TW: Mention of eating disorder habits.
This week is the National Eating Disorders Awareness Week (Feb 26 – Mar 4) in the USA. Considering that such illnesses are very common among teenagers, we at TTH could not let it pass without mention.
I’ve always said that the curse of being a teenager is that everything you do is credited to puberty. Teen struggles are often brushed off as something caused by “hormones”, “teenage angst” or something of the like. “It’s just a phase,” they say, “it will pass.”
That can be dangerous when it comes to mental health. When an adult overlooks a teen’s feelings and behaviors, he risks losing the chance to recognize the teen’s need for help.
For now, our best option is to educate the teens themselves to help identify mental illnesses in other teens. After all, teenagers are especially sensitive to the feelings of other people of the same age. That makes you the best person to identify an eating disorder in a friend or classmate during its earlier stages.
Most people with mental illnesses try to hide their struggle as much as they can. So if you’re not paying attention, you may miss the early signs. That means missing a precious chance of helping the person while his or her symptoms are still milder and easier to treat.
But before we start listing the signs you should look out for, let’s talk a little more about eating disorders.
What are eating disorders?
Eating disorders are mental illnesses. That means they’re not the person’s choice. They’re not a “trend” or a “phase”, and definitely not a joke. They need to be treated seriously.
There are many different types of eating disorders. The most common ones are anorexia, bulimia, and binge eating disorder. All three are characterized by unhealthy eating habits — eating too little, purging what one eats (by vomiting or provoking diarrhea), or eating too much.
Such habits lead to very dangerous symptoms. Those include severe malnutrition, sudden heart attacks, multiple failures of organs, and others. Because of that, eating disorders are by far the most deadly mental illnesses.
The first image that comes to mind when we think of eating disorders is that of an underweight young girl. But we need to understand that eating disorders come in all shapes and sizes. A person could be struggling with disordered eating habits, and not be underweight or overweight. Genetics plays a great role in how each person’s body will react to bad eating habits.
It’s also important to note that as human beings, we are all vulnerable to one day developing an eating disorder. It’s true that most diagnosed people are young women between the ages of 12 and 25. But eating disorders can occur in any age and gender.
But what causes eating disorders? There’s not one single answer. Many people think it’s all about weight, body image, and vanity. But it’s not that simples. It’s important to remember that as with any other mental illness, the physical symptoms we see are merely a reflection of intense psychological suffering.
Many therapists found a link between eating disorders and a need of control. The person feels they’re losing control of their own life and tries to take control of something easier to grasp — their own body.
There’s no better way to understand this than to listen to someone who has actually struggled with that. In his autobiography, Z (2016), the British singer Zayn Malik wrote briefly about his battle against an eating disorder:
“When I look back at images of myself from around November 2014, before the final tour, I can see how ill I was. Something I’ve never talked about in public before, but which I have come to terms with since leaving the band [One Direction], is that I was suffering from an eating disorder. It wasn’t as though I had any concerns about my weight or anything like that, I’d just go for days — sometimes two or three days straight — without eating anything at all. It got quite serious, although at the time I didn’t recognize it for what it was. I think it was about control. I didn’t feel like I had control over anything else in my life, but food was something I could control, so I did.”
It’s worth noting that by November 2014, Zayn was a young man aged 21. He had money, fame, and talent but still struggled with his mental health. This only proves the point that eating disorders can affect anyone, regardless of gender, age, or social situation.
What are the early signs of an eating disorder?
Finally, let’s talk about the warning signs that show someone may be struggling with an eating disorder. There are many behaviors and physical changes associated with those disorders. Below, I’m going to list only a few that can be more easily noticed by teen friends.
Changes in behavior
Eating very slowly (playing around with food, taking very small bites) or denying hunger
Developing a habit of going to the bathroom right after eating or during meals
Eating in secret or hoarding food “to eat later”
Using laxatives, diuretics, or diet pills
Avoiding social situations that involve food (lunchtime at school, birthday parties, etc.)
Avoiding family and friends (especially after their physical appearance or disordered eating habits are mentioned)
Sudden or rapid weight loss
Gaining a lot of weight in a short period of time
Change in clothing style (e.g. wearing baggy clothes)
Feeling tired all the time
Being too sensitive to the cold (feeling cold even when it’s warm)
Excessive preoccupation with weight or other aspects of one’s appearance
Obsessive worry about calorie intake or dieting
Being depressed or anxious
Showing signs of a low self-esteem (self-depreciative comments, excessive apologizing, feeling shame when around others)
If the above warning signs raised an alert with you, you can check out the full list of warning signs here.
How can I help them?
If you’re worried about a friend’s mental health, it’s important to talk to them about it. Don’t keep your worries to yourself. Talking, in this context, can save lives.
Here are the steps to take if you are in that situation:
1) Educate yourself.
Learn as much as you can about eating disorders. The internet is full of organizations who share great resources on the topic. I recommend you start by visiting the National Eating Disorders Association’s website.
2) Set a private time and place to talk.
Make sure you talk to them in a comfortable and safe environment. They are probably embarrassed about their illness. Most people who struggle with mental illnesses are embarrassed by their symptoms. Creating a private, safe environment is the best way to approach the issue.
3) Be honest and avoid making them feel guilty.
Be sincere with the person and explain why you are worried about them. But be careful not to make them feel guilty about their own illness — they probably already do. Avoid saying things like, “why are you doing this to yourself?” or “are you proud of how you look right now? You look terrible!”
Instead, use an uplifting tone. Try to reassure them that you’re not trying to judge them. Explain that there’s no shame in admitting they’re struggling, that that’s the first step in recovery. Make sure they understand you are there for them, not against them.
4) Encourage them to seek help.
There are many different professionals and support groups your friend could reach out to. Encourage them to talk to an adult about it. If they are too scared of opening up to their parents, suggest going together to talk to your school’s counselor.
If they are still too nervous about it, suggest that they talk anonymously to someone on a hotline first. Thus, they can rehearse how to talk about it. You can reach the National Eating Disorders Association (NEDA)’s helpline at 1-800-931-2237. For more information on availability, check out their website’s contact page.
5) If they don’t listen to you, tell someone.
Be prepared for the possibility of your friend reacting negatively to your concerns. If they insist that they are ok and begin to avoid you after that, that should be another huge warning sign for you.
If you notice that they’re not going to seek help for themselves, you should take that attitude yourself. Of course, there’s the chance your friend is going to be mad at you for that. But their safety and health should be a priority now.
Try opening up to your school’s counselor about your concerns. They are going to know how to talk to your friend and/or their parents about it. If a counselor is not available, reaching out to a teacher or even to your friend’s parents directly is another good option.
For more information and advice on how to help someone struggling with an eating disorder, check out NEDA’s guidelines.