Eating disorders affect a significant number of teenagers, with research suggesting that roughly 1 in 7 young people experience disordered eating behaviors by age 20. The numbers have climbed sharply since 2020, and emergency visits for adolescents with eating disorders remain well above pre-pandemic levels even into 2023. While exact counts vary by study and definition, the scale of the problem is larger than most people assume, particularly because many cases go undiagnosed.
How Common Eating Disorders Are Among Teens
Estimates of eating disorder prevalence in adolescents depend on how broadly “eating disorder” is defined. When researchers use strict diagnostic criteria (anorexia nervosa, bulimia nervosa, binge eating disorder), lifetime prevalence among teens falls in the range of 2% to 5% depending on the condition and study population. But when the definition expands to include disordered eating behaviors like purging, fasting for weight loss, or diet pill use, the numbers jump dramatically. A large study of U.S. high school students found that roughly 21% to 29% of girls and 8% to 13% of boys reported at least one disordered eating behavior.
The median age of onset for both anorexia nervosa and bulimia nervosa is 18, according to the National Comorbidity Survey Replication. Binge eating disorder tends to start a bit later, with a median onset of 21. But these are medians, meaning half of all cases begin even earlier. Many teenagers develop symptoms well before they receive a formal diagnosis, and younger onset is increasingly recognized as common.
Gender Differences Are Real but Misunderstood
Eating disorders affect far more girls than boys, but the gap is narrower than the old stereotype suggests. For any eating disorder overall, the male-to-female ratio is roughly 1 to 2.8. That means for every boy diagnosed, nearly three girls are. The gap varies by condition: anorexia has the widest split at about 1 to 3.5, while binge eating disorder is closer to 1 to 1.7, making it nearly as common in boys as in girls.
These ratios likely undercount boys. Eating disorders in males often look different, centering on muscularity and leanness rather than thinness alone, and both parents and clinicians are less likely to screen for them. The result is that many boys with eating disorders fly under the radar for years.
Race and Ethnicity Shape Both Risk and Diagnosis
A persistent myth holds that eating disorders primarily affect white, affluent girls. The data tell a different story. Among high school girls, disordered eating was reported by 29.2% of Hispanic/Latina students, 21.4% of white students, and 20.4% of Black/African American students. Hispanic/Latina girls carried a particularly elevated risk of purging and overall disordered eating, even after accounting for other factors.
Among boys, Black/African American teens (13.4%) and Hispanic/Latino teens (12.4%) reported higher rates of disordered eating than white boys (8.1%). Compared to white boys, girls of all racial and ethnic backgrounds and minority boys had significantly elevated risks of purging, fasting, and other disordered eating behaviors, with risk ratios ranging from about 1.5 to over 7 times higher depending on the specific behavior.
Despite these rates, teens of color are less likely to be referred for evaluation or treatment. The gap between who is affected and who gets help is wider in minority communities, partly because of provider bias and partly because of cultural differences in how eating problems are recognized and discussed.
The Post-Pandemic Surge
The COVID-19 pandemic triggered a well-documented spike in adolescent eating disorders. What’s more concerning is that the spike hasn’t fully receded. A population-based cohort study found that in 2023, emergency department visits for new eating disorders among adolescents were still 37% higher than expected based on pre-pandemic trends. Visits for teens with pre-existing eating disorders were 53% above expected levels.
Interestingly, this pattern is specific to adolescents. Among young adults (roughly ages 18 to 25), emergency visits for eating disorders had returned to or dropped below expected levels by 2022. Something about the pandemic experience hit younger teens harder and the effects have proven more lasting. Researchers point to social isolation during key developmental years, increased social media use, and disrupted routines around food and exercise as likely contributors.
ARFID: A Lesser-Known but Common Condition
Avoidant/Restrictive Food Intake Disorder, or ARFID, doesn’t involve body image distortion the way anorexia or bulimia does. Instead, it involves extreme avoidance of certain foods based on their texture, taste, or smell, or a general lack of interest in eating. It can lead to significant nutritional deficiencies and weight loss, especially in growing adolescents.
Research on ARFID is still catching up, but current estimates suggest it affects between 0.5% and 5% of children and adults. The wide range reflects how new the diagnosis is (it was formally added to diagnostic manuals in 2013) and how inconsistently it’s screened for. ARFID is more common in younger children than in older teens, but it can persist well into adolescence and adulthood when untreated.
Why So Many Cases Go Unrecognized
One of the most striking aspects of teen eating disorders is how many are never formally identified. Multiple barriers keep the real numbers hidden. Teens themselves often don’t recognize their behaviors as disordered, especially when diet culture normalizes restriction and “clean eating.” Parents may miss signs that look like typical teenage pickiness or health consciousness. And pediatricians, working with limited appointment time, don’t always screen for eating disorders unless a teen is visibly underweight.
Weight is part of the problem. The majority of people with eating disorders are not underweight. Teens with bulimia or binge eating disorder often have a normal or higher body weight, which can make their condition invisible to the people around them. A teen who is restricting food severely but started at a higher weight may even receive praise for losing weight, reinforcing the very behaviors causing harm.
The combination of underdiagnosis, delayed treatment, and rising rates means that the true number of affected teens is almost certainly higher than any published statistic captures. If roughly 1 in 5 high school girls and 1 in 10 high school boys report disordered eating behaviors, the scope of the problem extends well beyond what clinical prevalence numbers alone suggest.