A qualitative examination of adolescent and parent perspectives on early identification and early response to eating disorders

This qualitative study examined adolescent and caregiver perspectives on identification and early response in emerging eating disorders. Fifteen female-identified adolescents with an eating disorder diagnosis (M age = 15.20 years; 93% White; 20% Hispanic) and 12 caregivers (all biological parents: 1 father, 11 mothers; M age = 51.56 years) participated in semi-structured interviews about their experience identifying and responding to the eating disorder, eventually seeking treatment. Participants were recruited from three eating disorder treatment centers in the United States. Interview responses were coded by three raters using inductive consensual qualitative methods. Results found that parents were typically the first to notice and confront the eating disorder, and weight loss and thinness usually were the earliest symptoms identified. The most common adolescent response to detection was mixed (e.g., relief and anger), and common parental reactions included seeking professional consultation and creating limitations on disordered behaviors (e.g., encouraging eating). Barriers to earlier detection were highlighted (e.g., parental hesitancy to act on suspicions), suggesting that parents need greater support for swift and confident responding. To combat this, parents recommended increasing knowledge of eating disorder symptoms. Parents and adolescents both recommended parent-led monitoring of eating and exercise behaviors to increase the chance of noticing changes and responding quickly with aggressive and supportive action. These experiences provide a framework for early identification and the role of caregiver response, highlighting the need for assertive yet compassionate efforts to combat emerging eating disorders.