Why do eating disorders so commonly emerge during the teenage years?
Adolescence is a time of transformation and growth physically, mentally and biologically. This is a time when children move towards adulthood, and begin to discover who they are. They become more independent, establish friendships, and their bodies develop. This development is obvious physically, but there is also a large amount of change happening internally, especially in the context of hormone levels. For many, entering into puberty can be a very emotional, stressful, confusing, and frightening time.
In addition to the physical and hormonal changes, there are social mechanisms at work. Studies show that when a child hits puberty, his or her brain’s socio-emotional system changes and this is seen as an increased concern in being socially accepted. In ecological terms, this is a natural progression into sexual maturity and the social responsibilities that go hand in hand with getting older. As a result, the teenage brain seeks reward from being popular among peers, and behavior is often focused on activities and ways to be more socially accepted. Dieting is one such behavior that teens engage in in the hopes of being socially accepted and dieting may in turn trigger an eating disorder in some individuals who are genetically predisposed.
There are also theories that the hormonal changes as they happen in puberty initiate the activation of genes that predispose individuals to eating disorders. For example, some studies suggest that in teen girls with a higher level of the sex hormone estradiol, there is a greater prevalence of eating disorders. Researchers point to the influence of ovarian hormones as potential area for explorative research into the biological factors behind the development of eating disorders. Ovarian changes are also known to affect body weight and food intake when they occur in puberty.
These hormonal explanations help explain both why more women than men develop eating disorders, and also why adolescence is such a critical time for the onset of eating disorders. Generally people assume that more women are afflicted because they feel a greater social pressure to be thin than do men, but it could also be due to hormonal differences. Studies have shown that genes and gonadal hormones are influential in the timing and pattern of changes in the structure of the brain and the way that the brain functions while a teenager is experiencing puberty.
These biological factors intermingle with the environmental factors such as pressure to look thin and a diet culture. There are also other pressures that arise in the teenage years. School gets a lot more serious, and many teens feel this pressure to get good grades and be successful. For some, stress like this can be enough to make them lose weight, and this weight loss can then trigger an eating disorder.
Adolescence is a time of rapid growth. A large weight gain is necessary to fuel the growth and changes required for a body to go through puberty. Some adolescents may simply fail to eat enough to keep up with growth and this energy imbalance may trigger an eating disorder in those who are genetically predisposed. In addition, middle school is a time when adolescents get involved in a higher level of competitive sports. Some adolescents may unintentionally fail to keep energy intake up with the high level of energy expended in sports. This, too can cause an energy imbalance that may trigger an eating disorder. Remember, not all people who develop eating disorders start off wanting to lose weight on purpose. It is now understood that a variety of environmental factors may spark an eating disorder in a person who is biologically predisposed.
Middle and High Schools are in an excellent position to aid in the early identification of eating disorders in adolescents. Teachers, coaches, and school counselors should be made aware of the signs to look for. If eating disorders are caught early, the chances of recovery are greater.
Updated by Dr. Lauren Muhlheim and Tabitha Farrar – 2014
Written by: Colleen Thompson – 1997
Buchanan C, Eccles J, Becker J. Are adolescents the victims of raging hormones?: Evidence for activational effects of hormones on moods and behavior at adolescence. Psychological Bulletin
Sisk C, Foster D. The neural basis of puberty and adolescence. Nature Neuroscience.
A Social Neuroscience Perspective on Adolescent Risk-Taking. Laurence Steinberg