One of the most challenging aspects of eating disorders in children is what some call the "silent phase" when the illness is developing internally but hasn't yet manifested in obvious physical symptoms. During this time, 57% of young patients attend medical consultations for related symptoms, like headaches and fatigue, but symptoms are frequently dismissed as “non-specific” complaints. This means, even some pediatricians struggle to identify this silent phase.
Eating disorder behaviors can vary from child to child, but often in the early stages of an eating disorder, the signs may not be as extreme as you imagine. Warning signs during this silent phase can include avoiding social activities, a newfound inflexibility around routines, and even uncharacteristic emotionality which might be misinterpreted as preteen or teenage mood swings. Parents do often sense something is off during this phase but struggle to pinpoint what's happening.
As these early signs begin to surface, many parents find themselves wondering whether what they’re seeing points to “normal” developmental changes or something more serious. This is the moment when understanding the core types of eating disorders becomes helpful to give language to patterns that otherwise feel confusing, contradictory, or easy to dismiss. The following disorders are the most common in children and teens and offer a starting point for recognizing what may be unfolding beneath the surface.
Understanding these diagnoses is just the beginning. To truly support a child, it’s just as important to understand why eating disorders take hold and what makes certain kids more vulnerable than others.
One of the most persistent myths about eating disorders is that they’re about vanity or a desire to look thin. In reality, these illnesses are rarely about appearance. Instead, they often begin as a child’s attempt to manage overwhelming emotions like anxiety, depression, perfectionism, or trauma. By addressing co-existing conditions like these, Blackbird Health uncovers the root causes contributing to the eating disorder, ensuring a more accurate diagnosis and more effective treatment.
Eating disorders can develop at any age, but there are two periods when they most commonly emerge: the start of high school (around ages 14–15) and the transition to college (around ages 18–19). Both are times of major change, increased stress, and greater autonomy around food choices.
For younger teens, the pressures of puberty, academic challenges, and social comparison can trigger disordered eating. For college students, newfound independence, academic demands, and social stressors can set the stage for unhealthy coping mechanisms.
The COVID-19 pandemic intensified these vulnerabilities for many children. Sudden loss of structure, isolation from peers, and uncertainty disrupted emotional regulation, especially for kids with anxiety, autism, ADHD, or sensory sensitivities. Clinicians continue to see cases where eating disorder symptoms first emerged during pandemic shutdowns and never fully resolved as routines returned.
It’s important to recognize just how serious eating disorders can be. Anorexia nervosa, for example, has the second highest mortality rate of any psychiatric disorder, with suicide as the second leading cause of death among those diagnosed. Bulimia nervosa and binge eating disorder also carry significant health risks, including heart problems, digestive issues, and severe psychological distress.
The stakes are high, and early intervention is critical. Yet, because eating disorders often begin silently, many families don’t seek help until the illness has become deeply entrenched.
One of the strongest predictors of eating disorder development might surprise you: childhood anxiety. Research following 7,767 children found that physical anxiety symptoms and generalized worries at age 10 significantly predicted eating disorder diagnoses by age 16.
Both anxiety and eating disorders involve a heightened sense of threat and a desperate need for control. When children feel overwhelmed by worry, controlling food intake can provide a temporary sense of mastery over their internal chaos.
When children feel hopeless or emotionally numb, eating disorders can provide a sense of purpose or achievement. Parents may notice mood changes, irritability, or withdrawal from previously enjoyed activities long before any changes in eating behavior become apparent.
Neurodivergent children face unique challenges that can increase eating disorder risk:
ADHD considerations
Impulsivity can lead to binge eating episodes, while hyperfocus may cause children to forget to eat regularly. Additionally, medication side effects may suppress appetite, creating unhealthy eating patterns.
Autism considerations
Sensory sensitivities can make many foods intolerable, leading to highly restricted diets that are often mistaken for simple pickiness. Rigid thinking patterns can also intensify rules around “good” and “bad” foods. For autistic children especially, specific food textures or routines can provide comfort and predictability, but the line between sensory needs and disordered eating can blur, especially when societal pressure to eat “normally” creates additional anxiety.
The ARFID Connection
Many children with ARFID also have underlying neurodivergent traits. What starts as sensory sensitivity or executive function challenges can evolve into significant nutritional deficiencies if not properly addressed.
In recent years, the explosion of weight-loss medications and diet culture in the media has made things even harder for kids. The message that thinness equals health and worth is everywhere, and children are absorbing it at younger and younger ages. Whether it’s the constant discussion of GLP-1s or the constant exposure to filtered and edited images on social media, the atmosphere is becoming increasingly hostile to healthy body image and eating habits.
If you recognize your child in any of these descriptions, or if you've simply had that persistent parental worry that something isn't right, trust your instincts. You don't need to wait for obvious physical symptoms or a crisis. In fact, waiting is exactly what we don't want.
At Blackbird Health, we understand that eating disorders rarely exist in isolation. Effective eating disorder treatment addresses the whole child, not just eating behaviors. The most successful approaches combine medical monitoring, therapy, psychiatric care, nutritional support, family involvement, and educational advocacy. Our integrated treatment includes:
At Blackbird Health we believe recovery is about reclaiming joy, rebuilding relationships, and developing a healthy relationship with food and body image. Our team understands the urgency of eating disorder treatment and the importance of addressing the whole child, not just the symptoms. Our comprehensive evaluation process reveals the full picture of what's happening with your child, allowing us to create a precise, individualized treatment plan that addresses root causes from the start.
Unlike hospital systems with months-long waitlists, Blackbird Health serves southeastern Pennsylvania and Northern Virginia families without delays.
If you’re noticing changes in your child’s eating, emotions, or routines, reaching out early can make all the difference. We’re here to help.
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This article is for educational purposes only and does not replace professional medical advice. Consult with your child's healthcare provider or a mental health professional for personalized guidance.