Disordered eating is often a symptom of high anxiety in teenagers.

Disordered Eating and Anxiety in Teens: What’s the Relationship?

Teenagers are in a sensitive developmental period. There are so many changes happening throughout puberty —hormonal and physical —that adolescents must contend with constant shifts in mood, growth, and brain function. While teens are balancing all these internal changes, they are also trying to keep up with an external world filled with school demands, shifting friend groups, and perhaps navigating romantic relationships for the first time. It’s enough to make any person stressed.

This sensitive developmental period is a common time for mental health challenges to creep in. About 50% of all lifetime mental health concerns start in adolescence, and 14% of teens struggle with their mental health at any given point in time according to the World Health Organization. Not only are teenagers struggling with normal changes that occur during adolescence, they may also be exposed to mental health stigma, discrimination, questions about identity, and pressure from peers during this time, which increases the likelihood that mental health concerns occur.

In particular, anxiety is one of the most common struggles for adolescents.

Anxiety disorders in teenagers

Anxiety disorders are considered a common challenge for teenagers. Teenage anxiety can include social anxiety (intense fear in social situations), generalized anxiety (worries about a lot of different things), phobias (anxiety about a particular thing like insects or flying), panic attacks, and separation anxiety (fear of being separated from a caregiver or important figure). Different types of anxiety tend to cluster together, meaning that 40–60% of anxious children and adolescents struggle with multiple types of anxiety.

Anxiety can develop from a variety of biological, learned, and environmental factors. In particular, anxiety can start after certain stressful experiences. For example, the death of a loved one, changing the home or school environment, or facing a traumatic experience.

Even though many adolescents have anxiety, there is good news — psychotherapy tends to be effective for adolescent anxiety disorders. Some of the most helpful therapies are cognitive behavioral therapy (CBT), exposure and response prevention (ERP), and acceptance and commitment therapy (ACT). In particular, Joon Care is effective in treating anxiety disorders in teenagers. Alternatively, medication can also be an effective option.

Disordered eating in teenagers

Another common concern for teenagers is disordered eating. About 3% of all teenagers have some kind of disordered eating—with the highest rates among adolescent girls. Disordered eating can include anorexia nervosa (low weight paired with a fear of weight gain), binge eating (eating large amounts of food in a short period of time), bulimia nervosa (fear of weight gain that leads to binge eating and subsequent compensatory behaviors like vomiting, laxative use, or exercise), or avoidant restrictive food intake disorder (lack of interest in eating or fear of eating and its consequences like choking, which leads to low weight or nutrient deficiency).

Although these are the most common categories, most eating disorders do not fall neatly into these categories and are considered other types of feeding and eating disorders. Unfortunately, any type may have disastrous consequences regardless of category. These consequences include loss of menstruation, loss of bone density, extreme fatigue, cardiovascular problems, loss of organ function, and even death. Eating disorders are one of the most deadly psychiatric illnesses. The consequences are more severe for teenagers because they are still growing and developing and  these consequences can persist into adulthood.

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The overlap between eating disorders and anxiety disorders

Eating disorders and anxiety disorders have many similarities, and they often occur together. According to the American Journal of Psychiatry, about 66% of people with eating disorders also have some kind of anxiety disorder. Likewise, anywhere from 11–42% of people with anxiety disorders also have some type of eating disorder.

There is even a theory that eating disorders are simply an extension of anxiety disorders — meaning that people who have anxiety might develop an eating disorder when their anxiety becomes focused on fears of food or weight gain. For example, many people who develop eating disorders already have some pre-existing anxiety disorder that developed in childhood. Additionally, anxiety disorders tend to persist even after the eating disorder is treated.

This may explain why eating disorders and anxiety disorders are generally both well-treated with cognitive-behavioral therapy (CBT). Treatment involves understanding thoughts, feelings, and behaviors, and changing thoughts and behaviors to reduce and manage symptoms. Treatment for eating disorders additionally includes increased nutrition and weight restoration.

The takeaway

Both eating disorders and anxiety disorders are extremely common in teenagers. Some even believe that eating disorders are a type of anxiety disorder. Both these challenges tend to develop in the same critical developmental period of adolescence and can develop because of genetic and environmental factors. Generally, both of these challenges are well-treated with counseling for teens, including cognitive-behavioral therapy.

Resources

As a parent of a teenager with anxiety or disordered eating, it can be challenging to know where to start to help them. You can turn to certain resources to learn more about these disorders and best help your adolescent. You are not alone, and there is help out there.

Anxiety resources

Eating disorder resources

Sources:

February 1, 2022
Marina Harris, PhD | Clinical Psychologist

Marina Harris, PhD | Clinical Psychologist

Marina Harris, PhD | Clinical Psychologist

Dr. Harris is a psychologist with specialties in eating disorders, athlete mental health, sport psychology, perfectionism, mindfulness, and trauma-informed care. She earned her PhD in Clinical Psychology from the University of Nevada, Las Vegas, and trained at Duke University Medical Center and University of North Carolina Center of Excellence for Eating Disorders (UNCCEED).

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