An increase in the number of patients being treated for eating disorders at Johns Hopkins All Children’s Hospital is reflective of a trend in our country and around the world. One study shows in the United States from 2018 to 2022 health visits for eating disorders more than doubled for children under the age of 17.

Jasmine Reese, M.D., is director of the Adolescent and Young Adult Specialty Clinic at Johns Hopkins All Children’s in St. Petersburg, Florida. She shares some insight as to why young people may be especially vulnerable to eating disorders currently.

Why are so many children and adolescents struggling with eating disorders? What different factors may be contributing to this?

We have seen a large increase in eating disorders since the pandemic. Contributing factors include the isolation and increased stress during the pandemic leading to maladaptive coping mechanisms, or unhealthy ways of dealing with stress. During that period, an increase in screen time and social media use led to a lot more focus on body image and body comparison. The numbers we’re seeing now seem closer to what we experienced during the pandemic.

It is also holiday season, which is a typical time to see young people with eating disorders have increased challenges. I’ve received more calls and referrals from community primary care physicians who are identifying teens and children with eating disorders and inquiring about next steps to best support them.

How has social media changed the landscape for young people in regard to body image and how might that be having an impact?

Almost all teens have access to social media whether on a phone or a computer. This means easy access to online content that may be glamorizing fad diets, weight loss or certain body types. There is also easy access to content that may influence specific eating habits that lead to what we know as “orthorexia” (obsession with eating “clean” or “healthy”). This may lead to restricting calories and nutrients that young people need to grow and develop. 

There is so much in the media about the newest weight loss drugs. Does that have an impact on those who may be vulnerable to eating disorders?

Weight loss medications have become increasingly popular not only among the general population but also among celebrities and “influencers” whom teens and young adults admire. This can lead to the belief that this is what they need to lose weight — and misses the important point that all these medications have significant side effects to consider. Eating disorders such as anorexia nervosa, bulimia nervosa and binge eating disorder are mental health diagnoses. This means these individuals have an unhealthy relationship with food and their body. We highly encourage individuals to first seek treatment for the eating disorder before starting on any weight loss medications. 

How can parents help to keep their children from developing eating disorders? What conversations should they have — or not have — with their children?

We encourage parents to avoid strict rules around food and mealtimes in the home and outside of the home. For example, avoid labeling food as either “good” or “bad” food because we know there are nutrients and benefits to gain from eating a variety of foods. Eating sweets and high calorie foods in moderation is a good and common practice in general, however, when parents or caregivers are too rigid with eating habits, such as counting calories, constantly make negative remarks when someone is eating a food they consider “unhealthy,” there is a risk that their child can develop an unhealthy relationship with food to the point of significant calorie restriction, unhealthy weight loss and malnutrition. 

What else should parents and caregivers watch for?

If parents notice that their kids or teens are often skipping meals, if they stop eating foods they used to like, are losing weight, having irregular or missed periods (teen girls), suddenly feeling uncomfortable eating around others, or wearing abnormally baggy clothes as if to hide their bodies, these could be signs of an eating disorder and they should talk to their pediatrician.