What to Do if You Suspect an Eating Disorder in a Child or Teen

Step 1: Take warning signs seriously and trust your gut. 

Don’t wait to see if it “passes.” Early intervention improves outcomes.

Step 2: Make a Doctor’s Appointment.

Schedule an appointment with your child’s pediatrician or primary care provider.

Before the visit:

• Confirm that the provider is experienced in screening for eating disorders.

• If needed, ask them to review screening guidance at NCEED.org.

• If you’re unsure of their expertise, consider seeking a provider experienced in eating disorder care.

If you won’t be in the room during the appointment, send the doctor your concerns in advance.

Step 3: Share your concerns with your child with care and compassion.

Before talking to your child, write down objective, factual behaviors you’ve noticed.

Examples:

• “You’ve been pushing food around on your plate but not eating it.”

• “You’re spending more time in the bathroom looking at your body.”

• “I’ve overheard you criticizing your body more often.”

Let them know that you are not an expert in these issues, but that, together, you will visit with someone who is an expert that can help.

They may get defensive or upset with you (which usually indicates you are doing the right thing), but know that no matter what your child’s reaction, you are doing the right thing by trusting your gut and seeking help.

Step 4: Prepare for the Doctor’s Appointment.

Before the appointment with your doctor, if you will not be in the room with your child during the appointment, be sure to communicate with the doctor in advance the objective behaviors you have seen (i.e. the list you made prior to talking with your child).

If appropriate, pursue specialty treatment options to reestablish well-being and health with body image and food. This may include working with your child’s Primary Care Provider (first confirming they have basic training and know how to screen for eating disorders) , or working with a provider that knows how to treat disordered eating and eating disorders.

Step 1: Request a Private Conversation. 

“Hey, can we talk privately for a few minutes? I have some things I’d like to talk with you about.”

Keep it calm. Keep it caring.

If the child is younger (elementary or middle school), involve parents or guardians early. Share specific, objective behaviors you’ve observed and encourage them to connect with a pediatrician or eating disorder specialist. Early intervention significantly improves eating disorder recovery outcomes.

Here are some considerations on how to approach this by age of the athlete:

• Under 13: Let the young person know you will also connect with their parent or guardian.
• Age 14-17: Use your judgment or defer to program/school policies about when to bring in the parents, similar to how you would handle other health or safety concerns.
• Age 18+: Keep the conversation primarily between you and the young person.

Step 2: Share Specific Observations.

Come from a place of compassion. Be direct.

Example:

“I’ve noticed you’ve been training extra the last few weeks. At first it seemed like strong commitment, but now I’m worried you might be overtraining and risking injury.

I’m also concerned about the comments you’re making about food and your body. It makes me wonder if you’re fueling enough to support strong performance.

I’ve seen this kind of overtraining, under-eating, comments about food changes and eating before with athletes. And I’m concerned you might be struggling with eating and not be getting enough nutrition to support your training and recovery.”

Avoid:

• Accusations
• Debates about food rules
• Lectures about nutrition

Focus on care and concern.

Step 3: Ask and Listen.

“What do you think about what I’ve shared? Can you tell me more about how you’re thinking about food or training?”

Then listen.

Step 4: If you hear “I’m fine,” stay firm.

Defensiveness is common.

Stay calm and steady:

“I hear that you think you’re fine. I’m not so sure you are. I think we might have different perspectives.”

You can:

• Suggest reconnecting in a few days
• Offer to gather more information together
• Suggest speaking with a counselor, doctor, or parent
• Let them know you plan to follow up

They may be upset. That does not mean you were wrong to speak up.

Step 5: Follow Up.

This is not a one-time conversation.

Keep the focus on:

• Compassion
• Safety
• Getting professional support

If the student or athlete may be at risk, involve parents, school counselors, or healthcare providers as appropriate. Your goal is to get them connected to resources and support.

When involving others (such as athletic trainers or school staff), try to include people with experience in eating disorders or athlete nutrition. If you’re unsure about someone’s expertise, review resources, like these screening tools from NCEED.org together or seek guidance from an eating disorder professional.

You don’t need to be an expert in eating disorders to support your student! Speaking up early can help someone get the support they need, and may even save a life.