It seemed to start innocently enough. JD Ouellette’s daughter was a high school senior when she decided to do a “healthy eating makeover” with her friends. “As she explained it to me, now that they were done with their athletic careers, and in anticipation of gaining the ‘Freshman 15’ the next year, they wanted to make changes to their eating,” Ouellette says. “And at that time, it made perfect sense to me.”

But the “healthy” experiment quickly spiraled out of control and soon, Ouellette's daughter developed severe anorexia. It took time before Ouellette realized her daughter was in the throes of an eating disorder, however. “All of the food restriction and weight loss were initially seen as strictly gastrointestinal issues,” she says. “That’s what we were working on with her pediatrician before it became clear the answer was anorexia. We went from concerned to terrified in about three months.”

While weight loss isn’t always a sign of disordered eating, nor does every eating disorder include weight loss as a symptom, weight loss in teens can be cause for concern. Read on for more information about teen weight loss, how to know if it’s a sign of an eating disorder, and when to seek help.

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Weight loss pressures for teens

No matter how much progress society makes in terms of eating disorder awareness, teens tend to experience immense pressure to be a certain size and look a certain way. Part of this is due to the innate characteristics of this stage of life: teens live in bodies that are rapidly changing, they are exploring romantic relationships and the need to look “desirable” for the first time, they’re learning to navigate complex (and often appearance-based) social dynamics—and they’re doing all of this with frontal lobes that aren’t yet fully developed. The advent of social media has only amplified these pressures, and a resurgence of “thinspo” and the glamorization of weight loss exacerbates things even more.

“A fundamental reason we accept dieting as a rite of passage—and the age it starts at keeps getting younger—is that our entire society is steeped in diet culture,” Ouellette says. Diet culture isn’t just woven into the fabric of the media we consume; Ouellette argues that the promotion of weight loss and dieting is embedded into academics, athletics, social life, and social media—all because of the false but persistent belief that a thinner body is always a better body.

“Kids hear from the vast majority of the adults in their lives that dieting is normal and appropriate,” she says. “So while peer pressure is definitely a factor in dieting influence, so are doctors, coaches, teachers, and parents—who are almost always well-meaning.”

Indeed, teens experience the pressure to lose weight from a variety of different sources, including:

• Social media. “Social media algorithms can quickly fill a teen's feed with diet, ‘clean eating,’ and exercise posts—even if they only like one post or share a workout video,” says Equip’s Lead Dietitian Tanya Hargrave-Klein MS, RDN. “For teens predisposed to eating disorders, this constant exposure to hundreds of Photoshopped images of ‘perfect’ bodies, combined with diet messages disguised as health tips, can be dangerous, making it easy for them to fall into unhealthy dieting and exercise habits in the pursuit of ‘health.’”
• Mainstream beauty standards. “We have the prevailing aesthetic that thin is the only attractive or acceptable body size, which shows up everywhere,” Ouellette says. “Messages that I got once a month from Seventeen Magazine are in the faces of our youth almost nonstop through social media. Social media has supercharged diet and wellness culture influence.”
• Expectations around growth. “Puberty naturally leads to weight gain, a fact often misunderstood by teenagers,” Hargrave-Klein says. “The rapid changes in their bodies can make them feel disconnected from their new appearance. Additionally, adolescents who experience early or late puberty might feel isolated from their peers, which can intensify self-doubt and shame.”
• Everyday stressors. “Teenagers often experience a confluence of hormonal shifts and external stressors stemming from social dynamics, academic pressures, and personal insecurities,” Hargrave-Klein says. “This combination can lead to the adoption of maladaptive eating behaviors, including restriction or bingeing, as a coping mechanism.”

What are the risks associated with teenage weight loss?

While it’s true that losing weight isn’t always a sign of a problem, there are a number of potential risks to be aware of when it comes to weight loss in teens. “Pursuing weight loss during adolescence can have significant negative consequences, affecting physical health, mental well-being, social life, and athletic performance,” Hargrave-Klein says. “As a registered dietitian specializing in eating disorders and a mother whose daughter was diagnosed with anorexia at 14, I have observed the serious effects of weight loss efforts in teenagers. This path can quickly lead to isolation, injury, and the development of an eating disorder.”

A few of the most common risks of teen weight loss include:

• Growth disruption. “When a teenager is underfueled, it can hinder growth and potentially prevent them from reaching their full adult height,” Hargrave-Klein says. “For teen girls, this can disrupt hormonal balance, leading to irregular menstrual cycles and weakened bones.”
• Increased anxiety and isolation. “Socially, food-related activities, which are typically enjoyable, can become sources of anxiety,” Hargrave-Klein says. “Fear of food can lead to social withdrawal, resulting in isolation and a decline in mood.”
• Mental, emotional, and physical challenges. “Weight loss always carries risks, but for adolescents, these risks are significantly higher,” Hargrave-Klein says. “Adolescence is a crucial period of emotional, mental, and physical development, where adequate caloric intake is vital for energy and for establishing a healthy foundation for adulthood. The pursuit of a smaller body can have lasting negative impacts, costing teenagers more than just weight. It can affect their health, happiness, and future.”
• The development of an eating disorder. “For individuals with a genetic predisposition, creating an energy deficit for weight loss can act as a trigger, initiating destructive behaviors and thoughts that can overwhelm a young person's life,” Hargrave-Klein says.”

It’s also important to note that for young athletes, pursuing a leaner physique can negatively impact performance and overall physical health, increasing risks for injuries like stress fractures and compromising strength and agility. “I experienced this with my own daughter,” Hargrave-Klein says. “She was enthusiastic about track, but then suffered a foot bone fracture. Her participation in social gatherings diminished, and she became reclusive. These issues escalated, culminating in a severe eating disorder.”

When to worry about weight loss in teens

As Ouellette sees it, not only should weight loss in teens be considered cause for concern, but so should any stalled weight or height gain (in the absence of actual weight loss). “Falling off their height, weight, and BMI curves is a huge red flag and more dangerous than them going above previous curves,” she says. “Puberty is an especially vulnerable time because while rapid weight gain is normal and healthy, it is pathologized and many children react to the gain with dieting. Even if they don’t develop an eating disorder, they can still be doing damage in terms of building bone density, future vertical growth, and brain development and maturation.”

Hargrave-Klein says that because teenage bodies are still undergoing significant growth and development, weight loss is rarely, if ever, advisable. “Even a modest decrease in weight—as little as five pounds—can have profound effects on a teenager's physical, mental, and psychological well-being,” she says.

According to Hargrave-Klein, indicators that weight loss may be negatively impacting a young person include:

• A departure from the teen's historical growth curve, evident since the age of two years old
• Loss of menstrual cycle (in teens with a menstrual cycle)
• Increased anxiety or indecision surrounding meal and snack selection and consumption
• Social withdrawal or a loss of interest in previously enjoyed activities
• Hair loss
• Excessive worry and/or preoccupation about body shape and size
• Persistent feelings of coldness, fatigue, or dizziness
• Digestive complaints such as bloating, gas, or constipation
• Engaging in excessive or secretive exercise

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When might a teen’s weight loss signal an eating disorder?

Teenage weight loss can lead to a variety of mental and physical health issues, but it doesn’t always signal an eating disorder. However, there are certain signs to look out for that may indicate your teen is struggling with anorexia, or another eating disorder diagnosis. “The signs may be subtle at first, but paying close attention to changes in appearance, eating habits, and mood can be crucial,” Hargrave-Klein says.

Here are a few red flags to be aware of:

• Wearing looser, baggier clothes. “One of the most obvious indicators is a visible change in clothing fit,” Hargrave-Klein says. “Baggy, ill-fitting clothes, or a new preference for oversized hoodies and loose jeans, even on hot days, can be a deliberate attempt to conceal a thinning frame.”
• Dramatic shifts in their relationship with food. If a teen is suddenly finding excuses to miss meals, pushing food around their plate rather than eating it, or isolating themselves during mealtimes, they may be experiencing difficulties with food. “You might also notice a refusal to eat once-loved foods, or the sudden elimination of entire food groups, like starches, or a newfound obsession with ‘organic’ foods,” Hargrave-Klein says.
• Significant mood and behavioral changes. “As weight loss progresses, a teen's emotional and mental state can also deteriorate,” Hargrave-Klein says. “Look for increased social anxiety, a consistently low mood, or the emergence of obsessive compulsive characteristics.”

“If these warning signs resonate, don't hesitate,” Hargrave-Klein says. “Consulting your child's primary care provider is the crucial first step. It's vital to rule out any underlying medical causes for the weight loss and to seek support for your loved one as soon as possible. Early intervention can make all the difference in addressing disordered eating thoughts, beliefs, or behaviors.”

Is weight loss in teens ever okay?

While not all teens who lose weight will end up with an eating disorder, Hargrave-Klein cautions that there is no way to know who will and who won’t. “For that reason alone, weight loss is not recommended for teens,” she says. “Any discussion about wanting to lose weight should be had with the teen’s primary care provider.”

From Ouellette’s perspective, weight loss in teens is almost always problematic, for all of the reasons outlined above, and for another. “The vast majority of people who lose weight end up at higher weights than before, and this creates a vicious cycle of dieting leading to weight gain,” she says “I am a fan of focusing on healthy behaviors and letting your body—which is really smart until we impose artificial rules on it—decide where it wants to live size-wise.”

In Ouellette’s view, “healthy behaviors” refers not to food restriction or rigid workout routines, but to health-supporting habits like:

• Eating a wide variety of foods, including foods eaten for pleasure
• Having a relationship with movement based on enjoyment
• Getting plenty of rest
• Limiting technology and social media
• Maintaining social connections
• Spending time with family
• Having hobbies and passions

Seeking help for teen weight loss

It’s natural for parents to be concerned when their teen experiences any kind of sudden weight loss. And while it may be tempting to wait and see whether their weight stabilizes or the loss can be attributed to some other factor, Hargrave-Klein says it’s best to book an immediate consultation with a primary care provider or eating disorder specialist. “This proactive approach is crucial because unexplained weight loss can signal not only an eating disorder, but potentially an underlying medical condition requiring prompt assessment,” she says.

Regardless of whether the weight loss was intentional, Hargrave-Klein explains that a skilled healthcare provider can thoroughly evaluate the teen and collaborate with families to develop a treatment plan and provide a referral to eating disorder specialists, if necessary. The overall goal of this kind of immediate intervention is to guide the teen back to their historical growth curve and to minimize any potential negative impacts on their physical, psychological, and emotional development.

For any parents who are hesitant to jump to conclusions and don’t want to assume their teen is struggling with disordered eating, Ouellette says it’s important to follow your instincts and listen to your gut. “Pay attention to what you are seeing and hearing, schedule a doctor’s visit—and I would talk to the doctor in advance about your concerns—educate yourself around weight in general, and eating disorders specifically,” she says.

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Challenging diet culture to help your teen

Just as diet culture can lead teens to pursue weight loss, it can also make it more challenging for parents to intervene or get help from experts. As Ouellette points out, sometimes medical professionals hold their own biases and beliefs about weight, body size, and dieting that may reinforce weight loss or lead them to miss an eating disorder in those who don’t fit the stereotype of who these illnesses affect. “It’s really important to figure out where your physician stands before they talk to your teen,” she says.

Ouellette is also aware that many parents may have their own long-held internalized beliefs around weight. To begin to counter some of that thinking, she recommends reading Harriet Brown’s Body of Truth: How Science, History, and Culture Drive Our Obsession with Weight—and What We Can Do about It.

“The information in this article is likely opposite of what you hear in most spaces, and changing your thinking from conventional wisdom is hard and even lonely,” Ouellette says. “As I began to learn more over the last decade, you can imagine my shock at finding the BMI category with the longest life span is actually ‘overweight’! I say this not because I think BMI is a good way to evaluate health, but because this truth is a tangible reason to question everything you’ve ever learned about weight.”

If your teen is losing weight (or trying to), it’s important not to ignore it or assume it’s a passing phase. Teen weight loss can be the first step on the path toward an eating disorder, and even in the absence of an eating disorder, it can harm their physical, emotional, and cognitive health, as well as their social life and relationships. Speak to their doctor or an eating disorder professional about your concerns, or schedule a call with an Equip team member.