Eating Disorders in Young People: Understanding the Hidden Struggles Behind Food

It’s Not Always About Food

When we talk about eating disorders in young people, the conversation often gets reduced to body image, weight, or appearance. But in the therapy room, the story is often more complex — and far more human.

For many of the young people I work with, eating difficulties are not about wanting to look a certain way. They’re about control, safety, coping, and sometimes simply trying to make overwhelming feelings more manageable.

Food becomes a language — often the only one that feels available.

When food becomes more than food — a moment of pause, pressure, or protection.

The Modern Landscape: Why Eating Issues Are Rising

Young people today are navigating pressures that previous generations never had to face. Eating difficulties don’t appear in a vacuum; they grow in the soil of modern life.

Digital culture & constant comparison

• Social media creates a 24/7 mirror

• “Wellness” trends blur into restriction

• Fitness trackers and calorie apps normalise self‑surveillance

Post‑pandemic emotional fallout

• Disrupted routines

• Heightened anxiety

• Loss of predictability and structure

Neurodivergence & sensory overwhelm

For some young people, eating is tied to sensory sensitivity, rigidity, or routines — often misunderstood as “picky eating” or “defiance.”

School pressure, perfectionism & identity

High‑achieving environments and internal pressure can make food one of the few controllable variables.

Eating Disorders vs. Disordered Eating: Why the Distinction Matters

These terms are often used interchangeably, but they describe different experiences.

Eating Disorders:

• Diagnosable mental health conditions

• Often involve rigid patterns, compulsions, or rituals

• Not always visible or dramatic

• Can significantly impact physical and emotional wellbeing

Disordered Eating:

• Irregular or emotionally driven eating patterns

• Can include skipping meals, “earning” food, or rigid rules

• Often socially reinforced

• Can be distressing even without meeting diagnostic criteria

In therapy, I often meet young people who don’t fit neatly into a diagnostic box — but their relationship with food still causes fear, shame, or exhaustion. Their experience is valid, even without a label.

What Eating Disorders in Young People Are Really About

This is where the work becomes deeply relational.

Control in an uncontrollable world

When everything feels chaotic — school, friendships, family dynamics — food becomes a predictable variable.

Emotional regulation

A large study published in 2025 found that young people who struggle with big, overwhelming emotions are more likely to develop eating difficulties [1]. In simple terms, when feelings feel too intense or hard to manage, food can become a way of coping — a temporary sense of calm, control, or escape.

Numbing or avoiding feelings

Restriction, bingeing, or rituals can create distance from emotions that feel too big or too painful.

Identity & belonging

For some young people, the eating disorder becomes a part of how they understand themselves — or a way to communicate distress when words feel too risky.

Attachment & emotional safety

Research with adolescents diagnosed with anorexia nervosa found significantly higher attachment insecurity and emotional dysregulation compared to peers [2]. This aligns with what many clinicians observe: eating difficulties often emerge where emotional needs have felt unmet or misunderstood.

Subtle Signs Adults Often Miss

Not all signs look like dramatic weight changes. Some are quiet, private, or socially accepted:

• Hyper‑fixation on “healthy” eating

• Sudden interest in fitness trackers or calorie counting

• Avoiding meals with others

• “I’ve already eaten” becoming a frequent phrase

• Rigid routines around food or exercise

• Emotional flatness or irritability

• Increased secrecy or withdrawal

How Therapy Helps: A Person‑Centred Approach

Therapy isn’t about taking control away — it’s about helping young people build internal resources so they no longer need food to carry their feelings.

Creating safety

Young people need a space where they can explore what the eating behaviour does for them, without judgement or pressure.

Working with underlying emotions

Shame, fear, overwhelm, perfectionism, identity struggles — these are often the real drivers.

Supporting autonomy

Recovery is not about forcing change; it’s about helping the young person reconnect with their own needs, values, and sense of self.

Creative, gentle tools

In therapy, we often use simple, grounding activities that help young people understand what’s happening inside them without feeling overwhelmed. This might include:

• Parts work, where we explore the different “parts” of them — for example, the part that feels scared, the part that wants control, or the part that’s exhausted. Young people often find this easier than talking about “me” or “I.”

• Drawing or visual mapping, such as sketching what the eating disorder might look like if it were a character, or mapping out how feelings show up in the body.

• Grounding exercises, like noticing sensations, using objects with different textures, or practising slow breathing to help the body feel safer.

• Externalising the eating disorder, giving it a name or voice so the young person can understand it as something separate from who they are.

• Compassion‑focused work, helping them speak to themselves with the same kindness they’d offer a friend.

For Parents & Carers: How to Support a Young Person

Parents often feel frightened, confused, or unsure how to help - which is a natural response. These principles can make a meaningful difference:

• Stay curious rather than confrontational

• Avoid commenting on weight or appearance

• Focus on feelings, not food

• Keep communication open and non‑judgemental

• Seek support early — even if things “don’t look that bad”

Hope, Healing, and Reclaiming Self

Eating disorders can feel powerful, consuming, or even protective. But they are not a young person’s identity — and they are not always a life sentence.

With the right support, young people can learn new ways to regulate emotions, express needs, and feel safe in themselves. As trust grows, the need for food to carry their feelings often begins to soften.

When a young person feels truly seen — by themselves and by others — healing becomes possible.

References

1. Zhou, R., Zhang, L., Liu, Z., & Cao, B. (2025). Emotion regulation difficulties and disordered eating in adolescents and young adults: A meta-analysis. Journal of Eating Disorders.

2. Khaustova, O., & Sak, L. (2021). Emotional regulation and attachment in adolescents with anorexia nervosa. European Psychiatry.