Eating disorders
Eating disorders are conditions that cause a person to have unhealthy thoughts, feelings, and behaviors related to food and body image.
Some people with eating disorders severely restrict their food intake (anorexia nervosa), while others eat excessively (binge eating disorder or compulsive overeating). They may also vomit, take laxatives, or exercise excessively to try to prevent weight gain after binge eating (bulimia nervosa).
The cause of eating disorders is not clear, but experts believe that it is related to a number of physical, psychological, cultural, and social factors. Eating disorders are most common in teenage girls and young women, but they can occur at any age and in both sexes.
People who have eating disorders may develop health problems, such as dehydration and malnutrition. Eating disorders also increase a person's risk of other health problems related to a poor diet. These other health problems can include menstrual period changes, thinning of the bones (osteoporosis) and, in severe cases, heart and other organ problems.
Eating disorders are treated primarily with counseling. Sometimes medicines also are used.
What are the symptoms of eating disorders in teens?
Teens who have an eating disorder often strongly deny that they have one. They do not see or believe that they do. But there are some feelings and actions that are common with each type of eating disorder.
Teens who have anorexia may:
- Weigh much less than is healthy or normal.
- Be very afraid of gaining weight.
- Think they are overweight even when they are not.
- Obsess about food, weight, and dieting.
- Strictly limit how much they eat.
- Eat a large amount of food and then may vomit or use laxatives or water pills (diuretics) so they won't gain weight.
- Become secretive. They may pull away from family and friends, make excuses not to eat around other people, and lie about their eating habits.
Teens who have bulimia may:
- Eat a large amount of food in a short time (called bingeing), often over a couple of hours or less, on a regular basis.
- Feel out of control and feel like they can't stop eating during a binge.
- Go to the bathroom right after meals.
- Eat a large amount of food but don't gain weight.
- Be secretive about eating, hide food, or avoid eating around other people.
- Purge to get rid of the food so they won't gain weight. They may make themselves vomit, exercise very hard or for a long time, or misuse laxatives, enemas, water pills, or other medicines.
Teens with binge eating disorder may:
- Eat a large amount of food in a short time, often over a couple of hours or less, on a regular basis.
- Feel like they can't stop eating and eat so much that they feel painfully full.
- Eat a large amount of food and may gain weight.
- Feel unhappy, upset, guilty, or depressed after they binge.
- Eat alone because they are embarrassed about how much they eat.
How are eating disorders in teens treated?
Treatment for eating disorders includes counseling, medicines, or both. Cognitive behavioral therapy helps change how teens think about food and their bodies. Nutritional counseling teaches healthy eating habits. Antidepressants may help reduce bingeing and purging. Eating disorders can cause serious health problems if they're not treated.
Can eating disorders be prevented?
There is no known way to prevent an eating disorder. But knowing the early signs and seeking treatment right away can help prevent problems caused by an eating disorder. Early treatment may be the best way to prevent it from getting worse.
What tests will you need if you have an eating disorder?
As a part of the physical exam for eating disorders, a doctor may order certain tests to see whether your body is generally healthy. These may include blood or urine tests to check:
- Electrolyte levels. Electrolytes are minerals, such as potassium, calcium, and sodium. A severe imbalance of electrolytes can lead to seizures, an irregular heartbeat, muscle weakness, and other problems.
- Levels of iron, sugar, protein, and fat.
- The function of the kidneys, liver, and thyroid gland.
- Levels of certain hormones, such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in women and testosterone in men.
- Levels of vitamins and minerals in the body.
A doctor may also test whether you have difficulty digesting certain foods, such as milk and dairy products.
How can you care for yourself when you have an eating disorder?
When you're recovering from an eating disorder, it's important to take good care of yourself. Stick to your treatment plan, and listen to what experts say about healthy eating. Find ways to manage stress. Be kind to yourself. Work on one goal at a time, and remember that recovery is a process.
What puts you at risk for developing an eating disorder?
Experts don't know for sure what causes someone to have an eating disorder such as anorexia, bulimia, or binge eating. But certain things put a person at greater risk for getting an eating disorder. Some of these things include:
- Having a family history of an eating disorder.
- Struggling with depression, anxiety, low self-esteem, or obsessive behaviors.
- Feeling a need to be perfect.
- Feeling social or cultural pressure about thinness or weight.
- Having a poor body image.
- Taking part in sports or activities that encourage thinness. Modeling and dance are examples.
- Having a history of physical or sexual abuse.
Having risk factors for it doesn't mean a person will get an eating disorder. But knowing some of the things that can add to the risk may help to see a problem early when it is easier to treat.
Eating disorders and negative thoughts: Overview
Eating disorders cause people to have unhealthy thoughts and behaviors about food and their bodies. With an eating disorder, how much you weigh and how you look have a severe effect on how you feel and think about yourself—and how you think others view you.
If you think you might have an eating disorder, talk with a doctor. Eating disorders can cause serious health problems and even death. Treatment includes counseling and sometimes medicines. Some people need treatment in a hospital or eating disorders clinic.
Negative thoughts
Negative thoughts are part of having an eating disorder. Changing negative thought patterns may not be easy. But our minds can be trained to be stronger and healthier—just like a muscle. A technique called thought reframing can help.
Thought reframing is the process of replacing negative thoughts with more helpful thoughts. It's a skill taught in a type of counseling called cognitive behavioral therapy (CBT). There are also books and apps that can help you learn thought reframing on your own.
With practice, you can get better at choosing healthier thoughts to replace negative thoughts.
Handling negative thoughts when you have an eating disorder
Negative thoughts can be hard to silence. While nobody can stop all their negative thoughts, you can reduce them. And you can start choosing healthier patterns of thinking. Here are some tips to get started.
- Watch for common types of discouraging thoughts.
When you know some of the common types, it's easier to spot them when they happen. Here are a few to watch out for.
- Weighting the negative. This means giving more importance to something negative than to something positive. For example, you may see a relapse as proof that you can't get better rather than seeing the time before it as proof that you are getting better.
- All-or-nothing thinking. This is also called black-or-white thinking. For example, you may think about foods as either "good" or "bad," with no options in between.
- Filtering. Your view of yourself may not be accurate when it's "filtered" through the lens of an eating disorder. For example, people with body dysmorphia often see "flaws" on their bodies where there are none.
- Practice reframing your thoughts.
- Notice the thought. Negative thoughts can pop up sometimes before you can stop them. But learning to recognize them can help you shift them.
- Question the thought. Ask yourself whether it's helpful, kind, or true. Consider whether someone who cares about you would agree.
- Replace the thought. Ask yourself "What's something that's true and more helpful?" Use your answer to replace the discouraging thought. Here's an example:
- You might first think "I'm weak because I ate a big breakfast this morning. I don't deserve to eat lunch."
- You can replace the thought with: "My body needs fuel to stay healthy. Eating regular meals is a way to take good care of myself."
- Use a thought diary.
Write down negative thoughts throughout the day. Then rewrite them to be more encouraging. Over time, choosing more positive thoughts in the moment will get easier.
What is an eating disorder in teens?
An eating disorder is a condition that causes some people to have unhealthy thoughts and behaviors about food and body image. Teens with eating disorders often base how they feel about themselves on how much they weigh and how they look.
Common eating disorders include:
- Anorexia. Teens with this condition limit how much food they eat. They can become dangerously underweight.
- Bulimia. Teens with this condition eat a large amount of food in a short time. Then they do something to get rid of the food, like making themselves vomit, so they won't gain weight.
- Binge eating disorder, or compulsive overeating. Teens with this condition eat a large amount of food in a short time. They do this on a regular basis for several months.
Feeling better about yourself when you have an eating disorder
People who have eating disorders are often very self-critical. Try some of the following ideas to feel better about yourself.
- Pace yourself if you are feeling overwhelmed.
Everything you do may take more time and effort.
- Do not expect to do all the things you want to do right away.
- Choose what is most important and do those things first.
- Break larger tasks into smaller ones and do what you can.
- Remember that some of your thoughts are part of your condition.
These thoughts may include feeling bad about yourself, feeling hopeless, and feeling uncomfortable in your body. Counseling can help you work through your feelings.
- Remember that recovery takes time.
Your body needs time to adjust. As you begin to eat in a healthier way, you may feel better and have more energy.
- Do things you like to do.
Find things that make you feel good. For example, some people like to spend time with others or some like quiet time to read.
- Don't blame yourself for your condition.
- Work as a partner with your health care team.
What should you do if you think someone has an eating disorder?
If you think your child has an eating disorder:
- Talk to them. Tell your child why you're worried. Let them know you care.
- Make an appointment for you and your child to meet with a doctor or a counselor.
If you're worried about someone you know:
- Tell someone who can make a difference, like a parent, a teacher, a counselor, or a doctor. A person with an eating disorder may say that they are okay and don't need help. You can help by encouraging them to talk to someone they trust.
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