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

Teenager looking upset and withdrawn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.

Understanding Eating Disorders: Looking Beyond the Behavior

by Alison Pelz, LD, RD, CDE, LCSW

When you or your child is struggling with food, whether that looks like purging, restricting, binge eating, and/or rigid exercise, it can be terrifying and confusing for parents. It can also feel deeply isolating for the person living inside the experience.

What we see on the outside is food behavior: increased rigidity around food, eating in isolation, eating large amounts of food, or purging. The behaviors can look or feel so baffling that it may be hard to get curious about what is happening on the inside. But having this understanding is key to long-standing eating disorder recovery.

Most eating disorders serve some function, which means that they are “helpful” or serve a purpose for the person living with them. This may sound counterintuitive, because the behaviors can feel distressing and can be physically harmful. While the outcome is harmful, there is often a root need that it feels like the disorder is addressing.

Eating disorders are rarely about stubbornness or vanity

Eating disorder behaviors are the tip of the iceberg. These behaviors can look willful, defiant, obsessive, or confusing. But they are rarely about stubbornness or vanity. They are usually nervous system strategies.

When a child (or adult) cannot eat, eats beyond fullness, purges, or restricts, their body is often trying to regulate something overwhelming inside.

The nervous system is the hidden driver. Our nervous system is constantly scanning for safety or danger. This process happens automatically and below our conscious awareness.

Eating disorders are a survival response

When our nervous system is well regulated and feels safe, we can eat with flexibility, have awareness of hunger and fullness, digest food well, tolerate a wide range of emotions, and have the capacity for problem-solving.

In contrast, when our nervous system is in fight, flight, or freeze in reaction to distress, our brains and bodies do quite the opposite. Eating disorder behaviors often map directly onto these survival responses.

Not eating enough calories can subdue emotions

Dietary restriction, or not being able to eat enough, functions to dampen the nervous system over time, which reduces the intensity of our feelings. When the world feels chaotic, overwhelming or unpredictable, malnutrition can create a sense of safety and stability.

This is one of the reasons we think that anorexia nervosa often begins in early adolescence. During this time, lots of change is happening, including the onset of puberty. Additionally, the transition between high school and college represents another vulnerable period during which anorexia may emerge.

Binge eating and purging can function to help reduce distress

Binge eating is thought to be soothing when intense emotions crop up. In other words, food is used as an attempt to self-soothe or regulate distress. For someone who feels anxious, overwhelmed, depleted or lonely, eating can temporarily bring short-term relief. However, longer-term it makes one’s distress grow.

Purging behaviors often follow intense nervous system activation, including overwhelm, shame, panic, or sensory overload. Purging can create a rapid physiological shift. It may temporarily reduce anxiety or provide a feeling of release. The body learns: This brings relief. And so the cycle repeats.

Similar to purging, rigid, compulsive or overexercising can create quick physiological changes. These changes include a release of endorphins and changes in dopamine and serotonin, which can improve mood. Exercise can create short-term relief from emotions such as anxiety, guilt, shame, stress or sadness. Because of this relief, the brain learns to repeat it, which leads to increased amounts of exercise.

Understanding eating disorders is a key step in recovery

You or your child may be experiencing one or any combination of these eating disorder behaviors. The thing to remember is that eating disorder behaviors are serving some function. So, it makes sense that attempts to “have more willpower” or trying to abstain from the behaviors are often short-lived and ineffective. In fact, approaching eating disorders this way often causes an increase in shame, isolation and feelings of failure.

Treating eating disorders usually utilizes a combination of insight-oriented & behavioral therapies. The goal of insight-oriented therapy is to develop a deeper awareness of unconscious patterns, past experiences, and internal conflicts that influence current problems. The goal of behavioral therapies is to identify, modify, and replace maladaptive behaviors with healthier ones by changing the learning and reinforcement patterns that maintain them. Both are needed to recover.

Eating disorders are not just about food. They are about regulation, safety, and survival. If you or your teen are living inside this experience, your behaviors make sense in the context of your nervous system. They are not proof that you are broken or weak or that you failed as a parent.

Remember: recovery is possible.

Do you want to learn more about your treatment options? Sign up for a free consultation to learn more about how I can help you.

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2025 in Review: Resources for Eating Disorder Recovery and Caregivers

by Alison Pelz, LD, RD, CDE, LCSW

We’re about to wrap up 2025, so I wanted to take a look back at what I’ve discussed on the blog this year. Every year, different themes emerge, and this year was no different. This year, I focused on providing resources for the support network that often accompanies the individual in eating disorder recovery. We don’t heal in isolation, and the role of parents and caregivers in eating disorder recovery is an important one.

I’m passionate about making research accessible to parents and caregivers to empower families and increase compassion for their loved one who is experiencing the eating disorder. That’s why I focused so much on family-based treatment and validation, as tools in your toolbox to help you and your loved ones navigate eating disorder recovery and our diet obsessed culture.

I hope these posts are helpful to you on your journey to recovery and food peace.

Here’s what I wrote about this year:

Book Review: Binge Eating Disorder: The Journey to Recovery and Beyond is a Must Read

“Binge Eating Disorder: The Journey to Recovery and Beyond by Amy Pershing with Chevese Turner, seamlessly blends clinical knowledge with the lived experiences of those affected by BED. It is an invaluable guide for individuals experiencing BED and their families. It is divided into three parts: understanding BED, addressing its root causes, and finding sustainable recovery strategies. This book is a must-read for anyone looking for an insightful and compassionate resource on binge eating disorder (BED).” Read the full review here.

Supporting Your Child Through an Eating Disorder: A Guide for Parents

“Eating disorders are complex, but that doesn’t mean they are unknowable. Education is one of the most powerful tools you have at your disposal, not only to help you find effective methods of support, but also to help expand your understanding of what causes and may impact eating disorders, so you can give informed care to your teen–rather than having to rely on guess work and risk causing harm.

Understanding the nature of eating disorders and their impact on both physical and mental health can demystify the illness and empower you to provide informed support to your teen. Here are some highly recommended resources to deepen your knowledge and help you in supporting your child.” Get the resources here.

The Power of Validation: Supporting Your Child Through Eating Disorder Recovery

“Witnessing your child struggling with an eating disorder can feel overwhelming, confusing, and deeply painful. As a parent, you naturally want to help, but knowing how to respond in the most effective way is not always intuitive. One key tool you can use to support your child’s recovery is validation–understanding what it is, why it matters, and how to practice it can make a world of difference for both your child and your family.” Learn how to use it here.

Sick Enough: A Guide to the Medical Complications of Eating Disorders is a Must-Read

“All people with an eating disorder deserve care and treatment. This is a simple but powerful idea that is reinforced again and again throughout Sick Enough.

Eating disorders affect people’s physical health, not just their mental health. It is important to know how being underfed and undernourished can affect the body. People with bulimia, binge eating, and anorexia can experience these effects. Undernourishment can happen across the weight spectrum. It affects the digestive tract, mood, muscle tone, and much more.

Yes, Gaudiani emphasizes, all who experience eating disorders are “Sick Enough” to warrant treatment.” Get the full review here.

Free Workbook for Parents and Caregivers: Supporting Teens with an Eating Disorder

“Validation is not something that you learned from a typical parenting book. In fact it is something that therapists spend endless hours learning about in grad school and practicing with clients.

Because it is so tricky I wanted to provide a resource for caregivers to help learn more and hone their skills in validation–that’s why I created this free validation workbook. This workbook is geared towards parents supporting a teen with anorexia, bulimia or binge eating (not ARFID-that is a whole other workbook-stay tuned!) I hope you find the workbook helpful!” Download the workbook here.

Eating Disorder Recovery: Gain Momentum Over Summer Break

“Summer break, however, offers something the school year rarely does: breathing room. With fewer academic pressures and more control over your schedule, summer can be an opportunity to gain real momentum in your recovery journey. Here’s how you can use this season to refocus, reconnect, and strengthen your foundation for eating disorder recovery.” Get the tips here.

Nourish to Heal: How Eating Enough Supports Binge Eating Recovery

“Eating more will likely help you reduce binge eating. This feels counterintuitive and is certainly not what the weight loss industry or the medical community typically advises, so I know this recommendation can feel very scary.

The weight loss industry provides “tricks” to reduce binge eating, usually focusing on how to limit consumption of certain foods. However, rather than helping navigate binge eating, it often fuels and perpetuates binge eating. Science has taught us that dietary restriction is a risk factor for developing an eating disorder, including binge eating. Dietary restriction also maintains the eating disorder–in other words, a restrictive diet keeps the disorder going.” Here’s why.

Understanding ARFID: More Than Picky Eating

“Avoidant/Restrictive Food Intake Disorder is not just a simple case of picky eating; it is a complex psychological condition that can cause significant nutritional and reduced quality of life, particularly if it endures into adulthood.

Unlike other eating disorders that are often driven by concerns about weight and body image, ARFID is characterized by an avoidance of food based on sensory sensitivity, lack of interest in eating, depressed appetite, and/or fear of adverse consequences such as choking, throwing-up, or an allergic reaction.” Here’s what you should know.

Freshman Year of College: Why Eating Disorders May Start or Reappear

“The first year of college is often described as a thrilling new chapter—freedom, independence, new friends, late-night pizza, dorm life, and so much possibility. For many students, this first year is fun and exciting. But it’s also filled with major transitions—many of which are invisible until you’re in them. And for students with a history of disordered eating, or even those without, the shift can be enough to stir up or intensify existing eating disorders and their symptoms.” This is why–and what you can do about it.

A Note to Parents of Teens with Anorexia Nervosa

“If you’re reading this, chances are you’re scared, confused, and doing everything you can to help your teen who seems to be struggling with anorexia nervosa. Maybe you’ve noticed weight loss, increasing rigidity around food, or a once joyful child who now seems consumed by rules and restrictions. You’ve already tried reasoning, negotiating, and reassuring them, only to be met with resistance, tears, or even silence. You’re not alone—and you’re not to blame.” Read the rest of the note here.

Tackling Healthism in Eating Disorder Recovery

“Healthism is the belief that a person’s moral worth is tied to their health status—and that “health” is something we can fully control through the “right” choices. It often masquerades as wellness advice, clean eating trends, or motivational fitness culture. It’s sneaky. It’s normalized. And it can deeply harm those recovering from disordered eating.” Here’s how you can move beyond it.

Powerful Lived-Experience Stories About Avoidant/Restrictive Food Intake Disorder (ARFID)

“Avoidant/Restrictive Food Intake Disorder (ARFID) is often misunderstood by family members, school personnel and professionals, and sometimes even by the individuals who have ARFID.

Training as a therapist, of course, has been helpful in my work with clients, but listening to people with lived experience has been so powerful. It deepens understanding and builds compassion for oneself and for those around them.” Read the stories here.

I’ll be back with more in 2026! I’ll be writing more about eating disorder recovery, caregiver support, family-based treatment, body image, making peace with food, and navigating weight bias.

If you are in Texas and interested in working with me, click here to fill out a contact form. If there are any topics you want me to cover on the blog next year, let me know! You can send me a message here.

A Note to Parents of Teens with Anorexia Nervosa

by Alison Pelz, LD, RD, CDE, LCSW

If you’re reading this, chances are you’re scared, confused, and doing everything you can to help your teen who seems to be struggling with anorexia nervosa. Maybe you’ve noticed weight loss, increasing rigidity around food, or a once joyful child who now seems consumed by rules and restrictions. You’ve already tried reasoning, negotiating, and reassuring them, only to be met with resistance, tears, or even silence. You’re not alone—and you’re not to blame.

Eating Disorders Don’t Happen in a Vacuum

First, let’s clear some things up: eating disorders happen for a variety of reasons, and you did not cause this. Your child is not being difficult or manipulative. Anorexia nervosa is not a choice—it’s a serious mental illness, one that often emerges as a way to cope with overwhelming emotions, stress, or internal distress. While it’s common to want to understand the “why,” we’ve found that what’s often more helpful is understanding the “function” of the eating disorder.

Many teens develop anorexia as a way to regulate their nervous systems. It gives them a false sense of control, numbs emotions, or provides structure during times when life feels chaotic or uncertain. To you, their stressors may look like typical teenage challenges—school pressure, friendships, body changes—but to them, it may feel unmanageable. Anorexia becomes their coping strategy.

The First Priority: Nutrition

It’s completely understandable to want your teen to be motivated to recover. That desire is beautiful—and sometimes, they do. But more often than not, especially early on, they don’t. That’s because the eating disorder is serving a function that feels protective, even comforting. This is why insight is often low, particularly in the early stages. Your teen likely does not recognize the danger they’re in.

But as a parent, you must.

Malnutrition affects every system in the body—heart, bones, hormones, digestive system, and most importantly, the brain. When the brain is undernourished, it struggles to think clearly, manage emotions, and perceive risk. That means your child may not recognize how sick they are—or even that they’re sick at all. In this light, food is not just fuel—it’s medicine. Without nutritional rehabilitation, anorexia becomes more dangerous and more entrenched. Left untreated, it can be fatal.

Supporting Your Teen: Think “Food First, Life Second”

Your role as a parent is critical—and powerful. You don’t have to wait until your teen agrees there’s a problem. In fact, waiting can lead to more severe illness. Instead, treat this the way you would treat any other safety concern. If your child was struggling to breathe, you wouldn’t wait until they acknowledged the problem—you’d act. Anorexia nervosa requires the same kind of decisive care.

So what does that look like?

Offer three meals and three snacks a day. These should be complete, nourishing meals designed to support weight restoration and healing—not what your teen requests or feels “safe” eating. (Remember, the eating disorder is often dictating their choices right now.)
Before starting nutrition rehabilitation process, first get a full medical workup from your teens doctor, as they may be at risk for refeeding syndrome, which can be life-threatening.
Sit with them while they eat. This isn’t just about supervision—it’s about support. Offer to distract them if they’d like—scroll through social media together, play a card game, or watch a show. Distraction can be a helpful tool.
Validate, validate, validate. Acknowledge how hard this is. Say things like, “I know this is scary,” or “I can see how uncomfortable this feels.” Your calm, steady presence will help more than you know.

You’ve probably already tried to help your child eat more and have been met with pushback. That’s normal. Remember, the eating disorder is helping them cope, and asking them to let go of it—especially before they’ve learned other ways to regulate—is asking a lot. But with nourishment, the brain begins to heal. With nourishment, new coping strategies become possible.

You’re Not Alone

Recovery from anorexia is hard—but it’s possible. And no one should do it alone. Reach out to treatment professionals who understand eating disorders, and look for support groups for families walking the same path. Family-Based Therapy (FBT) is designed to support you as you support your teen.

Above all, remember this: your love is not enough to cure anorexia, but it is the foundation on which recovery is built. You can be firm and compassionate. And set boundaries and offer comfort. You can lead your teen through something they don’t yet want to leave behind.

You’re not failing. You’re fighting for your child’s life. And that matters more than anything else.

This article is meant to be educational about anoerxia nervosa, but it does not suffice as treatment. If you think your teen has an eating disorder, please seek a medical evaluation from your teen’s doctor.

If you would like to connect about how I work with families, feel free to schedule a consultation here.

Freshman Year of College: Why Eating Disorders May Start or Reappear

by Alison Pelz, LD, RD, CDE, LCSW

The first year of college is often described as a thrilling new chapter—freedom, independence, new friends, late-night pizza, dorm life, and so much possibility. For many students, this first year is fun and exciting. But it’s also filled with major transitions—many of which are invisible until you’re in them. And for students with a history of disordered eating, or even those without, the shift can be enough to stir up or intensify existing eating disorders and their symptoms.

The Perfect Storm of Change

Think about the months, even years, leading up to college: there’s pressure to get in, choose the “right” school, imagine your dream experience, and count down to this next life stage. Students often hear, “These will be the best years of your life.” That narrative leaves little room for the complicated, and very real, emotional reality of freshman year.

Starting college means stepping away from nearly everything that has felt familiar. Students leave behind the structure of high school, the predictability of home, their longstanding support systems, routines, and even the foods they’re used to eating. Meals in college are different—not just the food, but the context: dining halls, roommates watching what you eat, lack of privacy, food availability at odd hours. Schedules shift. Sleep is often disrupted. Social dynamics become more fluid and uncertain.

Our nervous systems thrive on predictability. When that predictability disappears, our bodies and brains notice.

Nervous Systems Don’t Just “Adjust”

The human nervous system is designed to keep us safe and regulated. When life feels overwhelming or uncertain, the body often reaches for something to regain a sense of control or grounding. For some students, that might be diving into academics or social life. For others—especially those with a history of disordered eating—old symptoms may resurface as a way to self-soothe, manage anxiety, or feel a sense of mastery in a suddenly unpredictable environment.

Even for students who have never struggled with an eating disorder before, the stress of transition can be enough to tip the scale. Eating disorders aren’t really about food. They are adaptive responses to stress, trauma, and dysregulation. And while they may seem counterproductive from the outside, they often serve a protective function—numbing overwhelming feelings, offering structure, or creating a sense of control.

When the Fun and the Stress Coexist

It’s important to recognize that freshman year doesn’t have to be miserable for it to be dysregulating. Students (and parents) are often surprised that eating disorder behaviors emerge during what appears to be a “good” year. It’s a common misconception that if a student is socializing, attending classes, or even enjoying college, they must be doing fine. But excitement and stress can coexist. A student might love their college experience and still be struggling silently with food or body image.

What can college students and families do?

Normalize the complexity of transitioning to college. Including feelings of worry, fear, and isolation.
Check in with yourself or your college student about disruptions to routine, the changes in eating patterns, and the emotional rollercoaster of being away from home.
Support emotional regulation strategies beyond food and body control—like mindfulness, journaling, movement, and connecting with others.
Encourage care, especially for students with a history of an eating disorder. Ongoing therapy or nutrition support through telehealth can make a significant difference.
Watch for warning signs that may get masked by the “college is fun” narrative—changes in weight, food rituals, isolation, or excessive focus on body image.
Reinforce that relapse is not failure, but a signal from the nervous system that something is overwhelming. It’s an invitation for support, not shame.

Final Thoughts

Freshman year is a season of growth, challenge, and self-discovery. It’s normal for it to feel both exciting and hard. When we understand the nervous system’s role in regulation—and how eating disorders often function as misguided coping tools—it becomes easier to see why symptoms might arise or return during this time.

By naming these challenges openly, we can help students and families feel less blindsided—and offer the compassionate, proactive support that helps them not just survive freshman year, but move through it with resilience.

If you would like to know more about how I work with families and college students with eating disorders, please feel free to contact me.