It’s ok to ask for help. It’s important to role model to our children that seeking help is not a sign weakness, but rather an act of love.
Be kind. Be brave. Be well.
Always with love,
AB
DISCLAIMER
The content of these webpages and blogs and information provided is for general information and educational purposes only and it is not intended as a substitute for professional medical or mental health advice, diagnosis or treatment. Always seek the advice of your qualified health provider with any questions you may have regarding a medical or mental health condition. Seek professional help immediately if you are experiencing a mental health crisis or any other medical condition.
HELPFUL LINKS:
National Eating Disorders Association (NEDA)
American Psychological Association
National Suicide Prevention Lifeline: Call or text 988
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