Eating disorders in adolescents

Anorexia, Bulimia, Binge Eating: Understanding What is Happening and Knowing How to Help

Are you worried about your teenager’s eating behaviors? Perhaps mealtimes have become increasingly tense, food seems to take up a massive amount of mental space in their daily life, or you feel like you no longer know how to step in without making things worse.

Sometimes, the changes are subtle at first. Other times, the behaviors quickly become more alarming. Whatever the situation, many parents feel overwhelmed, anxious, or hesitant to bring up the subject for fear of doing or saying the wrong thing.

Eating Disorders Can Take Different Forms

Eating disorders do not look the same for everyone, and they are not always easy to recognize in the beginning. In some teenagers, we mostly observe significant food restriction, an intense fear of gaining weight, or very rigid rules surrounding food and meals. These behaviors are most frequently associated with anorexia.

In other situations, a teenager might experience episodes where they feel a loss of control while eating, followed by guilt or compensatory behaviors—which aligns more closely with bulimia. For other youth, these episodes of losing control around food occur without any subsequent compensatory behaviors. This is known as binge eating disorder.

There are also many situations where a youth’s relationship with food, their body, or eating becomes difficult without a specific diagnosis necessarily being present. This can be described as disordered eating: rigid food rules, guilt after eating, anxiety around meals, difficulty listening to hunger or fullness cues, significant preoccupation with weight or body shape, etc.

It is important to know that we can support youth at various stages:

• Food preoccupations and rigidities without a formal diagnosis

• Disordered eating (emotional eating, guilt related to intake, cycles of restriction and compensation)

• Diagnosed eating disorders (anorexia, bulimia, binge eating disorder, etc.)

No matter where your child falls on this spectrum, the goal remains the same: to better understand what is happening and to support your teenager’s health in a safe, adapted way.

Please note: We do not provide diagnoses. Our role is to assess nutritional intake and eating behaviors, develop a concrete action plan, and guide you toward the right professionals if further medical or psychological investigation is required.

When Food Becomes Difficult to Understand

In the context of an eating disorder, food is no longer just about nourishment. It often becomes a way to cope with difficult emotions or even to regain a sense of control. For some teenagers, their eating behaviors are also deeply tied to body image, self-esteem, and how they perceive themselves.

In daily life, this can manifest as behaviors that seem to flip from one moment to the next: restriction, followed by a loss of control, followed by attempts to “catch up” or compensate. For parents, this constant shifting can be confusing and leave you feeling unsure of how to react.

A Situation Influenced by Many Factors

Eating disorders cannot be explained by a single cause. They are generally influenced by multiple interacting factors: societal pressure, media and peer influence, stress, anxiety, neurodivergence (ADHD, ASD), perfectionism, low self-esteem, genetics, family history, and many others.

It is not a choice, it is not a lack of willpower, and it is absolutely not something caused by parents. Most importantly, this type of situation cannot usually be resolved simply by “eating better” or changing a few dietary habits.

What We Aim to Do

In an eating disorder (ED) situation, the goal is not to immediately fix every unhealthy eating behavior. Instead, we begin by stabilizing the situation and reducing the factors that keep the cycle going.

Concretely, this can mean:

• Restoring a more stable meal structure

• Minimizing periods of restriction

• Reducing compensatory behaviors

• Calming the tension surrounding meals

• Supporting a more stable, reassuring approach to food

The idea is not to follow a rigid, “perfect” plan, but to start with your teenager’s current daily reality and progress at their own pace toward healthier behaviors and a better relationship with food.

Your Role as a Parent

You play a vital role in your teenager’s daily life, but you do not have to carry this entire burden alone.

Often, parents want to do the right thing but are left not knowing what to say or how to react. They want to help without causing harm, support without monitoring every bite, and intervene without fueling a conflict. This is precisely where professional support becomes invaluable.

We can help you:

• Understand what is happening, always without judgment

• Know how to react during difficult moments

• Reduce conflicts around mealtimes

• Support your teenager without increasing the pressure

• Identify clear, simple changes to implement at your family’s own pace

Where to Begin?

Nutrition as the Entry Point

The initial evaluation begins in nutrition. A first meeting with Jasmine Brousseau, Dietitian-Nutritionist, allows us to:

• Clarify your observations and concerns

• Understand current eating habits and identify behaviors to work on

• Screen for potential impacts on nutritional status

• Evaluate how the eating disorder is affecting your child’s physical health

• Determine if involving other professionals would benefit their recovery

• Identify priority intervention steps

Throughout the follow-up process, the role of the dietitian-nutritionist is to propose concrete, realistic changes to help:

• Provide an intake that matches your child’s individual nutritional needs

• Prevent or correct nutritional deficiencies

• Alleviate digestive symptoms caused by the eating disorder

• Limit the impacts the eating disorder could have on physical health (growth and metabolic health)

• Better detect and honor hunger and fullness cues

• Develop a healthier relationship with food

While she does not diagnose eating disorders, she can recognize red flags and guide you to the appropriate professionals if needed.

When Mental Health Support is Relevant

The emotional dimension of an eating disorder is often profound. This is why mental health support can be incredibly beneficial—not only for your child, but also for you as a parent.

This can be particularly relevant when:

• Anxiety surrounding food or the body is severe

• Mealtimes become a source of intense tension or crisis

• There is a high level of shame, guilt, or distress

• Self-esteem is heavily tied to appearance or food control

A social worker or another mental health professional can help to:

• Better understand the role of emotions in eating behaviors

• Develop strategies to manage anxiety around mealtimes (an often distressing time for teens with an ED)

• Improve family communication

• Support the teenager in their relationship with themselves

Dietitians and mental health therapists frequently work hand-in-hand to provide comprehensive care.

When Kinesiology Can Be Helpful

Kinesiology can also be integrated into the care plan. It can help your teenager:

• Reconnect with movement in a more stable, healthy way

• Move without the goal of compensation or control

• Regain confidence in their physical capabilities

• Develop a more realistic, sustainable motivation for physical activity

• Progress gradually, free from the pressure of performance

The goal is to rebuild a peaceful, lasting relationship with physical activity.

What This Approach Is Not

• It is not a diet.

• It is not a rigid meal plan.

• It is not an approach focused solely on weight.

• It is not a quick fix.

It is a step-by-step guidance process, tailored to the unique reality of your teenager and your family.

You do not have to wait until the situation is “severe enough” to ask for help. Nutrition is often the ideal starting point to understand what is going on, stabilize the situation, and clarify the next steps. From there, support is adjusted with the right professionals, at the right time, to best serve your teenager and your family.