Is My Kid OK? Know the Symptoms of Eating Disorders


Q: My daughter has become extremely concerned about her appearance. She is constantly looking in the mirror, changing clothes and changing her hairstyle. She has also become very picky about the food she eats and talks about not wanting to get fat. We focus on healthy foods at our house, but it is almost becoming an obsession with her. Does she need a counselor?

A: Good or bad, we all have ideas about the way we view ourselves. Pre-adolescents and teenagers are particularly prone to worrying about their bodies and how they may be seen by others. For them, it is a time of tremendous growth and change as well as heightened emotional sensitivity. While your daughter is experiencing normal behaviors that go along with the teenage years, she may be at risk for a more serious issue such as an eating disorder.

Talk with your daughter about her self-image and the pressures she may be feeling with regard to “fitting in.” Ask her open-ended questions and offer her some uninterrupted time to share how she is feeling. Acknowledge the challenges of being a teenager in today’s high-pressure society. Take this opportunity to speak with her about her innate value and the qualities that you and others admire in her, such as her ability to be a good friend or a loving daughter.

Ask other family members not to make negative comments about your daughter’s appearance. Teenagers who struggle with eating disorders can frequently recall comments made by family members and peers that set them on the path of self-doubt and unhealthy eating behaviors.

If your daughter continues to have unhealthy issues with her body and eating, there are several things to watch for with regard to a potential eating disorder:

  • Look for excessive amounts of time spent in the bathroom, especially after meals. This can be a time of purging or laxative use.
  • Red knuckles from teeth scraping the back of the hand can be a sign of forced vomiting.
  • Frequent use of gum, breath mints or bathroom sprays can be used to mask odors related to purging.
  • Dry skin can be a sign of dehydration that comes from losing necessary body fluids. Menstrual periods may change pattern or stop if enough body fat is lost.
  • Watch mealtime behaviors such as pushing food around on the plate or drinking lots of water instead of eating.
  • Look for physical changes such as fine hair growth (called lanugo) on the arms, legs or face, which is the body’s attempt to keep itself warm due to loss of body fat.
  • Rapid weight loss can also cause a feeling of being cold, and layered clothes may be worn as a means to maintain body heat or camouflage a rapidly changing appearance.
  • Patterns of exercise should also be monitored. Regular activity for limited periods is healthy and should be encouraged. However, if your daughter is becoming obsessed with exercise and appears anxious or panicked when she does not get her work-out time in, it may be cause for concern.
  • Monitoring intake and calorie-counting may be part of a healthy approach to weight loss, but an obsessive focus on food and its preparation can indicate a problem.
  • Anxiety related to eating in public, secretive eating and food hoarding can all be indicators that an individual has an unhealthy relationship with food.

If you become aware of one or more of these issues, seek help. The National Eating Disorders Association has wonderful online resources including screening tools, support groups and parent tool kits to help you get started. Contact your local mental health provider to seek treatment or assistance as needed.

Susan Michels works with children and adolescents at Cone Health Behavioral Health Hospital. Please submit your questions to Is My Kid OK? by emailing

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