What’s Underneath an Eating Disorder in Teens? Understanding the Root Causes
What’s Underneath an Eating Disorder in Teens? Understanding the Root Causes
Written by Lily Thrope, LCSW
When a teen develops an eating disorder, it can be tempting to focus on the behaviors we can see. Maybe they’re skipping meals, exercising more than usual, becoming increasingly rigid around food, or expressing distress about changes in their body.
But in my work with teens and adults struggling with eating disorders, I’ve found that it’s just as important to understand what’s happening underneath those behaviors.
Eating disorders don’t develop in a vacuum. Sometimes, food and body-related behaviors become a way to cope with difficult emotions, navigate changing relationships, feel accepted by others, or regain a sense of control when life feels uncertain.
In this episode of Full Recovery Is Possible, I sat down with Kelly Mosser to talk about what may be driving an eating disorder in teens, how parents can recognize potential warning signs, and how to support a teen without making them feel powerless.
Here are some of the most important things I want parents and caregivers to understand.
Why Do Teens Develop Eating Disorders?
One way I think about human behavior is that we tend to move toward pleasure and away from pain. When a teen develops an eating disorder, I want to understand what they’re getting from those behaviors and what they may be trying to avoid or cope with.
For one teen, an eating disorder might be connected to a desire to feel loved, accepted, or valued by their peers. They may believe they’ll be more attractive to a potential partner if their body looks a certain way, or they may feel pressure to fit in with a particular social group.
For another teen, the behaviors might be connected to fear. Adolescence brings so many changes, including physical changes that can feel unfamiliar or uncomfortable. As teens develop breasts, hips, muscles, and other characteristics of adulthood, they may struggle to understand or accept what’s happening to their bodies.
When so much feels outside their control, managing their food intake or exercise may become a way to feel in control of something.
These experiences can look very different from one teen to another. That’s why I don’t want parents to assume there’s one personality type, life experience, or reason that explains every eating disorder.
Eating Disorders Don’t Only Affect Perfectionists
There’s a common stereotype that eating disorders primarily affect highly driven, perfectionistic people who are focused on achievement and success.
While that can be part of someone’s experience, it’s far from the whole picture.
I also work with teens who are shy, lonely, struggling with bullying, or experiencing emotional pain they don’t know how to manage. An eating disorder can become a way of coping with those feelings.
I sometimes encourage people to think of the eating disorder as a part of themselves rather than their entire identity. For some teens, it can begin to feel like a best friend. It offers a sense of comfort, companionship, or safety when they’re having a difficult time.
The rules associated with an eating disorder can also make life feel simpler. When there are countless decisions to make every day, having a rigid set of rules about what to eat or how to exercise can temporarily reduce uncertainty.
Of course, those behaviors can become harmful over time. But understanding why they feel helpful in the first place can give us a more compassionate starting point for recovery.
Rather than asking only, “How do we stop this behavior?” I want to ask, “What need is this behavior meeting, and how can we help this teen meet that need in a healthier way?”
What Is Food Noise, and What Does It Mean?
Food noise has become a popular term, but I think it’s important to understand what it can mean.
My first question when someone describes experiencing food noise is whether they’re eating enough. Often, what people call food noise is hunger.
When your body needs nourishment, it sends signals that encourage you to eat. You might notice a growling stomach, thoughts about food, or an increased awareness of what you want to eat.
Sometimes, the difficulty comes from the thoughts we attach to those signals.
For example, a teen might feel hungry shortly after eating and immediately think, “Why am I hungry again? I shouldn’t need more food.” They might begin negotiating with themselves about what they’re allowed to eat, planning their next meal, or worrying about whether they’ve eaten too much.
Those thoughts can make it much harder to respond to hunger with trust.
When someone is consistently undernourished, their thoughts about food may become more persistent. Instead of assuming they need more control over their eating, it’s important to consider whether their body is getting enough nourishment.
There is some nuance here, too. Food noise doesn’t always have the same cause for everyone. Neurodivergence, emotional experiences, excitement around food, fear, and other aspects of someone’s relationship with eating can also contribute to persistent thoughts about food.
That’s why I want to look at the whole picture rather than assume there’s one explanation.
If your teen seems preoccupied with food, is frequently thinking about their next meal, or experiences distress around eating, it’s worth exploring what might be contributing to those thoughts with an eating disorder-informed professional.
When Exercise Becomes a Way to Cope
Movement can be a positive part of someone’s life. It can offer enjoyment, connection, and a sense of well-being, and I don’t want to demonize exercise.
What matters is the relationship someone has with movement.
When I’m concerned about a teen’s exercise habits, I look for signs of rigidity and distress. Does your teen feel like they must complete a particular workout, even when they’re sick, exhausted, or have other commitments? Do they become extremely upset when something interrupts their routine?
I also consider the amount and intensity of exercise, whether they’re eating enough to support their activity, and whether movement seems to be taking them away from other parts of their life.
For example, going on a walk with friends can be a social, enjoyable experience. On the other hand, exercising alone behind a closed bedroom door for long periods, particularly when it seems driven by anxiety or rigid rules, may raise different concerns.
There isn’t one exercise schedule that determines whether a teen’s behavior is healthy or unhealthy. The context matters, including their individual needs, activity level, emotional experience, and relationship with food and movement.
As a parent, you may notice that something has shifted from an activity your teen enjoys to something they feel compelled to do. It’s worth paying attention to that change and seeking professional guidance if you’re concerned.
How Diet Culture Can Make Eating Disorders Harder to Let Go Of
One of the most difficult things about eating disorders is that our culture often rewards behaviors that can be signs of someone struggling.
Think about how often people receive compliments for losing weight. Someone might hear, “You look amazing!” or “What have you been doing?” without anyone knowing whether that weight change was intentional, medically concerning, or connected to an eating disorder.
We don’t typically congratulate someone for having another mental health condition. Yet weight loss and restrictive eating can receive positive attention, even when a person is suffering.
For a teen, those compliments can make it much harder to recognize that something is wrong or feel motivated to change.
Over time, the eating disorder may become intertwined with their identity. They might feel proud of their behaviors, receive recognition from other people, and begin to associate their appearance with their value.
Then recovery can feel like losing something important, even when the eating disorder is harming them.
This is one reason I believe early intervention matters. The longer these behaviors are reinforced, the more difficult it can become to separate a person's sense of self from their eating disorder.
It’s also a reminder to all of us to be thoughtful about how we talk about bodies, food, and weight around teens. We may not know what someone is experiencing beneath the surface.
Why a Teen Might Feel Attached to Their Eating Disorder
Parents are sometimes surprised when a teen doesn’t immediately want to give up behaviors that are clearly causing problems.
From the outside, it might seem obvious that the eating disorder is making their life harder. But from the teen’s perspective, those behaviors may feel like the thing that helps them get through the day.
An eating disorder might provide a sense of control, a way to manage painful emotions, or a feeling of accomplishment. A teen may understand intellectually that they need help while feeling emotionally attached to the behaviors that have become familiar.
Recovery can also feel disempowering at first. A teen may feel frustrated that other people are telling them how to care for their body or asking them to change behaviors that still feel important to them.
They may look at their friends and wonder why they’re being asked to do something differently when other people seem to be getting away with the same behaviors.
That tension is real, and it deserves compassion.
Understanding this attachment doesn’t mean ignoring the risks of an eating disorder. It means recognizing that recovery involves more than stopping certain behaviors. It also involves helping a teen develop other ways to cope, feel safe, build relationships, and experience a sense of control.
How Parents Can Support a Teen Without Taking Away Their Power
When a parent realizes their teen may be struggling, it’s natural to want to fix the problem immediately. You might feel an urge to take away their phone, restrict their activities, or tell them all the things they need to do differently.
There may be times when safety requires clear boundaries and more intensive support. But I also want parents to think about how they can help their teen feel empowered throughout the recovery process.
Instead of approaching the situation as a list of things your teen is doing wrong, try to create opportunities for curiosity and connection.
You might ask questions like:
“Have you noticed anything that’s been feeling harder lately?”
“Is there anything about this situation that you wish felt different?”
“What do you think would help you feel more supported right now?”
You don’t need to have the perfect conversation or know exactly what to say. The goal is to help your teen feel that they can share their experience without being met with shame or judgment.
It’s also important to help them build sources of connection and enjoyment outside the eating disorder. What makes them feel like themselves? What activities help them feel connected to others? Where can they experience accomplishment, creativity, or belonging without needing to change their body or follow rigid rules?
And remember: you don’t have to manage this on your own. An eating disorder-informed therapist, dietitian, and medical provider can help you understand what your teen needs and determine the appropriate level of support.
Supporting your teen doesn’t mean leaving them to figure everything out independently. It means helping them feel heard and involved while ensuring their health and safety are being addressed.
Eating Disorder Recovery Is Possible
When we focus only on the visible behaviors, we can miss what a teen is trying to communicate or cope with underneath them.
Food restriction, rigid exercise, and persistent thoughts about food may be connected to many different experiences, including fear, loneliness, a desire for acceptance, or a need for control. Understanding those experiences can help us respond with greater compassion while still taking the eating disorder seriously.
Most importantly, we don’t have to wait until a teen is in crisis to offer support.
If you’re concerned about your teen’s relationship with food, exercise, or their body, you can reach out to an eating disorder-informed professional even if you aren’t sure exactly what’s happening. You don’t need to have all the answers before asking for help.
Full recovery is possible, and teens deserve support that addresses not only their eating disorder behaviors but also the emotional needs and experiences that may be contributing to them.
Listen to Full Recovery Is Possible
In this episode of Full Recovery Is Possible, I joined Kelly Mosser to discuss the factors that may contribute to eating disorders in teens, the meaning of food noise, the role of exercise, and how parents can support recovery without making their teen feel powerless.
If you’re a parent or caregiver trying to better understand what your teen may be experiencing, listen to the episode for more of our conversation.
At Thrope Therapy, we support teens and families navigating eating disorders and disordered eating. If you’re concerned about your teen and would like guidance on next steps, reach out to Thrope Therapy to learn more about working with our team. You don’t have to wait until things get worse to seek support.
