How Do You Find an Eating Disorder Therapist for Your Teen in Austin?

To find an eating disorder therapist for your teen in Austin, look for someone with specific training in eating disorders and experience working with families.

You may be reading this at the end of a long day. Maybe your teen skipped dinner again, or you found something that scared you. Maybe you just have a feeling you can’t shake. Looking for help is hard and can feel overwhelming.

This post covers what to look for in a therapist, who belongs on your teen’s team (including you), and how levels of care work. My hope is that the next step feels a little more doable.

What should you look for in an eating disorder therapist for teens

Look for someone who knows eating disorders well and knows how to work with both teens and parents. That combination is a must.

Eating disorders are complex. They affect your teen medically, socially, and psychologically. You may notice that your teen just isn’t themselves anymore. They may be more moody or shut down. They may be isolating. You may feel like you’re walking on eggshells.

The illness hides inside food, weight, and shame. A skilled therapist can help you know the difference between your teen talking and the eating disorder talking. That takes training and a lot of experience.

Here is what to look for:

Eating disorder specialty. Eating disorders should be a big part of their work, not one item on a long list.
Experience with teens. Not every eating disorder therapist works with teens. A therapist with experience in all three (teens, parents, and eating disorders) is the gold standard.
Experience with your teen’s diagnosis. Anorexia, bulimia, binge eating disorder, and ARFID each call for a different approach.
Treatment with research behind it. It’s fair game to ask a therapist what their treatment approach is.
Comfort working with others. Your therapist should be glad to talk with your teen’s dietitian and doctor.
Warmth toward your whole family. You should feel like part of the solution and feel encouraged to take part in your teen’s care. A therapist should include you in at least parts of treatment and spell out your role. They should tell you how they’ll keep you updated on your teen’s recovery. They should also tell you how to reach them if you notice something worrisome.

What questions can you ask on a first call?

You are allowed to interview therapists. Most therapists want you to! Here are some questions to start with:

How much of your work is eating disorders?
How long have you been helping teens with eating disorders?
How much of your work is with teens?
Do you involve parents in treatment? If so, how?
Do you work with a dietitian and a medical provider?
What happens if my teen isn’t medically safe?
How often will I hear from you, and how will we communicate?
Do you take my insurance, or can you give me paperwork to submit?
What appointment times do you have available?

Why should you be involved in your teen’s eating disorder treatment?

Recovery from an eating disorder doesn’t happen in a vacuum. Here is why your involvement matters:

You spend much more time with your teen than any treatment provider does.
The eating disorder has probably caused a fair amount of stress in your family. Being involved in treatment is meant to help lower that stress.
You are often the one engaging with your teen around eating and food. Most parents want to understand how best to support their child.
You may be wondering what is “normal teen” behavior and what is the eating disorder.
You have probably gone to many medical appointments with your child over the years. This is very similar.

Why does your teen need a treatment team?

Eating disorders hit the mind and the body at the same time. They can affect the heart, bones, and digestion. They also change how your teen thinks, feels, and sees themselves. One person can’t watch all of that alone.

A team also takes weight off you. When you try to hold everything, you wear out. With a team, you don’t have to carry this alone.

Who is on your teen’s treatment team?

A therapist. They work on the thoughts, feelings, and behaviors that keep the eating disorder going. They also coach you through the hard parts, like meals.
A registered dietitian. They help your family rebuild steady, safe eating. That includes meal plans, fear foods, and sorting out the scary nutrition messages the illness loves to twist. A dietitian who specializes in eating disorders will not put your teen on a diet.
A medical provider. This might be a pediatrician or an adolescent medicine doctor. They check vital signs and labs, and they help decide whether it’s safe to treat your teen at home. This role matters a great deal.
A psychiatrist, if needed. Not every teen needs one. A psychiatrist can help when anxiety or depression is part of the picture, or when medication might help.
You. For teens, parents sit at the center of treatment. Your teen’s team includes your whole family

Why does it matter that the team talks to each other?

When providers share information, everyone sees the same picture. When they don’t, you become the messenger, and you can end up with mixed messages. The doctor says things look fine while the therapist is worried. The dietitian gives one plan while the therapist points somewhere else.

Ask each provider whether they will coordinate with the others. You’ll sign a release so they can talk. It’s a small step that takes a lot off your shoulders.

What are the levels of care for teens with eating disorders?

Levels of care describe how much support your teen needs right now. Think of it as a dial, not a ladder. Turning it up does not mean you failed. It means the eating disorder got “loud” and you responded.

Outpatient care. Your teen lives at home and sees a therapist, dietitian, and doctor on a regular schedule. Most families start here. It works when your teen is medically stable. You do a lot of the work at home.
Intensive outpatient program (IOP). Your teen gets several hours of treatment a few days a week, often with a supported meal. They sleep at home. This fits when weekly visits aren’t enough but daily care isn’t needed.
Partial hospitalization program (PHP). Your teen attends treatment most days for much of the day, usually including meals. They go home at night. It offers more structure and closer medical monitoring than IOP.
Residential treatment. Your teen lives at a treatment center with staff around them day and night. Your team may suggest residential care when home isn’t safe enough for recovery, or when lower levels of care haven’t been enough.
Inpatient hospitalization. Hospitalization is a scary word. For many parents, it feels like the worst-case scenario. But it’s about safety. When your teen’s body is in danger, the hospital’s job is to get them stable. Then the healing can happen. The goal is a short stay. Most teens step down to another level afterward.

What is family-based treatment (FBT), and where does it fit?

FBT is an intensive treatment approach that happens in outpatient care. It is best suited to anorexia nervosa and bulimia nervosa. If your teen is medically stable, it can be used in place of partial hospitalization or residential care. It works best for younger teens and for those earlier in the illness. It requires parents to be actively involved.

FBT is not individual therapy for your teen. Instead, the therapist coaches you to take the lead in stopping the eating disorder behaviors at home, especially around meals. The goal is to keep the eating disorder from progressing so your teen can keep engaging in their life. Your teen’s doctor decides whether your teen is medically stable enough for this level of care.

In other words, FBT can be an option for intensive treatment while your teen stays outpatient.

How do you know which level of care your teen needs?

Your teen’s medical team decides this with you. They usually look at:

Medical stability, including vital signs and labs
How well eating goes with support at home
Safety and mental health
How much support your family has
What has and hasn’t worked before

If you’re unsure, ask your teen’s doctor for an assessment. Starting with outpatient care is often reasonable. If it isn’t helping after a fair try, say so and ask about stepping up. Please don’t wait for things to get worse before asking for more help.

Where do you start looking for an eating disorder therapist in Austin?

You don’t need to be sure your teen meets the full criteria for an eating disorder. It is OK to seek help. Here are a few places to start:

Your teen’s pediatrician. Some pediatricians are very good at identifying eating disorders, and others are not. That’s no knock on doctors. Medical school doesn’t include much training on eating disorders. If your concern gets brushed off, it’s OK to keep looking.
Your networks. Ask a school counselor or other parents in your community if that feels comfortable.
Central Texas Eating Disorder Specialists (CTEDS). This is a local group of professionals who specialize in eating disorders. Members include therapists, dietitians, and medical providers in the Austin area. I’m a member. It’s a good place to find people who do this work every day.
Your insurance directory. You can start with your insurance list, but cross-check each name. Insurance companies do not verify whether a provider has eating disorder experience.

Does virtual eating disorder therapy work for teens?

For many families, yes. Virtual therapy can work well for outpatient care. A medical provider still needs to check your teen’s vital signs and labs in person. If your teen’s doctor thinks they need a higher level of care, that comes first. I see families in person in Austin and virtually throughout Texas.

What if your teen doesn’t want to go to therapy?

This is very common. Many teens push back at first. The eating disorder often tells them nothing is wrong. Their resistance doesn’t mean you’re making the wrong call.

You can still start. An experienced therapist will help you talk with your teen and decide what to do next. Many parents begin by meeting with the therapist on their own. You know your child, and your concern is reason enough to get help.

Frequently asked questions

Can my teen have an eating disorder if they look healthy?

Yes. Eating disorders happen at every weight and body size. You can’t tell how sick someone is by looking at them. If you’re worried, trust that and seek help.

Do I need a referral to see an eating disorder specialist in Austin?

Usually not. You can call a therapist directly. Some insurance plans do ask for one, so check with yours. A visit with your teen’s doctor is still a smart early step.

Is FBT right for every teen?

No. FBT works best for teens who are medically stable and have a family who can take part. It has the strongest research for anorexia and bulimia nervosa. Your teen’s therapist can help you decide whether it fits.

Will I be involved in my teen’s treatment?

In most good adolescent treatment, yes. Parents are part of the team. In FBT, you take the lead at home. Even outside FBT, a good therapist and dietitian will keep you informed and give you a role.

Does insurance cover eating disorder treatment for teens?

Many plans cover some levels of care, but coverage varies a lot. Call your plan and ask what is covered at each level. You can also ask any provider whether they can give you paperwork for out-of-network reimbursement.

How long does eating disorder treatment take?

It depends on your teen, the diagnosis, and how early treatment starts. Some teens see real progress within months. Others need longer. Recovery is possible, and many families move between levels of care along the way.

What’s the difference between an eating disorder therapist and a regular therapist?

An eating disorder therapist has specific training in these illnesses. They know how to work with your teen’s medical team. They also know what to do when things become medically risky. A general therapist may not have that background.

You don’t have to figure this out alone

I know how much it takes to make that first call. You love your child, and you’re scared. That’s a strong place to start. Recovery is possible, and families get there with the right team beside them.

If you’re in Austin or anywhere in Texas, I’m happy to talk. We can think through what your teen and your family might need. Schedule your free consultation here.

Who Actually Diagnoses ARFID? Answers for Worried Parents

by Alison Pelz, LD, RD, CDE, LCSW

You may have known something was different about your child’s eating from a young age, even if you couldn’t quite put your finger on it. Maybe it started right after weaning, when your baby seemed to reject food after food while their siblings or peers moved easily from one new taste to the next. Maybe it crept in slowly, until one day you realized your child had been eating the same five foods for months.

You brought it up to the pediatrician. “They’ll grow out of it,” you were told, which isn’t terrible advice, since most kids do widen their diet with time. “They’ll eat when they’re hungry” is another common line, but it hasn’t turned out to be true for your child.

You dread mealtimes. You keep serving the same foods on repeat because it’s the only way to get anything into your child, and you worry about whether they’re getting what they need. And somewhere along the way, you started to feel like this is your fault. Like there’s something you should be doing that would make the worries around food and eating disappear.

Most of the families I see with a child who has ARFID (avoidant/restrictive food intake disorder) have collected a lot of advice by the time they reach me, but not a lot of real answers. Below are the questions I hear most often from parents trying to figure out what’s actually going on with their child’s eating, and how to get a real diagnosis.

How Do I Know If My Child Has ARFID?

ARFID is more than picky eating. It’s worth a closer look if your child’s eating involves things like a very limited number of “safe” foods, strong reactions to certain textures or smells, little interest in eating, or low appetite overall. Or if eating is starting to affect their growth, nutrition, or ability to participate in life such as school, birthday parties, sleepovers, and family meals. A formal evaluation is the only way to know for sure, but if mealtimes have felt this hard for a while and the advice you’ve gotten hasn’t helped, that’s reason enough to ask for one.

Who Can Diagnose ARFID?

ARFID can be diagnosed by a medical doctor or a mental health provider, a therapist or psychologist, who is trained in feeding and eating disorders. If your pediatrician isn’t familiar with ARFID, a GI doctor or a mental health provider who specializes in eating and feeding disorders is a good next step.

Dietitians, speech-language pathologists, and occupational therapists are often a crucial part of your child’s care team, and their input matters. But depending on where you live, they typically can’t provide the formal diagnosis itself. (This varies by state, so it’s worth asking directly.)

How Is ARFID Actually Diagnosed?

Diagnosis usually starts with a clinical interview that covers your child’s feeding history in detail, from infancy to now. Many providers also use a structured questionnaire called the PARDI to help assess the pattern and severity of the eating difficulty.

Medical evaluation and testing are typically part of the process too, mainly to rule out other conditions such as reflux, allergies, GI issues, sensory or motor differences that could be contributing to your child’s eating difficulties or need to be treated alongside ARFID.

Do I Need to Get My Child Formally Diagnosed?

That’s entirely up to you. A lot of parents feel relieved to have a name for what they’ve been living with. A diagnosis can be validating after months or years of being told just to wait it out.

It can also be practically useful. A diagnosis can make it easier to advocate with medical providers, explain things to family members, and get accommodations at school like being allowed to bring safe foods, eat in a quieter space, or snack throughout the day instead of only at set times.

What Can I Do While I Wait for an Evaluation?

A wait list is common. Getting connected to the right provider can take time. A few things can help in the meantime:

Learn what you can about ARFID. Understanding the condition can make the wait feel less disorienting and help you ask better questions when you do get in.
Get curious, not just worried, about your child’s patterns. What foods do they gravitate toward? Where and when do they seem most comfortable eating? Small observations like these are genuinely useful information for whoever eventually evaluates your child.
Try to hold off on new food pressure tactics in the meantime. Bargaining, rewards, or “just one bite” rules can add stress to mealtimes without changing the underlying issue and a good provider will help you build a real plan once you’re in.

Frequently Asked Questions About Getting an ARFID Diagnosis

Is ARFID just extreme picky eating? No. Picky eating is common in children and usually doesn’t affect a child’s growth or daily life. Clinicians diagnose ARFID when eating patterns significantly limit nutrition, growth, or a child’s ability to participate in normal activities.

What age can a child be diagnosed with ARFID? ARFID can be diagnosed at 5 years or older, and many families first notice signs in toddlerhood or early childhood. Older kids, teens, and adults can have it, too.

Can my child’s pediatrician diagnose ARFID? Some can, especially if they have training in feeding disorders. Many don’t, simply because ARFID is a relatively newer diagnosis and awareness varies. A GI doctor or a mental health provider who specializes in eating and feeding disorders can also diagnose it.

Will a dietitian or speech or occupational therapist diagnose my child? They’re often essential to treatment, but in most states they aren’t able to give the formal diagnosis. They can, however, help identify concerns early and refer you to someone who can.

Does my child need a diagnosis to start getting help? Not necessarily. Many providers will begin supporting your child’s eating and your family’s approach to mealtimes even before a formal diagnosis is in place, especially if there’s a waitlist for a full evaluation.

My child is growing fine, height and weight-wise, and may even have a larger body. Can they still have ARFID? Yes. Growth and weight are only part of the picture. A child can be growing well, or be in a larger body, and still have ARFID. Limited eating can affect a child’s nutritional status, their ability to socialize and participate in everyday life, or cause them significant distress, all of which can contribute to an ARFID diagnosis. The impact that the eating pattern has on your child is part of the diagnosis.

Ready to take the next step?

If you’re watching your child struggle at the table and the reassurances haven’t matched what you’re actually seeing, trust that. You don’t have to wait for things to get worse. Ask for an evaluation. You don’t have to figure this out with no support. Reach out if you’d like to talk through next steps for evaluating your child.

Schedule your free consultation here, and let’s talk through what getting your child evaluated could look like.

New School, New Pressures: How College Transitions Can Trigger an Eating Disorder

by Alison Pelz, LD, RD, CDE, LCSW

Heading to college is one of the biggest transitions a young person makes. For students with a history of an eating disorder or those who’ve never struggled before, it can also be a vulnerable time. Big change, even welcome change, is one of the conditions under which eating disorders tend to surface or intensify.

This post is for two groups: students who want to know what to watch for, and parents who aren’t sure how to help from a distance.

Why Is College a High-Risk Time for Eating Disorders?

One of the reasons eating disorders develop is that they can serve as a way to cope with difficult feelings, including stress, uncertainty, loneliness, and loss of control. College delivers all of these at once. You’re away from the people and routines that have anchored you, navigating a new social world largely on your own.

College campuses also tend to be saturated with diet culture, the normalization of food rules, fad dieting, and body commentary, alongside a drinking culture that can quietly worsen mental health and increase impulsivity.

None of this means college is dangerous. It means it’s worth paying attention.

What Are the Signs of an Eating Disorder in College Students?

Whether you’re in recovery or have never had a formal diagnosis, here’s what to watch for:

Thoughts about food, weight, or your body are taking up significantly more mental space
You’ve started making rigid rules around eating, such as only one meal a day, eliminating food groups, strict time limits on eating
Exercise feels less like something you enjoy and more like something you can’t skip, or you’re using it to compensate for eating
You’re eating in ways that feel out of control, or eating far less than you need or sometimes both
You’re avoiding social situations that involve food
Your mood has shifted: more anxious, more irritable, more withdrawn

You don’t need to be in crisis to deserve support. If any of this sounds familiar, it’s worth talking to someone.

Where Can College Students Get Help for an Eating Disorder?

A good first step is your campus counseling center. Many colleges have eating disorder resources on site. If you’d prefer support off campus, search for a therapist and dietitian in your area with specific eating disorder experience. It’s completely reasonable to ask a provider directly: How many clients with eating disorders do you see? How long have you been doing this work? Experience matters with eating disorders.

What Should Parents Do If They’re Worried About Their College Student?

Don’t wait and hope it resolves. If you’re noticing something- weight changes, mood shifts, comments about food & body- your instinct is worth listening to. Eating disorders rarely improve on their own, and earlier support tends to lead to better outcomes.

Start with what you’re observing, not what you’re concluding. Lead with specifics rather than a diagnosis: I’ve noticed you seem more tired lately, and when we talk you mention not eating much. I’m not trying to alarm you. I just care about how you’re doing. That kind of opening tends to land better than naming the eating disorder directly, at least initially.

Make sure they’re medically stable. If you have concerns, a medical evaluation is a reasonable and important first step.

Help them find the right support. If your child was already in treatment before college, reconnecting with that team is a natural starting point. If they’re starting fresh, look for a multidisciplinary team, therapist, dietitian, and medical provider, with eating disorder experience. Helping with logistics, even if your child is resistant, can remove real barriers to getting started.

The eating disorder is already getting in the way of your relationship with your child. Addressing it, even imperfectly, is more likely to protect that relationship than to damage it.

Frequently Asked Questions

Can college cause an eating disorder? College doesn’t cause eating disorders, but it can be a trigger. The combination of stress, social pressure, diet culture, and distance from support systems creates conditions where eating disorders are more likely to develop or return.

What’s the difference between stress eating in college and an eating disorder? Stress eating is common and doesn’t always indicate an eating disorder. An eating disorder typically involves significant distress, a sense of loss of control, rigid food rules, or behaviors that interfere with daily life, and it persists over time.

Should I tell my college student I think they have an eating disorder? Not necessarily right away. Starting with observations and concern, rather than a label, tends to open the door to conversation more effectively. Focus on what you’re noticing and that you care, rather than leading with a diagnosis.

Can you recover from an eating disorder while in college? Yes. Many students get support and make meaningful progress while staying enrolled. Others may have to put college on pause in order to get help. Putting help off, Recovery is rarely linear, but it is possible and getting help earlier rather than later makes a real difference.

If you’re a student struggling with food or your body, you don’t have to figure this out alone. And if you’re a parent worried about your college-age child, reaching out to a professional is a reasonable next step for both of you. To learn more about how I work with college students or parents, please schedule a free consultation here.

The Thing No One Tells Parents About Binge Eating Disorder in Teens

by Alison Pelz, LD, RD, CDE, LCSW

Teenager looking upset and withdrawn

If your teenager has been struggling with binge eating, there’s a good chance you already feel confused and a bit perplexed. You may have noticed food going missing. You may have found wrappers hidden in their room, or realized they’re eating in secret late at night. You may have tried talking to them about it and hit a wall. Or maybe they’ve shut down entirely, and you’re not sure why.

Here’s what I want you to know first: you are not the only parent in this situation. And your teen is not the only teenager going through it.

But there’s something about binge eating disorder that makes it much harder to talk about than other eating disorders, and that silence is part of what keeps families stuck. So let’s talk about it.

What Binge Eating Disorder Actually Is

Binge eating disorder, often called BED, is the most common eating disorder in the United States. More common than anorexia. More common than bulimia. And yet many people have never heard of it as a real diagnosis.

BED involves recurring episodes of eating large amounts of food in a short period of time, often past the point of fullness, and often feeling out of control while it’s happening. What makes it an eating disorder and not just overeating is the distress that comes with it. The shame afterward. The secrecy. The sense that something happened that your teen didn’t quite choose and couldn’t quite stop.

Unlike anorexia, BED doesn’t come with visible signs that most people are trained to look for. Your teen may not be losing weight. They may not look sick. And so the eating disorder can go unnoticed sometimes for a very long time.

The Thing Most Parents Don’t Know: Shame Is Running the Show

Here’s what I don’t see talked about enough: the central experience of binge eating disorder, for most teens, isn’t the eating itself. It’s the shame.

By the time a teenager is in the middle of a binge eating disorder, they are usually already caught in a cycle that’s very hard to see from the outside and very hard to break from the inside. Something happens. Stress, boredom, emotional pain, a fight with a friend, a hard day at school. The urge to eat feels overwhelming and then suddenly unstoppable. And then, after, comes the shame. Why did I do that? What is wrong with me? I have to hide this.

That shame does something important, and not in a good way: it drives the behavior underground. It makes it harder for your teen to tell you what’s happening. It makes them less likely to ask for help. And it often feeds the next episode, because shame is one of the most powerful emotional triggers for binge eating there is.

This is the cycle. It isn’t about willpower. It isn’t about discipline. It isn’t about how you raised them or what you put in the pantry. It’s a shame cycle, and it has a life of its own.

Your teen is probably hiding it from you not because they don’t trust you, but because they’re deeply ashamed of something they can’t explain. They may not have words for what’s happening, or they may worry you’ll be angry, disappointed, or put them on a diet, which often makes things worse. The hiding isn’t defiance. It’s self-protection, and it’s part of how well this disorder hides, even from a parent who’s paying close attention.

If You’ve Already Been Trying to Help

Most parents who end up here have tried to help their teen, often for a long time, in ways that made complete sense given what they knew.

Maybe you’ve had heart-to-heart conversations with your teen, the kind where you stayed up late, chose your words carefully, told them you loved them and just wanted them to be okay. Maybe you framed it around health, not weight, because you knew that was the right thing to do. Maybe you’ve started cooking differently, suggested a family walk after dinner, or quietly cleared the house of certain foods.

None of that is wrong. All of it came from love. But most of those approaches, even the thoughtful ones, work on the surface of the problem. A heart-to-heart about wanting your teen to be healthy, even when you’re genuinely not making it about weight, can still land on a teenager in a shame cycle as one more reminder that their eating is a problem, that they are a problem.

This isn’t a reflection of what you’ve done wrong. It’s a reflection of how well BED hides, and how much of it lives underneath the behaviors you can see.

What Helps (And What Doesn’t)

If you’ve been trying to address this by monitoring your teen’s food, commenting on what or how much they’re eating, or encouraging them to eat less, I want to gently tell you: that approach usually backfires. Not because you’re doing something wrong, but because it increases shame, and shame is what’s keeping this going.

What actually helps is the opposite of what most parents instinctively want to do. It starts with lowering the temperature around food in your home. Not making meals a place where your teen feels watched or judged. Finding small ways to signal that you are safe to talk to, not about eating, but about whatever is hard.

It also helps to get a professional involved. Binge eating disorder responds well to treatment. Cognitive behavioral therapy approaches have strong evidence behind them. A therapist and registered dietitian specializing in eating disorders can help your teen build a more regular relationship with food that reduces the conditions under which binges are most likely to happen. These aren’t quick fixes, but they work.

What your teen needs most from you, right now, probably isn’t a conversation about food. It’s to feel like you see them, that you’re not disgusted or disappointed, and that the relationship between you isn’t contingent on what or how much they eat.

What to Say (and What Not to Say)

This part is hard, because your instincts as a parent are to problem solve. To fix it. To say something useful.

But the most useful thing you can often say is something much simpler. Something like: I’ve noticed you seem like you’ve been having a hard time lately. I’m not here to make things harder. I just want you to know I’m in your corner.

And then leave space. Don’t push for details. Don’t bring up food or eating. Just let them know the door is open.

What tends to make things worse: comments about their body, about portions, about eating habits, about weight. Even gentle, well intentioned comments. Even comments framed as health concerns. For a teenager already deep in a shame cycle, these land as confirmation that they are the problem, and that confirmation makes the eating disorder louder, not quieter.

Getting the Support You and Your Teen Need

If you’re reading this and recognizing your family in it, the most important thing you can do right now is get support. Not a diet plan, not a meal tracking app, actual clinical support from someone who understands eating disorders.

That means finding a therapist who specializes in BED, and ideally also working with a registered dietitian who has eating disorder training. These two pieces, together, the psychological piece and the food relationship piece, are what give treatment the best chance of working.

You deserve support too. Parenting a teenager through an eating disorder is exhausting and frightening and often isolating. Finding a therapist or a parent support group can make a real difference, not just for you, but for your teen, because a calmer, more grounded parent is one of the most stabilizing things a teenager in recovery can have.

Your teen is not broken. You are not at fault.

If you have questions about what treatment for binge eating disorder might look like for your teenager, feel free to reach out. I’m happy to talk through what support could look like for your family. Schedule your free 20-minute consultation today.

Frequently Asked Questions

Q: My child seems “addicted to sugar.” I’ll buy a pack of cookies, and they eat the whole thing in one sitting. When I ask about it, they tend to fib. Should I stop buying sugary foods?

It’s a completely understandable instinct. If the food disappears, maybe the problem does too. But this isn’t really about the cookies. If you remove sugar from the house, your child will likely find a way to get it elsewhere, because the food itself doesn’t drive the behavior. It’s driven by what the eating is helping them cope with. The more useful path is getting your child support to build other ways of handling difficult feelings. The food is the symptom, not the cause.

Q: Our pediatrician referred us to a dietitian, and we’ve been going, but it doesn’t seem to be helping. What should we do?

Working with a dietitian who has experience treating eating disorders is a great foundation. What I’d suggest adding is a therapist who also specializes in eating disorders. Binge eating has a psychological component that needs its own dedicated attention alongside the nutrition piece; the two work best in tandem, not in place of each other.

Q: We eat very “clean” at home, but when our teen is out of the house, they go after sugary food like crazy. We don’t understand what’s happening.

This happens more often than parents realize, and once you understand what’s driving it, it starts to make sense. We’re surrounded by confusing, often fear-based messaging about food, the idea that we’re one bite away from disaster. But research tells a different story: dietary restriction and rigid food rules are a known contributor to binge eating developing in the first place. The “clean” eating at home and the “going crazy” outside it are often two sides of the same cycle, not two separate problems.

Please feel free to reach out for a free 20-minute consultation if you would like to discuss your child’s relationship with food further.

If you are a clinician who wants to learn more about eating disorders, check out my services for clinicians here.

Overtraining and Undereating: Could It Be an Eating Disorder?

by Alison Pelz, LD, RD, CDE, LCSW

The short answer: possibly, and you’re not alone in wondering.

If you’re an athlete questioning your relationship with food and exercise, or a parent worried about a teen who trains hard and eats less, this is worth understanding. The line between athletic discipline and disordered eating can be genuinely hard to see, especially from the inside.

This post breaks down the signs of an eating disorder in athletes, why athletes are at higher risk, and what to do if you’re concerned.

What Is Disordered Eating in Athletes?

Disordered eating in athletes exists on a spectrum. It doesn’t always look like the stereotypes.

You might be:

Following strict food rules that feel necessary for performance
Eating in ways that feel out of control after high-output training days
Restricting intake to make weight or achieve a certain body composition
Exercising through illness or injury because skipping feels unbearable

These patterns can overlap with recognized eating disorders, including anorexia nervosa, bulimia nervosa, binge eating disorder, and ARFID, as well as clinical syndromes specific to athletes, including Relative Energy Deficiency in Sport (RED-S) and the Female Athlete Triad (low energy availability, menstrual dysfunction, and low bone density).

Signs of an Eating Disorder in Athletes

Behavioral signs:

Rigid rules around food: what, when, and how much to eat
Binge eating: large amounts of food consumed with a feeling of loss of control
Purging behaviors
Continuing to train when sick or injured
Excessive preoccupation with food, weight, or body shape
Low insight that eating has become a problem
Excessive worry about food, weight, and body shape
Continuing to train when sick or injured

Physical signs:

Significant weight changes (loss or gain)
Low resting heart rate
Loss of menstrual cycle
Changes in appetite, mood, or energy
Dizziness or lightheadedness
Low blood sugar
Stress fractures or osteopenia

If any of this sounds familiar for yourself or a teen you care about, an evaluation by a doctor or mental health provider is a worthwhile next step.

Why Athletes Are at Higher Risk for Eating Disorders

Eating disorders don’t develop randomly. For athletes, several factors converge:

Performance culture. Athletic environments reward discipline, control, and pushing through discomfort — qualities that can easily slide into disordered patterns.
Perfectionism. Strongly correlated with anorexia nervosa, perfectionism is common among high-achieving athletes.
Body and weight pressure. Many sports emphasize a specific build to be competitive. That pressure is distressing on its own and even more so because genetics, not willpower, largely determines body shape and weight.
Diet culture overlap. The pressure athletes feel to eat the “right way” is amplified by a broader culture already obsessed with food rules.
Sport type. Endurance sports (distance running, triathlon, ultra-endurance) and weight or appearance-focused sports (wrestling, gymnastics, figure skating) are associated with a higher risk of eating disorders.

Eating Disorders Affect All Athletes

Disordered eating in athletes does not have a single look. Eating disorders affect:

Elite and recreational athletes
All genders
All ages: children, teens, young adults, and adults at midlife and beyond
All body sizes: most people who meet diagnostic criteria have what others would consider a “normal” body
All races, ethnicities, and socioeconomic backgrounds

Presentations vary widely, too. You might restrict and binge, purge without restricting, eat the same foods on rotation, or go all day without eating and then have a seemingly ordinary dinner. You may have gone to the doctor and gotten a “clean bill of health”, but the psychological distress of the eating disorder feels like it’s taking on a life of its own. None of these patterns is less real or less deserving of care.

What to Do If You Think You (Or Your Athlete) Has an Eating Disorder

Get support sooner rather than later. Eating disorders are chronically undertreated. Most people don’t seek help until things have been serious for a long time. You don’t have to wait.

If you have had an eating disorder for years and have “been O.K.” so far you still deserve treatment. If you have had a chronic eating disorder and received treatment before, don’t give up.

Eating disorders rarely announce themselves as disorders. They often start as wanting to “eat healthier” or “get in better shape” and then take on a life of their own. Like all behaviors, they serve a function: managing distress, feeling in control, and coping with difficult emotions. Recovery involves both nutritional stabilization and building new ways to navigate life.

Frequently Asked Questions: Eating Disorders and Athletes

What is the difference between athletic training and disordered eating? The key distinction is psychological distress and functional impairment. Athletes who train hard but eat flexibly, rest when injured, and don’t experience significant anxiety around food are generally not in disordered territory. When food rules feel rigid and non-negotiable, when missing a workout causes panic, or when eating feels out of control — those are signs worth paying attention to.

I don’t look like I have an eating disorder. Does that mean I don’t need help? No. Body size is not a reliable indicator of eating disorder severity. You can have a larger body and be dealing with a serious, life-affecting eating disorder that deserves treatment.

My eating disorder doesn’t feel that bad. Do I still need treatment? Yes. Eating disorders are underdiagnosed and often minimized by the people experiencing them and by providers. They can become chronic, affect relationships, work, school, and family life, and they can be fatal. They also carry a significant association with suicide.

If I start treatment, do I have to stop my sport? Maybe, but likely only temporarily. Whether exercise needs to pause depends on your physical and mental health at the time. The goal of eating disorder treatment is always to restore a healthy relationship with both food and movement and ultimately return to sport.

ADHD and Eating: Why It Might Feel So Hard (& Why That Makes Sense)

by Alison Pelz, LD, RD, CDE, LCSW

Have you ever had moments where you wondered, Why is eating so much harder for me than it seems to be for other people? Or maybe, I can manage work or school, so why does something as basic as feeding myself feel so overwhelming?

If that sounds familiar, there may be a reason that actually makes sense.

We know from research that people with ADHD are more likely to experience eating disorders such as anorexia, bulimia, binge eating, or ARFID. But beyond the statistics, what matters most is this:

For many people, their struggles with food are not random. They are connected to how their brain works and how they are trying to cope in a world that often expects consistency, structure, and follow-through.

That mismatch can be exhausting.

When ADHD Doesn’t Look Like ADHD

A lot of people don’t immediately recognize themselves in ADHD.

You might have been told that you are doing fine. Maybe you did well in school or you are managing your job. From the outside, things may look steady enough. And part of you might think, If I really had ADHD, wouldn’t it be obvious?

But many forms of ADHD, especially inattentive ADHD, are easy to miss. This is particularly true for girls and women. Instead of being loud or disruptive, it often shows up internally. It can feel like constantly pushing yourself to stay organized, to keep up, to not forget things that seem like they should be easy. It can mean feeling overwhelmed by everyday tasks while also being very hard on yourself for struggling.

On the outside, you may appear capable. On the inside, it can feel like you are working much harder than everyone else just to stay afloat.

Over time, that gap between how things look and how they feel can turn into shame or self-doubt. You may not have the language for it, but you can feel that something is off.

Why Challenges Often Show Up Around Food

When eating feels difficult, it is easy to assume it is a personal failing. You might think you lack discipline or that you should have figured this out by now.

But eating regularly asks a lot from your brain. It requires planning, starting tasks, remembering, organizing, and following through. These are all part of executive functioning, which is exactly where ADHD creates challenges.

So when you find yourself putting off meals, skipping them, or feeling overwhelmed by the idea of cooking and cleaning, it is not because you do not care. It is because your brain has a harder time getting started and moving through all the steps.

You may even notice a pattern where you do not eat for a while and then suddenly you are extremely hungry and trying to catch up. Then afterward, there can be confusion or frustration about how it got to that point again.

When Food Feels Complicated or Overwhelming

For some people, eating is not just about getting started. It is also about how food feels.

You might notice that certain textures or smells are hard to tolerate, or that food has to be just right for you to eat it. At the same time, it may be difficult to recognize hunger until it becomes intense.

This can create a strange push and pull. Sometimes eating feels like too much. Other times it barely registers until your body demands attention all at once.

From the outside, this might look inconsistent or restrictive. From the inside, it often feels confusing and hard to predict.

When Eating Becomes a Way to Cope

If you have experienced binge eating, you might feel stuck in a cycle that does not make sense to you. You may wonder why it keeps happening, especially when you genuinely want it to stop.

But in those moments, eating often serves a purpose. It can soothe overwhelming emotions, create stimulation when things feel dull or restless, or provide a sense of relief. Even if that relief is temporary, it matters.

Understanding this does not mean the behavior feels good or sustainable. It simply means there is a reason your brain keeps returning to it.

When Control Starts to Feel Important

For others, the struggle can look very different. Eating less or creating strict rules around food can feel grounding, especially when everything else feels unpredictable or overwhelming.

You might notice a sense of calm or clarity when things are controlled, and anxiety when that control is disrupted.

This can become more intense during times of change, like adolescence or moving into adulthood, when external structure disappears and you are expected to manage everything on your own. Without enough support, food can become one of the few areas that feels manageable.

A More Compassionate Way to Understand Your Eating Patterns

It is easy to fall into the belief that something is wrong with you.

But what if your eating patterns are not random or broken, but actually attempts to cope with stress, overwhelm, or disconnection?

That does not mean they are working in the long term. But it does mean they deserve understanding, not judgment.

How Healing Can Look Different for People with ADHD

Instead of focusing on fixing yourself, the work becomes about understanding yourself.

Together, we look at how your brain works, what makes things harder, and what kinds of support actually help. We explore what your eating patterns have been doing for you and where there may be unmet needs.

From there, we begin to build systems and strategies that feel more sustainable. Not perfect, not rigid, but supportive and realistic for your life.

If You See Yourself in This

You might feel tired of fighting with yourself. You might feel confused about why something that seems simple feels so difficult. Or you might just want to feel more steady, more nourished, and less overwhelmed.

That is where this work begins.

Ready to Take the Next Step?

If this resonates with you, you do not have to sort it out alone. I offer a free 20-minute consultation where we can talk about what has been going on and what kind of support might actually feel helpful.

Are you struggling with eating, food, or your relationship with your body, or just not sure if something feels off? You don’t need all the answers to reach out. If you’re in Texas and interested in working with me, click here to fill out a contact form.

If you’re a parent supporting a child with an eating disorder or ARFID/”picky eating”, therapy can give you the space to heal and show up for your child. You don’t have to carry this alone.