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When Food Becomes The Battleground: Eating Disorders + Teens
It often starts quietly. A teenager decides to “eat healthier”. Dessert goes first, then lunch at school. A morning run becomes a morning and evening run. Suddenly she has very firm opinions about which foods are “good” and which are “bad”.
As a parent, it can be hard to tell whether this is a phase, a health kick or something more serious. In my experience, parents usually sense something isn’t right well before anyone says the words “eating disorder”. That instinct is worth listening to.
Eating disorders affect boys and people of all ages too. I’m focusing on teenage girls here because adolescence is the most common time for these illnesses to begin, and girls are diagnosed most often.
What is an eating disorder?
Eating disorders are serious mental health conditions. They are not a lifestyle choice, vanity, or a diet that has gone a bit too far. The DSM-5, the manual psychologists and psychiatrists use for diagnosis, describes them as ongoing disturbances in eating, or eating-related behaviour, that significantly affect physical health and everyday life.
At the centre is usually an intense preoccupation with food, weight or body shape. Over time, a young person’s sense of self-worth becomes tightly bound up in these things. Eating disorders tend to show up in a few main ways.
You can’t tell by looking. Many young people with an eating disorder are in a body that looks “normal”, or even larger than their age-group average. |
How do eating disorders develop?
There is no single cause. The National Eating Disorders Collaboration (NEDC) and the Academy for Eating Disorders proport that parents do not cause eating disorders - there are a myrad of factors which contribute.
Eating disorders tend to grow from a mix of biology, temperament and environment.
Common contributors include:
Genetics and puberty. Eating disorders often run in families. Puberty brings rapid body and hormonal changes that can feel unsettling.
Temperament. Perfectionism, anxiety, high achievement and sensitivity to criticism are common in the girls I see.
A need for control. When life feels unpredictable (exams, friendship shifts, family change), food can become the one thing that feels controllable. Restricting can bring a brief sense of calm or achievement.
Low mood and anxiety. Depression and anxiety often travel alongside eating disorders. Restricting or bingeing can numb painful feelings for a while.
Social pressure. Diet culture, comments about bodies and social media all play a part. In The Anxious Generation, Jonathan Haidt highlights how image-based platforms and constant social comparison hit teenage girls particularly hard.
Dieting. Many eating disorders begin with an innocent-looking “healthy eating” plan.
Once an eating disorder starts, it tends to keep itself going. The well-known Minnesota Starvation Experiment showed that under-eating makes people more rigid, anxious and preoccupied with food, even when they had no eating disorder to begin with. This is why nourishment comes first in treatment. A starved brain can’t do much therapy.
Where to start
1. Seeking help, even when your teen doesn’t want it
Resistance is very common, and it is part of the illness. To your daughter, the eating disorder may feel like a friend or a solution. She may deny there’s a problem, minimise it or become angry. This isn’t deliberate dishonesty. It is often fear.
Choose a calm moment. Not at the dinner table, and not mid-argument.
Lead with care and what you’ve noticed, not weight. “I’ve noticed you’re skipping lunch and you seem really tired and flat. I’m worried about you.”
Expect pushback, and don’t wait for agreement. “I hear that you feel fine. I love you too much to guess, so we’re going to see the GP and check.”
Book the appointment. For under-18s, this is a parent’s call to make. You wouldn’t wait for your child to feel ready for a cast on a broken arm. Early treatment leads to better outcomes.
The medical side: why your GP matters
Eating disorders affect the whole body, which is why medical monitoring is a non-negotiable part of care. Teenage bodies are still growing, so changes can happen quickly, and they can happen even when weight doesn’t look concerning.
Your GP will typically check heart rate and blood pressure (often lying down and standing up), order blood tests to look at things like electrolytes, and monitor growth and weight over time. They’ll also ask about dizziness, fainting, energy and periods, which often stop or become irregular. Longer term, bone health and growth can be affected, which is another reason early help matters.
Your GP may refer you to a paediatrician, and sometimes a short hospital stay is needed to get things medically stable. This is a safety step, not a failure. Your GP can also set up an Eating Disorder Treatment and Management Plan. For eligible young people, this gives Medicare rebates for up to 40 psychology sessions and 20 dietitian sessions over 12 months.
When to seek urgent help Go to your nearest emergency department or call 000 if your daughter faints, has chest pain, a very slow or irregular heartbeat, becomes confused, refuses fluids, or talks about self-harm or suicide. |
2. What help looks like
The best treatment brings together medical care, nutrition and psychology.
Treatment usually involves two kinds of work running side by side:
Behavioural strategies | Psychological strategies |
A structured meal plan: three meals and two to three snacks at regular times, often built with a dietitian. | Understanding the function: what the eating disorder is doing for her, such as giving a sense of control or numbing feelings. |
Parents plan and serve meals early on, so she doesn’t have to fight the eating disorder over every portion. | Challenging the rules: CBT-E (an eating disorder specific CBT) helps older teens question rigid thinking about food, shape and weight. |
Support during and after meals, when anxiety and urges are often strongest. | Emotion regulation skills: learning to ride out distress, especially after meals, rather than act on it. |
Pausing or limiting exercise until it is medically safe. | Treating what sits alongside: anxiety, low mood and perfectionism. |
Gradually bringing back “fear foods” in small, planned steps. | Rebuilding identity: reconnecting with who she is beyond food and her body. |
Removing scales and calorie-tracking apps, and unfollowing triggering accounts. | Handing back independence step by step as recovery takes hold. |
Parents taking charge of meals can feel like a big step backwards for a teenager. It isn’t forever. Responsibility is handed back gradually as she gets well.
3. Externalising the eating disorder
One of the most helpful ideas in treatment comes from narrative therapy, developed by Michael White and David Epston. It is also a core part of E-CBT The idea is simple: your daughter is not the eating disorder. The eating disorder is something happening to her.
This matters for a few reasons:
It reduces shame. Brené Brown’s research separates guilt (“I did something bad”) from shame (“I am bad”). Shame drives secrecy. Saying “the eating disorder is loud today” is far easier than “I’m a bad person”.
It lets you be firm and kind at the same time. You can be fierce with the illness and still warm with your child.
It helps behaviour make sense. Hiding food, tears or rage at dinner are often the eating disorder’s fear talking, not your daughter’s character.
It unites the family. Everyone is on the same side, against a shared opponent, rather than fighting each other.
In practice, this might sound like: “I can hear the eating disorder is really loud right now. I know this feels scary. I’m going to help you eat this anyway.” Some families even give the eating disorder a name. This isn’t about excusing every behaviour. It is about giving your daughter room to fight back.
4. What helps parents, and what usually doesn’t
Dr Laura Markham often talks about combining empathy with firm limits, and the Gottman Institute’s emotion coaching approach is similar: name the feeling, stay with it, hold the boundary. That balance is the heart of supporting a teen with an eating disorder.
What helps | What usually doesn’t |
Staying calm and consistent at meals. You’re the steady one. | Arguing with the eating disorder using logic (“But you’re not fat!”) |
Validating the feeling while holding the plan: “I know this feels terrifying. You still need to finish it.” | Negotiating portions mid-meal or bargaining with rewards and threats |
Keeping mealtimes as pleasant as possible, with light chat or a gentle distraction | Any comments on weight, shape or appearance, including “You look healthy” (often heard as “You’ve gained weight”) |
Presenting a united front between parents and carers | Labelling foods as good or bad, or family dieting |
Praising who she is: her humour, kindness and effort | Waiting for her to feel “ready” for help |
Modelling a relaxed relationship with food and your own body | Endless reassurance loops about food or her body |
Getting your own support. This is a marathon. | Blame, punishment or going it alone |
Recovery is possible, and families are one of the most powerful parts of it. It is rarely a straight line. Expect good weeks, hard weeks and the odd dinner where everyone ends up in tears.
You don’t need to get it perfect. You need to keep showing up, calm and consistent, meal after meal. If you find yourself sitting through the fortieth supervised lunch and wondering if anything is changing, it is. Consistency is the medicine. And please look after yourself along the way. You matter in this too.
Get in touch with us at Manly Minds if you need more guidance and help. Early intervention is intregral in this area of mental health, especially in teenagers.
Where to get support
If you’re worried about your daughter, the team at Manly Minds is here to help. |
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