Causes
There are many theories about what causes eating disorders. There is rarely one cause; most eating disorders are caused by a combination of biological, psychological, and environmental factors. Sometimes the cause may not be completely clear.
There are biological reasons that may help to explain why some young people are more likely to develop an eating disorder. Your child may be more likely to have symptoms of an eating disorder if he/she has ever been diagnosed with a mood disorder, anxiety, or depression. Some people with certain traits or temperament and/or family history of eating disorders are at a higher risk of developing anorexia, bulimia, and/or binge eating.
There are psychological reasons that may put a young person at risk such as being diagnosed with obsessive compulsive disorder (OCD), having past or current trauma such as physical, emotional, or sexual abuse, or if a young person feels the need to have more control over some aspect of their life. Personality traits such as perfectionism, extreme desire to succeed, and impulsivity can also play a role. Family values about body size, appearance, feelings about food, how people feel about themselves and their self–worth are important factors as well.
In today’s society, there is an intense focus on thinness and dieting. Websites and social media feeds filled with photographs of thin models as well as articles that focus on weight loss abound. Teens might spend hours each day online, constantly looking at photos and stories, many by “influencers” who do not have an scientific background in nutrition. Even if someone or something is promoting “wellness,” their ideas or message may still be influenced by diet culture. Other environmental factors such as participating in sports that place emphasis on body shape and size such as dancing, rowing, gymnastics, track, and wrestling may in some cases influence whether a young person develops an eating disorder. Finally, stress at school, in sports, with peer groups, or at home, along with cultural attitudes about how a young woman or young man perceives how they should look and behave may play a role. Keep in mind that much more research is needed to understand risks and possible causes.
Signs and Symptoms
You can’t tell whether a person is struggling with an eating disorder just by looking at him or her, but there are often warning signs. Warning signs or “red flags” might suggest that a young person may develop or already has an eating disorder. Below is a list of signs that are linked to some or all types of eating disorders. These signs may also mean that a person has another kind of health condition, so it’s best to talk with your child’s primary care provider (PCP) about your concerns before jumping to any conclusions.
- Skips meals, makes excuses not to eat, or avoids eating in front of others
- Over exercises or prioritizes exercise over other previously valued activities
- Doesn’t eat certain food groups or nutrients (such as carbs or fats) or starts following a vegetarian, vegan, paleo, ketogenic, or other restrictive diet
- Has unusual behaviors around food such as organizing food, cutting food into small pieces, always finding something wrong with food, or pushing food around
on the plate - Obsessively reads nutrition information or counts calories
- Constantly weighs themselves or “body checks” (looks at their body in the mirror or feels their body with their hands)
- Chews gum constantly or drinks large amounts of water, coffee, diet soda, or calorie–free drinks
- Uses the bathroom after eating or in the middle of meals
- Consumes unusually large amounts of food at one time
- Loses control around food
- Has scars or calluses on hands and knuckles (from using fingers to vomit)
- Hides food or empty wrappers
- Diets often or eats mostly diet foods
- Eats secretively (food may be missing from cabinets at home or disappearing quickly)
If any of these behaviors are a problem for your child, call your health care provider.
Truth: Although people with anorexia nervosa are typically underweight, individuals suffering from bulimia, binge eating disorder, and OSFED (other specified feeding and eating disorder) can be at a normal weight, or even overweight. Also, people with eating disorders may try and hide their bodies by wearing baggy clothes or dressing differently.
Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.