It’s normal for teens to experiment with food choices, routines, and identity. But when concerns about food, body image, or control start driving daily life, it may signal something more serious. From a Dialectical Behavior Therapy (DBT) perspective, eating disorder behaviors often develop as ways to cope with overwhelming emotions, stress, or a sense of loss of control. They are not about vanity, attention, or willpower. They are attempts to regulate intense internal experiences. Early awareness and early intervention matter. When support is introduced sooner, teens have a better chance of building healthier coping skills before patterns become deeply ingrained.
This guide is meant to help parents recognize early warning signs with clarity and compassion—without jumping to conclusions or shaming your teen.
Understanding eating disorders in teens
There is no single “type” of teen who develops an eating disorder. Teens of any size, gender, background, or activity level can struggle. What often connects teens is that food and body image start to feel like the primary way to manage stress, emotions, or self-worth. Eating disorders may reduce anxiety temporarily, create a sense of control during chaos, numb emotional pain, and serve as a punishment when shame is high.
Some of the common eating disorders parents hear about include:
- Anorexia nervosa, often involving restriction, fear of weight gain, and intense distress around body shape
- Bulimia nervosa, involving cycles of binge eating followed by compensatory behaviors such as vomiting, laxatives, or excessive exercise
- Binge eating disorder, involving episodes of eating with a sense of loss of control, often followed by shame or emotional distress
These are medical and mental health conditions that affect both the brain and the body. They are not phases, rebellion, or something a teen can “snap out of.”
Early warning signs to watch for
Eating disorders often start quietly. Many teens work hard to hide symptoms, which is why patterns matter more than a single behavior.
Changes in eating habits and eating behaviors
Watch for shifts that feel rigid, secretive, or driven by fear.
- Skipped meals or consistent “not hungry” explanations that become routine
- Sudden rules about food (cutting out entire categories, “clean eating,” moralizing food as “good/bad”)
- Avoiding meals with family/friends, eating alone, or making excuses to not spend time around food
- Frequent trips to the bathroom after eating (especially if it becomes a pattern)
- Signs of binge eating, such as food disappearing, wrappers hidden, eating late at night, or intense guilt after eating
From a DBT lens, these behaviors often function as short-term emotion relief, even though they create long-term harm.
Body image and weight-related red flags
Body insecurity is common in adolescence. The difference with eating disorders is intensity, persistence, and emotional impact:
- Obsessive mirror checking or constant body comparisons
- Harsh self-talk tied to worth (“I’m disgusting,” “I don’t deserve to eat”)
- Extreme distress around photos, clothing fit, or normal pubertal changes
- Escalating fear of weight gain or fixation on weight loss
These thoughts often reflect high shame and invalidation, not confidence or motivation.
Exercise becoming compulsive
Movement can be healthy—but it can also become another form of emotional control:
- Exercising despite injury, illness, exhaustion, or important obligations
- Panic, guilt, or irritability if a workout is missed
- Using exercise to “earn” food or punish eating
Physical and mental signs
Eating disorders impact both physical health and emotional regulation.
Possible physical signs:
- Weight changes (in either direction), dizziness, fainting, fatigue
- Feeling cold often, hair thinning, stomach complaints
- Changes in menstrual cycles or growth patterns
- Dental issues or sore throat (possible with purging)
Possible emotional and behavioral signs:
- Increased anxiety, perfectionism, irritability, withdrawal
- Rigid routines and difficulty tolerating change
- Depression, secrecy, shame, or emotional volatility around food
How to talk to your teen without making it worse
The goal isn’t confrontation—it’s connection. DBT emphasizes validation first. Teens are more likely to open up when they feel understood, not judged.
What to say
- “I’ve noticed you’ve been skipping meals and seem more stressed after eating. I’m not here to blame you. I want to understand what’s going on.”
- “I’m worried about how much pressure you’re carrying around food and your body.”
- “I love you, and we’ll figure this out together.”
What to avoid
- Comments about weight or appearance (even positive ones)
- Threats, lectures, or power struggles at the table
- “Just eat” or “You’re fine” reassurance that dismisses real distress
Your teen may deny there’s a problem. That doesn’t mean you’re wrong, it often means they’re scared, ashamed, or not ready to let go of a coping strategy that feels necessary.
When to seek intervention and support
If you’re seeing multiple warning signs, it’s time for intervention and support. Waiting for “proof” can allow symptoms to deepen. Early intervention improves outcomes because behaviors are less entrenched and medical risks are less likely to escalate.
A strong support plan may include:
- A pediatrician visit to assess medical stability and nutrition concerns
- Therapy with a clinician experienced in treating eating disorders
- Family-based support and coaching on how to respond at home
- Coordination with the school when needed
If your teen shows signs of rapid weight change, fainting, chest pain, severe restriction, or frequent purging, seek urgent medical care.
You don’t have to handle this alone
If you suspect your teen may be struggling with an eating disorder, trust the signal. Support early is not overreacting. It’s protective parenting.
At Mindsoother Therapy Center, we support teens and families across Livingston, Short Hills, Chatham, and surrounding New Jersey communities using compassionate, evidence-based care rooted in DBT principles. We have several eating disorder specialists on staff and ready to support you. If you’re concerned about eating behaviors, body image, or emotional regulation, we offer consultations to help you:
- Understand what you’re seeing
- Reduce fear and confusion
- Build a clear, supportive plan forward
Help is available—and recovery is possible with the right support and skills in place. Reaching out early is not overreacting—it’s protective parenting.