Eating Disorders Symptoms Signs of Anorexia to Watch for in Teens By Barbara Poncelet Barbara Poncelet Barbara Poncelet, CRNP, is a certified pediatric nurse practitioner specializing in teen health. Learn about our editorial process Updated on April 30, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Margaret Seide, MD Medically reviewed by Margaret Seide, MD LinkedIn Margaret Seide, MS, MD, is a board-certified psychiatrist who specializes in the treatment of depression, addiction, and eating disorders. Learn about our Medical Review Board Print Verywell / Chelsea Damraksa Anorexia nervosa is a serious, and sometimes deadly, eating disorder that impacts 0.3% to 0.4% of young women in the United States. Adolescents between ages of 15 and 24 with anorexia have 12 times the risk of dying compared to their same-aged peers. Because the disease often starts in the teen years and can be fatal if not treated, it's important for parents to know the signs of anorexia in teens. Signs of Anorexia in Teens Anorexia nervosa is an eating disorder that causes the person to severely restrict what they eat or drink. A person with anorexia is often underweight, but continues to feel overweight or “fat.” There is often a great fear of gaining any weight, despite the fact that the person is underweight. Signs in Teens There are many and varied signs of anorexia in teens, including physical as well as emotional/behavioral symptoms. Not all teens with anorexia nervosa are emaciated. Anorexia nervosa can also be diagnosed in individuals who have recently lost a lot of weight and are what many would consider "normal weight." Physical: Dry skin or skin rash Erosion of tooth enamel Feeling cold Poor nail quality Thinning hair Emotional/behavioral: Frequently skipping meals with family and/or denying hunger Anxiety at mealtimes, claiming they have already eaten, and/or making excuses to avoid meals Prepping elaborate meals for friends or family but rarely eating them Cutting food into tiny pieces or moving it around to look like they're eating Wearing big, baggy clothing to cover up their body Withdrawing from friends and skipping social functions Spending an excessive amount of time at the gym or training for sports Complaining about being "fat" or obsessing over "flawed" parts of their body Focusing on nutritional labels in an excessive way or constantly trying restrictive diets (like eating no carbs or no fat) Being moody, anxious, or depressed Developing rituals regarding food (eating food in a certain order, excessive chewing, etc.) 40 Potential Warning Signs of Anorexia Consequences Teens with anorexia nervosa deprive their bodies of sufficient calories and nutrients, which can lead to a variety of physical health consequences, including: Anemia (iron deficiency) Amenorrhea—if the anorexic is female, she may never get her first period, or her periods may stop or become less frequent Brittle bones (osteoporosis) Decreased testosterone (in boys with eating disorders) Decreased thyroid hormone Dehydration/kidney failure Delayed physical maturation (due to decreased growth hormone) Dry skin Edema (swelling) Electrolyte imbalance (which can lead to seizures) Gastrointestinal problems (bloating, constipation) Growth of fine, downy hair over the body (lanugo) Hair loss Heart disease Infertility Irregular or abnormally slow heart rate Fainting Low blood pressure Memory loss/disorientation Muscle weakness and loss of muscle Poor circulation Weakness and tiredness In addition to physical complications, anorexia has been linked with a variety of emotional and mental health consequences, including low self-esteem. Many adolescents with anorexia are often hard-driving perfectionists. Despite the fact that they usually get good grades and excel in after-school activities, they often have low self-esteem and a need to control the people and things around them. These personality traits might be obvious or they might be subtle, but they can point towards a tendency towards anorexia. Teens with anorexia nervosa can also have co-occurring mental health disorders, including: Anxiety disordersDepressionSubstance use disorder If your child has an eating disorder, contact the National Eating Disorders Association (NEDA) Helpline for support at 1-800-931-2237. For more mental health resources, see our National Helpline Database. Treatment If you suspect your teen may have an eating disorder, seek immediate treatment. Talk to your teen’s physician about your concerns and discuss treatment options, which often aim to: Restore weight and nutrition that has been lost to severe dieting and purgingTreat any psychological disturbances, such as distortion of body image, low self-esteem, and interpersonal or emotional conflictsAchieve long-term remission and rehabilitation, or full recovery There's no one-size-fits-all treatment, but there has been significant advances in treating adolescents with anorexia over the past decade. Treatment should be guided by a physician and mental health professional who address the psychological and physical health of a teen throughout the treatment process. Early intervention improves the chances for a teens' successful recovery from an eating disorder, so don't wait to seek treatment for your loved one. Your first step may be reaching out to your teen's primary care physician about eating disorders, the signs you may be noticing, and potential ways to help. Treatment for an eating disorder may consist of nutritional rehabilitation and psychotherapy, including individual therapy (adolescent-focused therapy), family therapy (systemic family therapy), or even residential treatment. There are no FDA-approved medications for the treatment of anorexia. Family-Based Treatment (FBT) for Eating Disorders Overview A Word From Verywell Caring for a teen with an eating disorder can be scary and overwhelming, and unfortunately, there is no easy fix. Because of the complicated nature of the disease, enlisting the help of professionals along with other parents who have experience with eating disorders is key. Start today by educating yourself on the signs of anorexia, building a solid support system, and reminding yourself that recovery for your teen is possible. What Influences Anorexia Recovery? Was this page helpful? Thanks for your feedback! Learn the best ways to manage stress and negativity in your life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Eating Disorder Association. Statistics & research on eating disorders. Gravina G, Milano W, Nebbiai G, Piccione C, Capasso A. Medical complications in anorexia and bulimia nervosa. EMIDDT. 2018;18(5):477-488. doi:10.2174/1871530318666180531094508 National Eating Disorder Association. Anorexia nervosa. National Eating Disorder Association. Health consequences. American Academy of Child and Adolescent Psychiatry. Eating disorders in teens. Updated March 2018. Lock J. Updates on treatments for adolescent anorexia nervosa. Child and Adolescent Psychiatric Clinics of North America. 2019;28(4):523-535. doi:10.1016/j.chc.2019.05.001 Speak to a Therapist for Eating Disorders Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.