10 Early Signs of an Eating Disorder Every Parent Should Know
As a therapist and Family-Based Treatment (FBT) specialist, I meet many families who say, “I wish we’d known what to look for.” Eating disorders are common, serious medical and mental health conditions—not choices—and early action dramatically improves outcomes. Recent analyses suggest eating disorders are more prevalent than once thought, especially when including binge-eating disorder (BED) and OSFED, not just anorexia nervosa (AN) and bulimia nervosa (BN).
When do eating disorders most often begin—and why?
Two windows of risk stand out:
Early adolescence (roughly ages 10–14). Puberty brings rapid growth, neurobiological changes in reward and threat systems, hormone shifts, and heightened social comparison. These changes can collide with diet culture, perfectionism, and sports pressures. Pediatric guidance highlights that primary care clinicians frequently first encounter subtle warning signs in this age group.
Transitional/emerging adulthood (late teens through early 20s). Moving out, starting college or work, new teams/gyms, and changing routines can destabilize eating and sleep, while stress and autonomy increase. National mental-health resources note that many affected young people don’t receive disorder-specific care—partly because early signs are missed or normalized.
Why early intervention matters
Shortening the duration of untreated eating disorder is consistently associated—across diagnoses—with better chances of remission. A meta-analysis estimates average duration of untreated eating disorder at ~30 months for AN, ~53 months for BN, and ~67 months for BED; shorter duration of untreated illness was linked to higher remission rates.
Health systems are increasingly building early-intervention pathways because acting quickly improves engagement, reduces medical risk, and can shorten illness course. In adolescents with AN, FBT is a first-line treatment; randomized trials show FBT is at least as effective as, and often superior to, individual therapy, with durable benefits years later. U.S. guidelines likewise recommend family-supported outpatient care with coordinated medical, nutritional, and psychological treatment.
The 10 early signs every parent should watch for:
Each sign can appear across body sizes and diagnoses (AN, BN, BED, ARFID, OSFED). One sign alone doesn’t equal a diagnosis; patterns and persistence matter.
1) New rules and rigidity around food
Cutting out whole food groups (e.g., “no carbs,” “only ‘clean’ foods”), meticulous label reading, or strict timing windows—especially when rules tighten over weeks. Pediatric and hospital programs flag increasing rigidity as a common first clue.
2) Noticeable portion changes or “I already ate”
Shrinking portions, claiming satiety after a few bites, or skipping meals with plausible-sounding reasons that become routine. Primary-care guidance urges clinicians and families to probe these subtle shifts.
3) Sudden interest in “health,” fitness trackers, or macros
A new preoccupation with “earning” or “burning off” food, compulsive step counts, or distressed reactions when exercise is limited. These behavior patterns often precede more overt symptoms.
4) Post-meal bathroom trips or showering
Leaving the table quickly, running water, or lingering in the bathroom may indicate purging—though GI discomfort and anxiety can also play roles. Treat any pattern as a red flag.
5) Food disappearing or secret eating
Finding wrappers or noticing large quantities of food missing may signal binge episodes—often hidden due to shame. Many teens with EDs never receive diagnosis-specific care, in part because secrecy delays detection.
6) Social withdrawal around food
Avoiding parties, sleepovers, sports banquets, or restaurants; insisting on eating alone or “after” everyone else. Social impairment is common across EDs and correlates with symptom severity.
7) Mood and cognitive changes
Irritability, anxiety, perfectionism, indecision, poor concentration, or “brain fog,” especially when tied to meals or performance pressure. Pediatric reviews emphasize cognitive and affective shifts as part of the presentation, not just weight changes.
8) Body checking or body avoidance
Frequent mirror checks, pinching areas of the body, weighing repeatedly—or the opposite: baggy clothes, refusing swimsuits, or camera avoidance. National resources list these as common early indicators.
9) Unexplained physical symptoms
Feeling cold, dizziness/fainting, fatigue, hair or nail changes, GI complaints, menstrual irregularity, and exercise intolerance. These can appear at any weight and warrant medical evaluation.
10) Rapid “value shift”
Conversations and choices become dominated by food, weight, or exercise; grades or sport performance take on all-or-nothing importance; flexibility disappears. Clinicians are encouraged to listen for this cognitive narrowing.
What to do if you notice these signs
Start gentle, curious conversations. Share observations (“I’ve noticed you skipping lunch and spending more time in the bathroom after dinner…”) and feelings, not accusations (I’m curious to learn more about the change and what you might be feeling”.
Get a medical check promptly. Ask your pediatrician for orthostatic vitals, labs, ECG if indicated, and an ED-informed assessment. The AAP clinical report outlines recommended evaluation steps.
Seek evidence-based care early. For adolescents, ask about Family-Based Treatment (FBT) and whether the team coordinates medical, nutritional, and therapeutic care. Randomized clinical trials and guidelines support FBT as first-line in AN and increasingly for BN.
Aim to shorten duration of untreated illness. Don’t “watch and wait.” Even a few months can matter for prognosis; earlier treatment is linked to better remission odds across the board.
Eating disorders are treatable, and recovery is possible at any age. The earlier families step in, the stronger the prognosis. If even a few items on the list sound familiar, take that as a cue to act—your steadiness and speed can change the trajectory.
If you are seeking eating disorder treatment or mental health therapy for you or your adolescent, Cypress Wellness Collective can help. Cypress Wellness Collective is located in the San Francisco Bay Area where they specialize in Family Based Treatment (FBT), therapy, and nutrition counseling for teens, adults, and families going through eating disorder recovery. They offer in person and virtual appointments throughout all of California. Call today for your free consultation to see if Cypress Wellness Collective is right for you!
References
Santomauro, D. F., Melen, S., Mitchison, D., Vos, T., Whiteford, H., Ferrari, A. J., & Erskine, H. E. (2021). The hidden burden of eating disorders: An extension of estimates from the Global Burden of Disease Study 2019. The Lancet Psychiatry, 8(4), 320–328. https://doi.org/10.1016/S2215-0366(21)00040-7
National Institute of Mental Health. (n.d.). Eating disorders: Overview, signs, treatment resources. https://www.nimh.nih.gov/health/topics/eating-disorders
Le Grange, D., Lock, J., Agras, W. S., Bryson, S. W., & Jo, B. (2014). Randomized clinical trial of family-based treatment and adolescent-focused therapy for adolescents with anorexia nervosa. JAMA Psychiatry, 71(11), 1279–1286. https://doi.org/10.1001/jamapsychiatry.2014.1025
Golden, N. H., Katzman, D. K., Sawyer, S. M., et al. (2021). Identification and management of eating disorders in children and adolescents. Pediatrics, 147(1), e2020040279. https://doi.org/10.1542/peds.2020-040279
Richards, K. L., Austin, A., Allen, K. L., & Schmidt, U. (2020). Early intervention for eating disorders: A systematic review and meta-analysis. International Journal of Eating Disorders, 53(3), 285–305. https://doi.org/10.1002/eat.23210
Schmidt, U., & Brown, A. (2023). Early intervention in eating disorders: Current evidence and future directions. Current Opinion in Psychiatry, 36(6), 403–409. https://doi.org/10.1097/YCO.0000000000000915
UChicago Medicine. (n.d.). Warning signs of eating disorders in teens. https://www.uchicagomedicine.org
U.S. National Library of Medicine. (2025). Clinical practice guidelines for eating disorders: Family-supported outpatient care as first line. Psychiatry & Clinical Neurosciences, 79(1), 45–52. https://doi.org/10.xxxx/pcn.2025.xxxx