Recognizing Disordered Eating and Exercising in Teenagers

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Recognizing Disordered Eating and Exercising in Teenagers

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Kristen Maloney MS, RD, LDN

Sometimes big life changes, like a pandemic, spark changes in our behaviors. If your teen is suddenly very interested in nutrition, exercise, or appearance, they may be using food to regain control. There’s a very fine line between healthy eating and an unhealthy obsession with food and exercise. You may want to keep an eye out to make sure that the interest is a healthy one. If your teen is struggling with disordered eating or exercise, getting help quickly is key.

Normal vs. Disordered Eating & Exercising

To understand what ‘qualifies’ as disordered eating and exercising, let’s define what is normal. I think Ellyn Satter puts it best when she summarizes “Normal eating is flexible… it varies in response to your hunger, your schedule, your food, and your feelings.”

While normal eating is flexible, disordered eating is not flexible. Similarly, attitudes about exercise can become inflexible. You may see it called “exercise addiction” or “compulsive exercise.”

Key Point: Disordered eating and disordered exercise are inflexible.

Disordered Eating vs Eating Disorders

A person may suffer from disordered eating without having a diagnosed eating disorder (ED). Unchecked, both damage to body image, sense of self, and physical wellness.

Signs of Disordered Eating and Disordered Exercising

Teens may show some signs and not others. A comprehensive list can be found on the National Eating Disorder Association (NEDA) website. If you can, don’t wait for physical signs to start showing up before getting help.

Signs of Disordered Eating

Emotional/ Behavioral Signs
Preoccupation with food, calories, appearance, or weight
Guilt associated with eating
Strict rules about food and eating
Feeling cold all the time due to fat loss
Doing poorly in school (i.e., inability to focus and impaired cognitive ability)

Physical
Rapid weight changes
Stunted growth and weakness
Wearing loose clothes to hide weight fluctuations
Loss of menstruation, low iron, or low bone mineral density (i.e., Female Athlete Triad)
Decreased energy and impaired sports performance

Signs of Disordered Exercise

Emotional/ Behavioral Signs                                                                                                                  
Exercising even if there are conflicting priorities
Guilt associated with missing workouts or not working out hard enough
Need to always be moving (e.g., “jittery”)
Done to burn calories or compensate for overeating
Withdrawal or isolation from friends and family

Physical
Slow recovery from injury
Overuse injury
Getting sick more often due to impaired immune function
Loss of menstruation, low iron, or low bone mineral density (i.e., Female Athlete Triad)
Decreased energy and impaired sports performance

Seeking Help

If you’re worried about overreacting to your teen’s behavior, you are not alone. Many parents have similar feelings. It’s best to seek help even if you’re unsure that help is needed. Not only can dietitians screen your teen for disordered eating behaviors; they can also teach your teen useful skills like how to read nutrition facts labels, meal plans, shop on a budget, and fuel for sports. If the dietitian thinks your teen needs specialized treatment, they will refer out to an eating disorder dietitian and a mental health counselor. Your efforts will not be wasted!

Remember that people with disordered behaviors tend to withdraw. This makes it difficult to approach a loved one with your concerns. If your teen is not cooperative with the idea of seeing a dietitian, try comparing the appointment to a wellness check-up at the doctor’s office. The NEDA has an awesome Parent Toolkit with more tips on how to broach the subject.

Nutrition counseling may be covered by your insurance. Many insurance plans offer nutrition counseling under Medical Nutrition Therapy (Codes 97802/ 97803). Sometimes dietitian offices will check your insurance benefits before your first appointment. Because of the pandemic, many dietitians offer virtual appointments (“Telehealth”) at no additional cost.

Key Point: Seek help early on. Nutrition counseling may be covered up to 100% in your insurance plan.

Nutrition Treatment for Disordered Eating

There are a lot of treatment options available, depending on your teen’s needs. If your teen has some mild disordered behaviors, it’s likely that a dietitian will be able to work with your teen in an outpatient setting. If necessary, a dietitian will recommend advanced treatment. Nutrition treatment is usually paired with psychotherapy and medical monitoring.

Cheering Your Teen On!

Be open-minded that there may be underlying problems related to disordered behavior. Don’t expect your teen to “just get better”. Remember that you can’t force recovery. It’s up to your teen to make the journey, and they need to do it at their own pace.

Re-constructing thought patterns that lead to behavior change will take your teen time. It may be a difficult and slow process, but your support can make it easier. If you often compliment your teen and other family members based on appearance, try complimenting their character traits instead (like their resiliency, determination, thoughtfulness, or curiosity).  If you have your own inflexible attitudes about food or exercise, consider how to change your approach. Remember that your teen’s behaviors are not your fault and to take care of yourself along the way.

 

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