Eating disorders in youth and adolescents

When weight loss is happening rapidly, each week, each kilo is significant. (Photo:

Eating disorders often begin with a seemingly harmless diet. Some adolescents may feel too fat and wish to loose weight. Most of the time, they are firmly convinced that they only want to lose just a few kilos.

The vicious circle of eating disorders

When adolescents begin loosing weight, they are often very happy about their success and initially receive many compliments. The most troubling thing about eating disorders is that they usually begin in a very unsuspecting manner.  On the contrary, the initial phase is often experienced as a success, during which no help is needed. A person suffering from eating disorders will often claim being healthy. During the first months, emotional and physical symptoms increase in such a way that the eating disorder takes over everything else.

Look for help: the sooner the better!

When parents see that their adolescent child is slowly sliding into an eating disorder, they should act immediately and not "wait and see". First and foremost, it is important to speak to the adolescent. Parents should be able to express their concern, but also listen to their child's opinion and take it seriously. They should be able to ask him or her the reason of their unhappiness. However, it is recommended to insist on the fact that a professional advice should be sought as soon as possible. When weight loss is happening rapidly, each week, each kilo is significant. Indeed, the vicious circle of eating disorders will get stronger, the more weight is being lost.

Warning signs of an incipient eating disorder

  • Young people no longer participate in family meals.
  • They invent excuses ("I have already eaten...").
  • There barely eat anymore, and in any case no carbohydrates and no fat.
  • Should they eat, they will only eat vegetables, salads and fruits.
  • They practice sports and exercise on a daily basis.
  • They enjoy cooking for others, but hardly eat any of it themselves.
  • They eat extremely slowly and move the food around on their plate.
  • They lose weight rapidly.
  • They look pale, have rings around the eyes and their hands are cold.
  • The increasingly withdraw themselves.
  • As soon as they have eaten, they disappear in the restroom (possibly to vomit).

When eating disorders take the upper hand: from anorexia to bulimia

For some adolescents, the eating disorders slides from constant hunger to over-eating. By renouncing on nutritious food, the desire for these foods increases and gives way to binge-eating episodes. There comes the time when the adolescent begins to devour huge quantities of food and loose control. Many enter a vicious circle oscillating between hunger during daytime and "eating attacks" in the evening. With time, the person feels ashamed of this behaviour and would rather not admit the problem. However, parents may often find traces of vomit in the toilet, or see their child disappear in the washroom every evening: in this case, it is essential to begin with therapy and treatment as soon as possible.  For this reason, parents should not close their eyes to what their child is going through. Speak with your child, ask her about how she feels, and seek professional advice.

Specialised centres and specialists for adolescents with eating disorders

  • Specialists in child and adolescent psychiatry
  • Paediatrician
  • Children's clinics
  • Child and adolescent psychiatry

Text: Dr. D. Pauli, chief physician, hospital director at Zurich Psychiatric University Clinic – 02/2018
Translation: myh