Post-COVID-19 disordered eating behaviour in teens

  • Three teens eating pizza
Edwina Ekins
Nutrition 4 Performance
Edwina Ekins,

I’m a nutritionist, based in Sydney, with rural connections and a special interest and focus in teen health. I see many teens in my clinic either face to face or via telehealth. In the past 12 months, I have noticed an increase in teens presenting with difficult relationships with food. This is not just a condition that affects females; male teens are presenting with this as well – a key group is those that are following a strict muscle-gain routine.

Disordered eating can be either undereating or overeating, restricting certain food groups, extreme ethical views about food, vomiting after eating, or a combination of any of these. These behaviours are often a symptom of underlying anxiety or a previous trauma; food becomes one element of the chaos in their life that a teen can control (whether they realise that or not). COVID-19 seems to have exacerbated this for many teens, for a number of reasons. For example, they could be experiencing social anxiety about returning to school post-lockdown.

Disordered eating is really a psychological condition and requires the help of an experienced psychologist, hopefully in conjunction with the teen’s general practitioner (GP). Early detection and intervention by a parent, friend or GP is really important to improve the chances of recovery. As a nutritionist, I play a secondary role by creating a nutrition plan and encouraging flexibility and variety in food choices.

What to look out for

The main thing to look out for is a change in attitude and behaviour toward food. For example:

  • skipping meals
  • eating excessive amounts – more than reasonable at each meal
  • eating in secret
  • becoming a fussy eater
  • going to the bathroom after each meal
  • eating a lesser amount that previously
  • commenting on weight and appearance
  • excessive exercising
  • sudden weight loss or weight gain
  • obsessively following an online influencer with strong views on food and diet.

These are just some of the associated behaviours but the key is to notice changes – especially in times of stress, anxiety or disruption to normal routines.

What to do if you are concerned

The first step is to speak with your teen about the behaviour you are noticing. Your teen may not actually be aware of their behaviour and might be surprised, angry or even grateful. Be prepared for a variety of responses. When discussing, it is best to avoid showing anger or frustration. Your teen needs empathy, understanding and support.

Ask your teen if they are stressed or if there is anything going on in their life that may be triggering issues with food. Most of the time, a teen will struggle to make the link between chaos in their life (big or small) and disordered eating behaviour, however it helps to name and identify the behaviour, to bring awareness and remove the secrecy.

Suggest to your teen that there are many professionals who can help. A good start is your GP – they can refer you to a psychologist and nutritionist or dietitian. Sometimes a teen just needs some education and guidance and they will self-correct. Other times, the behaviour is more chronic in nature and reflective of a more long-term issue that requires extensive support from a psychologist or psychiatrist.

The single most important thing to understand is that early intervention is correlated with a greater chance of recovery from disordered eating.

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