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The combination of societal pressures around us about body, weight, and food, and the body changes and other changes of adolescence may lead to an unhealthy focus on body, food, and control.

Some behaviors to look for may be:

• Frequent talk about food 
• Frequent talk about body parts and their size
• Having excuses for not eating with family or friends
• Not eating but pushing food around on the plate
• Wearing layers of clothes all the time
• Disappearing after meals or going to the bathroom soon after meals

In therapy, adolescents and their families benefit by:

• Changing the way they think about the body and their eating
• Reducing the amount of time they focus on food 
• Reducing the struggle with thoughts and feelings that may be upsetting
• Improved relationships with friends
• Getting along better with family members

Many teens become very self conscious, particularly about their bodies. At the same time, pre- teens find their bodies changing and many will suddenly get heavier. This is a normal part of development that happens when certain hormones increase before a major growth spurt. 

Some teenagers get started in an unhealthy relationship with food and eating when they decide to “go on a diet,” when they want to lose weight for a special occasion or to fit into special clothes. Other times someone may comment on their body or their eating. Some teens get “stuck” in the dieting pattern, sometimes adding a lot of exercising. In spite of concern raised by friends, parents, or the pediatrician, the teen may continue losing weight. Although the dieting gets to be out of control, the teen may feel good, like she is finally in control of some things in her life.

Another pattern seen in teens is the experiment with purging food - that is, finding ways to get rid of food- like through a lot of exercise or making oneself throw up. Some teens begin to throw up when they feel uncomfortable with the food they have eaten and a friend tells them to try it. Soon she may find herself throwing up when she feels stressed, as a way to relieve her anxious feelings.

Signs and symptoms of an eating disorder in a teen are may include:

• Feeling bloated and “fat” after meals or eating certain foods
• Thinking a lot about meals and food
• Feeling ashamed of, or uncomfortable with, one’s body
• Overly focused on body weight or shape
• Feeling fearful about gaining weight
• Eating overly large amounts of food at one sitting
• Getting rid of calories by throwing up, exercising excessively, or taking laxatives