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Eating disorders are medical conditions, not lifestyle choices.
The most common eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder.
Parents and caregivers should watch for both emotional and physical signs of disordered eating.
A Swedish clinical psychologist offers insights into these types of disorders and guidance on how to get help.
Food plays numerous roles in our lives. Maybe it’s a shared meal with loved ones or a special treat you savor in solitude. Food can bring people together, evoke cherished memories and provide the nourishment your body needs. But for people with eating disorders, mealtime and eating too often bring feelings of guilt, distress and shame with every bite.
Eating disorders are often thought of as lifestyle choices — but they aren’t. Eating disorders are serious medical conditions that drastically affect your eating habits, thoughts and feelings about food and body image.
Common eating disorders include:
- Anorexia nervosa, which causes extreme food avoidance and strict, self-imposed eating restrictions. You may see yourself as overweight even when you’re dangerously underweight. Anorexia nervosa is the least common eating disorder. It is the most serious, with the highest death rates of any mental disorder.
- Bulimia nervosa, defined by periods of binge eating large amounts of food followed by self-induced purging accomplished by throwing up or using laxatives. Overexercising and fasting are also common if you have bulimia.
- Binge eating disorder, which is characterized by uncontrollable consumption of enormous amounts of food. It can lead to extreme overeating and obesity.
According to the National Eating Disorders Association, roughly 30 million people in America will have an eating disorder in their lifetime, and many of them are children and adolescents. We talked to licensed clinical psychologist Courtney Lavadia, Ph.D., a behavioral health specialist at Swedish, to get answers to parents’ most common questions. Here’s what she shared.
Q. Who gets eating disorders? Is it mostly female-identifying people or does it also affect males and male-identifying people?
A. There is a common misconception that eating disorders are mostly associated with young, white females, but this is due to cultural bias. In reality, eating disorders affect people from all demographics and all walks of life.
Q. What are the warning signs of eating disorders? What should parents and caregivers look for if they’re concerned?
A. Parents and caregivers should be on the lookout for either emotional or physical symptoms of disordered eating.
Physical symptoms are frequently easier to spot. Things to watch for may include:
- Dramatic fluctuations in weight
- Gastrointestinal issues, such as acid reflux
- Dental problems
- Dizziness or fainting
- Feeling cold all the time
- Muscle weakness
Emotional and behavioral warning signs can be a little more difficult to identify. Children and teens may not necessarily communicate these concerning perceptions to parents. Red flags often include:
- Preoccupation with weight loss
- Discomfort eating around others
- Skipping meals or taking significantly smaller portions
- Extreme concern for body size and shape
- Starting practices related to dieting or fad diets
Q. How does social media affect someone struggling with an eating disorder?
A. Social media does not directly cause an eating disorder. There are biological, physical and social-emotional factors that are also at play. Social media use has been linked with poor body image, reduced self-esteem, increased body dissatisfaction and disordered eating behaviors and attitudes.
Current research suggests that focusing on thinness versus fitness contributes to body image concerns and disordered eating behaviors. Although there has been a general shift away from the thin ideal and towards the fit ideal, fit idealization has its own problems. For example, fitness-related content may encourage excessive or compulsive exercise as well as compulsive meal planning or preparation.
It is also worth mentioning that the rates of common eating disorders have remained fairly constant despite the correlations we see in the research between social media use and the attitudes and behaviors of disordered eating. This means that even as social media use continues to grow in younger populations, we are not seeing significant increases in rates of diagnoses.
Q. What can parents do to minimize social media’s negative influence on their child’s body image and/or eating disorder?
A. One of the most crucial protective factors against disordered eating is a strong parent-child relationship. Have open discussions with your children about how social media use can impact their mental and physical health. Provide them with a safe space to share their thoughts and feelings.
Parents can offer the greatest support by:
- Developing a safe environment at home for children to talk freely about these topics without reprimand
- Taking time to listen to children’s emotions and thoughts instead of giving advice
- Focusing on feeling healthy instead of working towards some ideal body.
- Limiting access to social media groups and hashtags such as #thinspo or #fitspo that encourage extreme thinness, starvation and unhealthy ideals and activities
It’s helpful to give yourself frequent reminders of what you can and cannot control. It can be difficult, if not impossible, to manage the content that’s available to your children. It’s unrealistic to expect that you’ll be able to protect them from everything.
Make decisions about social media use that meet your family’s unique needs. What works for one family does not always work for another. Some families may choose to not allow their children access to social media until a certain age or at all. Others may decide to allow limited access to certain content or applications.
At the end of the day, this decision is up to the parent or guardian. I hope to empower you in doing whatever you feel is best.
Q. How has COVID-19 affected people with eating disorders?
A. Several significant risk factors have been identified that impact disordered eating and eating disorder symptoms. Social isolation can affect those who struggle with disordered eating behaviors.
Some people have had difficulty accessing appropriate food due to grocery store closures and limited item availability because of COVID-19. Food access can be a challenge to individuals diagnosed with anorexia nervosa due to their already very restricted diets. When foods they are typically comfortable eating are no longer available, this may cause additional weight loss
For those with binge eating disorder or bulimia, bulk buying, which has become common during the pandemic, can be challenging. Having large quantities of food in the home may trigger increased binge eating or purging behaviors.
Pandemic-driven gym closures and concern about infection disrupted the exercise regimens of many people. For those who use healthy exercise to cope with disordered eating, disruptions to their regular routine can be stressors that prompt maladaptive coping. When people who struggle with eating disorders cannot engage in moderate, healthy activity, they might be more likely to restrict calories, purge or make unhealthy choices when faced with psychological distress.
Understanding risk is an essential facet of preventing or treating mental health concerns. But it’s equally as important to focus on those factors that help us be resilient through difficult times.
Some things that can enhance resiliency include:
- Spending meaningful time with friends and family, even if only virtually
- Give yourself frequent breaks throughout the day
- Doing exercises at home or going on neighborhood walks
- Choosing healthy, nutritious meal and snack options as often as possible
The most crucial aspect of all these resilient behaviors is focusing on connection. Try doing these things together — as a family — as often as you can to support meaningful connections in a time when it has been so hard to truly connect.
Q. When should you seek professional help?
A. The warning signs listed above are a good start for identifying a potential issue with your child’s eating. However, the list is not all-inclusive. If you have any concerns about your child's emotions or behaviors, it's important to check in with your primary care doctor to seek professional guidance.
Q. What resources are available to help?
A. The team of behavioral health experts at Swedish offers a wide range of services to diagnose and treat all forms of eating disorders. Several national organizations offer free, confidential assistance.
The National Eating Disorder Association Website and Helpline:
- Helpline: 800-931-2237
- For 24/7 crisis support, text “NEDA” to 741741
Eating Disorder Hope
988 Suicide and Crisis Lifeline (formerly the National Suicide Prevention Lifeline)
- Dial 988 or 800-273-TALK (8255)
- People who are deaf and hard of hearing can use a preferred relay service or dial 711 then 988.
Find a doctor
If you have questions about eating disorders, contact Swedish Behavioral Health and Wellbeing. We can accommodate both in-person and virtual visits.
Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.
Join our Patient and Family Advisory Council.
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
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