What young people find when they go looking for fitness information can be highly problematic. They are likely to come across harmful “thinspiration” and “fitspiration” posts celebrating slim or sculpted bodies, or even sites that encourage eating disordered behavior. Worse, algorithms record online search information and are “deliberately designed to feed harmful weight loss content to users who are already struggling with body image,” such as advertisements for dangerous diet supplements, Dr. Austin said.
When to worry
With so many forces contributing to teenagers’ body dissatisfaction and eating disordered behavior, how do parents know when to worry?
Parents should be alarmed, Dr. Kaye said, “if your child suddenly loses 10 to 20 pounds, becomes secretive about eating, or if you are seeing food disappear,” as becoming furtive about what, how and when one eats is a common occurrence in anorexia, bulimia and other eating disorders.
Experts agree that adults should be on the lookout for behaviors that veer from previous norms, such as suddenly skipping family meals or refusing to eat food from entire categories, such as carbohydrates or processed foods. Worth concern, too, is the teenager who develops fixations such as carefully counting calories, exercising obsessively or hoarding food, which may be a sign of a binge eating disorder. Parents should also pay close attention, said Dr. Accurso, if adolescents express a lot of guilt or anxiety around food or eating, or feel unhappy or uncomfortable with their bodies.
According to Dr. Bhatnagar, the view of eating disorders as a “white girls’ illness” can keep teens who are not white girls from seeking help or being properly screened for eating disorders by health professionals, even though eating disorders regularly occur across both sexes and all ethnic groups.
“Boys are having the same troubles,” said Dr. Bhatnagar, “but heterosexual boys may talk about body image a little differently. They tend to talk in terms of getting fit, getting lean or being muscular.”
Dr. Austin also noted that it is common to see elevated rates of eating disorders in lesbian, gay and bisexual youth of all genders as well as transgender and gender diverse young people.