Signs of Eating Disorders Parents Often Miss (Especially in High-Achieving Girls)

High achievers are often praised for their self-discipline, drive, and determination; qualities parents naturally feel proud of. They earn top grades, juggle demanding schedules, excel in extracurricular activities, and seem remarkably “put together.” Yet the very traits we admire most in high-achieving girls can quietly mask the early warning signs of an eating disorder. 

Eating disorders are serious mental health disorders that involve severe disturbances in eating behaviors, thoughts, and emotions. Parents often expect eating disorders to be noticeable and look for changes such as dramatic weight loss, refusal to eat, or visible distress around food. While these signs can occur, many eating disorders can hide in plain sight, especially when symptoms are masked in socially praised behaviors like discipline, perfectionism, and achievement.

This blog will help explore why eating disorders are more common in high achieving teens, eating disorder symptoms that are overlooked, and when to seek professional support for disordered eating or an eating disorder in Houston.

Types of Eating Disorders

Not all eating disorders look the same. Understanding the different types of eating disorders can help parents recognize warning signs earlier, especially when symptoms are subtle. Below are some of the most common eating disorders seen in adolescents.

Anorexia nervosa

Anorexia nervosa is characterized by restrictive eating and an intense fear of weight gain. Not all individuals with anorexia appear underweight. Anorexia can occur in people living in larger bodies.

Common signs include: 

• Severe restriction of food intake
• Intense fear of gaining weight or becoming “fat”
• Low body weight (in some cases)
• Distorted body image

Bulimia nervosa

Bulimia nervosa is characterized by cycles of binge eating followed by compensatory behaviors. Many individuals with bulimia have stable or above average weights, leading to unnoticed symptoms for longer periods of time. 

Common signs include:

• Repeated episodes of binging and purging (vomiting, laxative, diet pills)
• A sense of loss of control over eating
• Self-worth heavily influenced by body shape and weight

Binge-eating disorder

Binge-eating disorder involves recurrent binge eating episodes associated with a loss of control. 

Common signs include:

• Repeated binge-eating episodes 
• Eating rapidly or past the point of comfort 
• Distress, guilt, or shame about eating behaviors

Not All Eating Disorders Are Visible

One of the most harmful misconceptions about eating disorders is they are visible and easy to detect. In reality: 

• Girls in “normal” or higher weight bodies can have an eating disorder
• Eating disorders are not a choices, but biologically and psychologically influenced illnesses 
• Eating disorders are not just “food problems,” but involve extreme control and rigidity around eating behaviors, weight, and shape
• Eating disorders affect people of all ages, genders, races, ethnicities, body sizes, sexual orientations, and socioeconomic backgrounds
• Eating disorders are not just about restriction. Many teens can eat regularly while still experiencing intense fear or guilt

Eating disorders are mental health conditions, not appearance-based diagnoses. Focusing only on weight or obvious behaviors can delay intervention until symptoms become severe.

Why High Achieving Girls Are More Vulnerable

High-achieving girls possess traits and characteristics that are admirable, highly praised, and rewarded. Many begin to internalize their self-worth and value is dependent upon performance and external validation. To manage ongoing pressures, academic or athletic expectations, and anxiety, control may be exerted over food, exercise, and body. Common characteristics include:

• Responsible and dependable 
• Perfectionistic 
• Motivated and goal-oriented
• Confident 
• Resilient

Because high-achieving girls continue to perform well academically and athletically, many adults may assume everything is fine. However, these behaviors are masking suffering and creating the perfect conditions for an eating disorder to develop. 

Symptoms Parents May Miss

1. Rigid "Healthy Eating"

What may appear to be health-conscious behaviors can actually be a warning sign of an eating disorder.

• Cutting out or significantly limiting entire food groups (carbohydrates, fats, processed foods, sugar)
• Eating foods that are labeled as “clean,” “healthy,” or “pure.”
• Monitoring and reducing daily caloric intake 
• Spending excessive amounts of time reading nutritional information
• Having a narrow list of “safe” foods

2. Perfectionism Around Food and Body Image

All–or-nothing thinking around food and body image can quietly develop into an eating disorder.

• Strict adherence to diets and extreme guilt and shame with dietary rules are broken
• Engaging in excessive exercise, skipping meals, or extreme restriction as a form of compensation or punishment
• Rigid exercise routines to obtain a “perfect” or “ideal” body, even when ill or exhausted

3. Busy Schedules

Consistent patterns of limiting or skipping meals can lead to nutritional deficiencies, emotional dysregulation, and binge eating.

• “I don’t have time to eat because of school”
• “I can’t eat before sports practice or I won’t perform as well”
• “I lost track of time while I was studying”
• “I’d rather get more sleep before school than get up early and eat breakfast”

4. Excessive or Compulsive Exercise

Exercise is encouraged for physical and mental health, especially in achievement oriented environments (e.g., sports) but it can become problematic when it’s excessive, compulsive, or fear-or-punishment driven. 

• Intense guilt when missing a workout
• Continuing to exercise when injured or ill
• Using exercise to “earn” or compensate for food

5. Anxiety Around Eating in Front of Others or Eating Out

Eating around others or in unfamiliar places can be stressful.

• Eating foods that fall on the “safe” list
• Researching menus in advance
• Comments about feeling full or lacking an appetite 
• Excuses to avoid social situations that involve food

6. Body Checking or Comparison Making

High-achieving girls have high standards for themselves and often engage in self-criticism

• Checking appearance or scrutinizing body parts in the mirror
• Touching, pinching, grabbing, or mentally scanning body parts
• Weighing self too much or avoiding the scale
• Trying to maintain a specific clothing size
• Comparing their body to peers or social media images 

7. Praise Related to Body Changes

Consequently, eating disorders are silently reinforced by praise. Compliments about weight loss, fitness, or body changes, though well-intentioned, can strengthen disordered eating patterns and make it harder for teens to seek help.

Why Early Intervention Matters

Eating disorders are serious mental health conditions but they are also highly treatable, especially when addressed early.

Early intervention leads to:

• Better long-term recovery outcomes
• Less disruption to school and social development
• Reduced medical and psychological complications

If you notice multiple eating disorder signs or a pattern that concerns you, seeking support sooner rather than later can make a significant difference.

How Parents Can Respond Supportively

If you’re concerned about your teen:

• Focus on behaviors and emotional changes, not weight
• Express curiosity rather than accusation
• Avoid commenting on appearance or food choices
• Seek guidance from a mental health professional

You don’t need to have the perfect words. Showing concern, openness, and willingness to get help sends a powerful message. 

Important Take Aways for Parents

You are not to blame. 

You did not cause this.

You can help!

Eating disorders are treatable. With the right support from an eating disorder specialist, parents and teens learn about the early warning signs, develop healthier relationships with food and body image, build coping skills, and move toward fulfilling lives. 

If you believe your child may be silently struggling with an eating disorder, support is available! At Houston Anxiety and Wellness Center, we have trained eating disorder specialists who are here to help. Schedule a free 15 minute consultation or an initial appointment today. 

Additional Supports That Can Help: Books* and Website

For Parents:

1. Help Your Teenager Beat and Eating Disorder by James Lock and Daniel Le Grange
2. When Your Teen Has an Eating Disorder by Lauren Muhlheim 

For Teens:

1. 8 Keys to Recovery From an Eating Disorder by Carolyn Costin and Gwen Schubert Grabb

National Eating Disorder Association (NEDA)

National Association of Anorexia Nervosa and Associated Disorders (ANAD)

*These resources may include Amazon affiliate links. As an Amazon Associate, Houston Anxiety & Wellness Center earns from qualifying purchases. We only share resources we believe are genuinely helpful and aligned with evidence-based care.