In Spain, around 300,000 adolescents and young adults between the ages of 12 and 24 suffer from some type of eating disorder, according to data from the Spanish Association for the Study of Eating Disorders (AEETCA).

Eating Disorders or EDs are psychological disorders related to alterations in food intake, body image and weight that can affect the physical, psychological, social, and academic/professional spheres of the person who suffers from them.

EDs are complex disorders, so there is no single factor that causes their onset, but rather they are multifactorial in origin, where a variety of genetic, personal and social factors play a role.

¿Puede estar mi hijo:a desarrollando un trastorno de alimentación? 1

The most common eating disorders in adolescents are anorexia, bulimia and binge eating disorder. Anorexia is characterized by a restriction of food intake resulting in considerable weight loss. Bulimia is characterized by a restriction of food intake, with episodes of consuming a large amount of food in a short time, followed by self-induced vomiting. Binge eating disorder is characterized by eating a very large amount of food in a short time with a feeling of loss of control, without subsequently employing methods to compensate for what has been eaten, and is therefore frequently associated with weight gain.

Although eating disorders can appear at any age, adolescence is a period of special vulnerability due to the large number of physical, mental and social changes, so EDs have a higher incidence at this stage of life, especially between 12 and 18 years of age.

Below are some warning signs that can help you identify if your child is suffering from an eating disorder.

Food-related warning signs

  • Avoiding family meals.
  • Skipping meals or eating small portions.
  • Fasting (not eating for a period of time).
  • Eating large amounts of food in a short period of time.
  • Excessive interest in counting calories, diets, fat grams, and food composition.
  • Creating "eating rituals" (e.g., chewing each bite a certain number of times, breaking food into very small pieces, eating very slowly).
  • Eliminating entire food groups (e.g., carbohydrates, sweets or fats).
  • Disappearance of food at home.
  • Control and supervision of food preparation at home.

Warning signs related to weight and physical appearance

  • Unjustified weight loss.
  • Rapid weight gain.
  • Worry or fear of gaining weight.
  • Guilt about their weight or after eating.
  • Feeling overweight, despite having a normal weight.
  • Avoiding going to the beach or swimming pool.
  • Hiding your body with oversized or baggy clothing.

Warning signs related to behaviors

  • Exercising excessively.
  • Feeling intense discomfort if he/she cannot exercise.
  • Keeping an accurate record of body weight and calories consumed.
  • Going to the bathroom immediately after meals.
  • Depressed mood.
  • Irritability.
  • Social isolation.
  • Difficulty concentrating.
  • Perfectionism.
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When to see a specialist

If your child presents any of these symptoms it is important to go to a mental health professional as soon as possible, since an early diagnosis and treatment increases the probabilities of success of the treatment. Your child may only present one of the indicators, but when in doubt it is best to see a specialist to rule out or confirm the presence of an eating disorder.

What the specialist's diagnostic process is like

The evaluation process for an eating disorder includes an initial interview with the patient, as well as with the patient’s parents in the case of children and adolescents. In this interview a detailed clinical history is done to learn about the patient’s developmental history, current symptoms related to eating behavior, the presence of other possible symptoms related to mood and personality as well as the family´s medical and psychiatric background.

Specific psychological tests for eating disorders that evaluate body image, eating behavior and eating habits are also usually performed. It is also important to conduct a physical examination to know the height, weight, body mass index and other medical parameters of the person.

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How to talk to my child if I identify any of the warning signs of an eating disorder?

It is important to understand that children and adolescents with an eating disorder have little awareness of the problem and even if they do, they are usually ashamed of it and try to hide or deny it. Here are some tips for addressing the issue with them:

  1. Find a quiet time and place to have a conversation in a relaxed setting. It can be on a walk alone with your child or during a quiet time on the weekend. Avoid mealtimes or times when other family members are present.
  2. Express your concerns about changes you have observed in their eating behavior or mood, trying to be as objective and fact based as possible. Focus on expressing your concern for how they feel and their health, and avoid comments related to their weight or appearance.
  3. Provide accurate and understandable information about eating disorders, their treatment and the importance of getting professional help. You can explain that the psychologist's role is to help them understand what is going on and to help them feel better about themselves, and that what they tell the psychologist is confidential.
  4. Offer them a safe space to express their concerns, thoughts, emotions, and questions without interruption or judgment. As you listen, ask what you can do to support them and what they need.
  5. Practice patience and compassion: your child may have initial fear or resistance to seeing a specialist so it is important to be patient during this process as well as consistent. If he/she initially refuses help, do not insist at that time. Allow some time to go by talk to bring it up again and let him or her know that he or she can come to you with any questions or concerns that arise.

Eating disorders are one of the most common psychological disorders in children and adolescents. If your child develops an eating disorder it is important not to blame yourself or feel ashamed, as they are complex mental disorders that arise from a variety of factors.

If you identify one or more of the indicators of eating disorders in your child it is important to see a specialist as soon as possible because early intervention increases the chances of successful treatment. The family plays a key role in both the initial detection of warning signs as well as during the recovery process. Fortunately, eating disorders have a solution. With proper professional guidance and your love, support and patience, your child can overcome an eating disorder.

About the author

Verónica Sarria is a health psychologist at Sinews. She is specialized in eating disorders and obesity, working with adolescents and adults. She also treats other problems such as anxiety, depression, grief, self-esteem and interpersonal relationship problems, among others. Her orientation is cognitive behavioral but she integrates tools and techniques from other currents according to the needs of each patient, thanks to her training in mindfulness, mindful eating, attachment theory and systemic (family) therapy.

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