Looking out for eating disorders in children & adolescents
Eating disorders do not always look alike and can be hard to pick up.
They can develop quietly. They can begin with small changes in eating, increasing concerns about body shape, or a growing need to control food. In younger children, the signs can sometimes look quite different again.
Eating disorders are serious mental health conditions, and early recognition and treatment are important.
Signs to look out for
Changes in eating
You might notice that your child:
starts skipping meals or regularly leaves food uneaten
becomes increasingly selective about what they will eat
suddenly avoids foods they previously enjoyed
becomes distressed when preferred foods are unavailable
takes an unusually long time to eat
develops increasingly rigid rules around eating
becomes very uncomfortable eating with other people
frequently says they have already eaten
becomes secretive about food
develops a much narrower range of foods.
For some children, particularly younger children, these changes may initially look like “fussiness”.
The important question is whether the pattern is becoming more restrictive, rigid or distressing over time.
Increasing concern about weight or body shape
Another early sign can be a noticeable change in the way a child talks about their body.
They may:
frequently talk about being “fat” or needing to be thinner
compare their body with friends, siblings or people online
become worried about gaining weight
repeatedly check their appearance
ask for reassurance about their body
become distressed about particular parts of their body
suddenly want to go on a diet
become increasingly interested in “healthy” or “clean” eating in a rigid way.
It is important to take these comments seriously, even when they seem to be made casually.
A child does not need to appear underweight to be experiencing significant eating disorder symptoms. Conditions such as atypical anorexia nervosa can involve serious restriction and psychological distress without the child necessarily appearing underweight.
Exercise can become different
Exercise is not inherently a problem.
Children and adolescents can enjoy sport, movement and physical activity.
The concern is when exercise becomes rigid, compulsive or connected to food and body concerns.
For example, you might notice that your child:
becomes distressed if they cannot exercise
feels they have to “burn off” food
exercises despite being unwell or exhausted
becomes increasingly driven to exercise
finds it difficult to have rest days
seems anxious or guilty after eating unless they exercise.
Behaviour after eating
Some children and adolescents may develop behaviours designed to compensate for eating.
You might notice:
going to the bathroom immediately after meals
vomiting
excessive exercise after eating
periods of fasting or significant restriction after eating
increased secrecy around food or eating.
Not every child who goes to the bathroom after a meal has an eating disorder, of course. It is the overall pattern and context that matters.
Emotional and psychological changes
Sometimes the first thing parents notice isn't actually food.
It may be a change in their child's mood or behaviour.
Your child might become:
increasingly anxious or irritable
preoccupied with food, weight or appearance
socially withdrawn
less interested in activities they usually enjoy
perfectionistic or increasingly rigid
distressed by changes or uncertainty
more secretive
increasingly distressed around mealtimes.
Some children may also become very upset when routines around food change.
What looks like stubbornness or defiance may sometimes reflect genuine anxiety around eating.
Physical signs
Eating disorders can also affect physical health.
Depending on the eating disorder and its severity, children may experience things such as:
tiredness or low energy
dizziness or fainting
feeling cold
headaches
difficulty concentrating
gastrointestinal complaints
changes in growth or weight trajectory
weakness
menstrual changes in adolescents.
Physical symptoms should always be taken seriously, particularly when they occur alongside changes in eating or exercise.
Some complications of eating disorders can become medically serious, which is why assessment by a GP or paediatrician is important when there are concerns.
What about younger children?
Eating difficulties in younger children can be particularly complicated.
A child may not say:
“I am worried about my weight.”
Instead, they may simply refuse foods, become extremely distressed around particular textures, have a very limited range of accepted foods or become increasingly anxious about eating.
For some children, this may be related to sensory sensitivity or fear rather than body image.
Avoidant/restrictive food intake disorder (ARFID), for example, can involve significant restriction without the weight or shape concerns typically associated with anorexia nervosa.
This is why understanding why a child is avoiding food is so important.
What parents sometimes miss
One of the most common traps is waiting for things to become “serious enough”.
Parents might think:
“They are still eating.”
“They don't look underweight.”
“They're only being fussy.”
“They're just interested in eating healthily.”
But early changes can be easier to address than well-established patterns.
A child may also become very skilled at hiding what is happening.
This means that your concern is worth exploring even when you are not completely sure what is going on.
What should I do if I am worried?
You do not need to diagnose your child yourself.
Start by talking with your child calmly and without criticism.
Try to communicate:
“I've noticed that eating has seemed harder for you lately, and I want to understand what’s up.”
Rather than focusing immediately on weight, calories or appearance, try to understand their experience.
Questions such as:
“How have you been feeling about food lately?”
“Are there foods that feel difficult at the moment?”
“Does eating make you feel anxious?”
can open up a conversation.
If you are concerned, arrange an assessment with your GP or an appropriately qualified professional experienced in eating disorders. For children and adolescents, assessment often involves looking at both psychological wellbeing and physical health.
Most importantly, don't wait for certainty.
Parents often worry about “making a big deal out of nothing”.
But seeking help does not mean you are labelling your child with an eating disorder.
It means you are paying attention.
And it gives you the opportunity to understand what is happening before the problem becomes more entrenched.
Your child may not have an eating disorder.
They may be experiencing anxiety, sensory difficulties, body image concerns, gastrointestinal problems, developmental changes or something else entirely.
But if eating, exercise or body image is beginning to take up more and more space in your child's world, it is worth paying attention.
Early support can make a difference.