Signs Your Teen Has an Eating Disorder - NJ Parent Guide
What Every Bergen County Parent Needs to Know
Your teenager has always been a good eater. Or maybe they've always been a little picky. Either way, you did not expect to find yourself Googling "does my teen have an eating disorder" at 11pm. You're here because something feels off, and you're not sure whether you're overreacting or whether your worry is actually warranted.
I'm Dana Colthart, LCSW, a certified eating disorder specialist (CEDS) and the clinical director of Clear Light Therapy in Englewood, NJ. My team and I work with teenagers and young adults across Bergen County, including Ridgewood, Tenafly, Teaneck, Paramus, Fort Lee, Mahwah, and Hackensack, who are struggling with eating disorders, disordered eating, and body image distress. This guide is for you: the parent who is watching something unfold and doesn't know what to do about it.
Why Eating Disorders Are So Often Missed in Teenagers
Eating disorders are among the most misunderstood and most under-recognized mental health conditions. There are several reasons why they go undetected, sometimes for years:
First, eating disorders do not look the way most people expect them to. They do not announce themselves. The person struggling does not necessarily look sick. Eating disorders exist across every body size, every weight, every appearance. Some of the most medically serious eating disorders present in people who appear to be in a "normal" weight range.
Second, eating disorders are masters of concealment. The shame and secrecy that accompany them mean that teenagers hide their behaviors, sometimes extraordinarily skillfully. They learn what to say to reassure you. They eat in front of you at dinner and find other ways to manage what they've consumed. They wear loose clothing. They make excuses.
Third, our culture normalizes disordered eating. When everyone around your teenager is talking about what they're not eating, going on elimination diets, commenting on bodies, and tracking their food, it becomes very hard to recognize when something has crossed a line. In the high-achieving communities of Bergen County, where academic and athletic pressure is intense and appearance is often tied to self-worth, eating disorders can develop in ways that initially look like discipline or health consciousness.
The Warning Signs, What to Actually Look For
Here are the signs that should prompt you to take action:
Changes in eating behaviors
Cutting out entire food groups or categories suddenly (all carbs, all fats, all processed food)
New food rituals: cutting food into very small pieces, rearranging food on the plate, eating in a particular order, eating very slowly or very quickly
Claiming not to be hungry when they previously had a normal appetite
Disappearing to the bathroom immediately after meals
Eating very differently in private than in front of others
Hoarding food, or hiding food
Talking constantly about food, calories, "clean eating," or what others are eating
Changes in physical appearance or health
Noticeable weight loss or weight fluctuation
Feeling cold all the time, especially hands and feet
Hair loss or thinning
Lanugo (fine hair on the body, a sign of severe restriction)
Dental erosion, swollen cheeks or jaw (signs of purging)
Fainting, dizziness, or complaints of weakness
Irregular or absent menstrual periods
Swelling in the hands or feet
Changes in behavior and mood
Increasing social withdrawal, especially around food-related activities
Declining to go to restaurants, birthday parties, family dinners
Intense distress or irritability around mealtimes
Wearing loose or layered clothing to hide their body
Excessive exercise — exercising through illness, injury, or extreme weather, being unable to rest
Expressing intense fear of weight gain or specific foods
Intense preoccupation with body image, weight, or appearance
Increased isolation from friends
Signs specific to binge eating disorder
Finding wrappers or empty food containers hidden in their room
Large amounts of food disappearing from the house
Eating very rapidly or to the point of discomfort
Intense shame or guilt after eating
Eating alone because of embarrassment
Understanding the Different Types of Eating Disorders
Eating disorders are not one-size-fits-all. At Clear Light Therapy, we treat the full range:
Characterized by significant restriction of food intake, intense fear of weight gain, and a distorted experience of body shape or size. Anorexia has the highest mortality rate of any mental health condition. Early intervention is critical.
Bulimia Nervosa
Characterized by cycles of bingeing (consuming large amounts of food) followed by purging behaviors to compensate — vomiting, laxative use, excessive exercise, or fasting. Bulimia is often hidden and can be very difficult to detect, since body weight may appear typical.
The most common eating disorder. Characterized by recurrent episodes of eating large amounts of food without compensatory behaviors, accompanied by feelings of shame, guilt, and loss of control. Binge eating disorder is often missed or dismissed because it is not associated with the extreme thinness that people associate with eating disorders.
ARFID — Avoidant/Restrictive Food Intake Disorder
ARFID involves severe restriction of food intake driven not by body image concerns but by sensory sensitivities, fear of choking or vomiting, or lack of interest in food. ARFID is common in children and teenagers and often co-occurs with anxiety and OCD. At Clear Light Therapy, we have specialized training in ARFID treatment, which is still uncommon even among eating disorder specialists.
Other Specified Feeding or Eating Disorders (OSFED)
Many eating disorders do not fit neatly into one category. OSFED includes presentations like atypical anorexia (all the restriction and medical severity of anorexia, but without low weight), purging disorder, and night eating syndrome. These presentations are just as serious and just as treatable.
What Not to Do (Even Though It Feels Helpful)
When parents discover that a teenager has an eating disorder, several common responses can inadvertently make things worse:
Commenting on food choices: "Are you sure you need that?" or "You haven't eaten much today", even well-meaning observation increases shame and anxiety around food
Commenting on body: Even positive comments like "You look healthy" or "You've gained some weight back" can be deeply triggering
Forcing eating: Confrontational pressure around food increases anxiety and power struggles without addressing the underlying disorder
Minimizing: "Every teenager thinks they're fat" or "They'll grow out of it", eating disorders do not resolve on their own and early intervention dramatically improves outcomes
Waiting for it to get bad enough: Eating disorders are easier to treat earlier in their course. You do not need to wait for a crisis.
What Eating Disorder Treatment Looks Like at Clear Light Therapy
At Clear Light Therapy, we use evidence-based treatments including CBT-E (Enhanced Cognitive Behavioral Therapy for eating disorders), ACT, DBT skills, and ERP for food-related fears. We work within a HAES, Health at Every Size, informed framework, which means we focus on health behaviors and psychological wellbeing rather than weight or appearance as treatment goals.
Because eating disorders almost never travel alone, they commonly co-occur with anxiety, OCD, depression, and trauma, we are particularly well-equipped to treat the whole picture. Our team includes therapists trained in both eating disorders and OCD/anxiety, which is rare and which allows us to treat co-occurring conditions without referring you to multiple providers.
We also collaborate with registered dietitians and psychiatrists when a team approach is needed. Treatment is individualized, no two eating disorders are exactly alike, and no two treatment plans are exactly alike.
We serve teens and adults across Bergen County, including Ridgewood, Tenafly, Paramus, Fort Lee, Teaneck, Mahwah, Fair Lawn, Hackensack, Englewood, and Bergenfield, in person at our Englewood office and virtually throughout all of New Jersey.
What to Do If You're Worried About Your Teen
Trust your instincts. You know your child. If something feels wrong, it probably is worth exploring. You do not need to wait for a dramatic crisis. You do not need to be certain. You can call us with a question, describe what you're seeing, and let us help you figure out whether what you're observing warrants evaluation.
Early intervention matters enormously in eating disorder treatment. The sooner a teen receives appropriate, specialized care, the better the outcomes.
Frequently Asked Questions
My teen insists nothing is wrong. What do I do?
Denial is an extremely common feature of eating disorders, not because your teen is lying, but because the disorder itself often involves distorted thinking and significant shame. Your instinct matters more than their reassurance in this context. You can seek a professional consultation even without their full cooperation. An evaluation by a specialist can help you understand what you're dealing with and what your options are.
Does my teen need to be in a "bad enough" place to get help?
No. Please do not wait for a crisis. Eating disorders are more responsive to treatment earlier in their course. Medically, the longer restriction or purging continues, the greater the physical consequences. Psychologically, the longer the disordered behaviors persist, the more entrenched they become. Reach out now.
Will therapy be enough, or does my teen need a higher level of care?
This depends on the severity of the eating disorder. Some teens do very well with outpatient therapy, which is what we provide at Clear Light Therapy. Others need a higher level of care: intensive outpatient, partial hospitalization, or residential treatment. We do thorough assessments and are honest about what level of care we think is appropriate. If we believe your teen needs more intensive support, we will tell you, and we will help you find it.
What if my teen is also struggling with anxiety or OCD?
This is very common. Anxiety and OCD frequently co-occur with eating disorders, and in some cases what looks like an eating disorder has significant OCD features underneath it. This is one of the areas where our practice is particularly specialized, we can treat the eating disorder and the co-occurring conditions simultaneously, without bouncing your teen between multiple providers.
Do you work with teenagers?
Yes. We work with teens from 14 and up at Clear Light Therapy. Our therapists are trained in working with adolescents and understand the unique pressures that teenagers in Bergen County face.
How do I make the first appointment?
Visit danacolthart.com and fill out our contact form. Dana personally reviews all inquiries and responds within 24 hours. We start with a free 15-minute consultation to talk about what you're seeing and whether we're the right fit for your family.
