How to Teen Girl: A frank discussion about eating disorders
- Dr Natalie Hutchins
- Sep 1
- 5 min read
Updated: Sep 16
Hosted by Dr Natalie Hutchins, with guest Annelise Lai, Clinical Psycologist and founder of Soma Psychology Clinic Singapore
Guest bio:
Annelise is a Registered Clinical Psychologist, Supervisor, and Founder of Soma Psychology Clinic. She previously practiced at The Other Clinic in Singapore, where she supported both the local and expatriate population. Her private practice supports individuals facing a range of concerns, including mood and anxiety disorders, obsessive-compulsive disorder (OCD), low self-esteem, and childhood attachment trauma, with a specialised focus on eating disorders.
Annelise’s clinical approach is highly personalised and grounded in evidence-based modalities, including Schema Therapy, Cognitive Behavioural Therapy (CBT), and Enhanced CBT (CBT-E) for eating disorders.
She is widely recognised for her calm and grounded presence, coupled with a firm yet compassionate therapeutic style. Annelise works primarily with adults, helping them uncover the roots of their struggles and take meaningful, intentional steps toward a more fulfilling life.
Show notes for the episode:
Eating disorders aren’t a choice; they’re coping strategies that can take root during times of stress, change, and pressure. Early, compassionate action and coordinated support from home, school, and healthcare, gives teens the best chance of recovery.
Why we’re seeing more problems now
In the episode, psychologist Anneliese Lai explains that body image worries pre-date social media, but platforms have supercharged comparison and made bullying and rumination occur around the clock. Add academic pressure, friendship drama, a culture of dieting, and disruptions (divorce, moves, illness), and you have fertile ground for disordered eating to start as a way to find control when life feels chaotic.
“Think of an eating disorder as a frenemy: it offers certainty and comfort, then slowly takes over.” Dr Anneliese Lai
Spotting the difference: normal teen life vs. a mental health concern
Teen emotions can be intense and changeable, which is completely normal, but it can be difficult to tell what signals a problem?
Look for two big clues: intensity + impact on functioning:
Intensity/distress:
Reactions that are far bigger than the situation
Anxiety that won’t settle
Rigid food rules
Impact on functioning:
Falling grades
School refusal
Withdrawal from friends/activities
Disrupted sleep
Health concerns.
“And they're more likely to tell you about physical symptoms. Like, I feel like I can't relax, I'm really restless, or, you know, I can't sit still.” Dr Anneliese Lai
What are some of the early signs of disordered eating
New rigid rules: cutting out whole food groups (carbs/fats/sugar), “good vs bad” foods, skipping meals to “save” calories.
Preoccupation with food/recipes/“What I eat in a day” content; cooking for others but not eating.
Comparison & competitiveness about how little they eat or how much they exercise.
Compensatory behaviours: over-exercise, fasting, laxatives/diuretics (sometimes), frequent bathroom trips.
Anxiety around eating , not just guilt.
You can’t rule out the diagnosis because of body size. A teen can be a “normal” weight and still have a serious eating disorder (e.g., atypical anorexia).
Boys get eating disorders too. Boys and men also struggle—often masked as “lean bulking,” macro-counting, or “discipline.” Shame can block help-seeking.
Eating disorders are more than just anorexia: it’s a spectrum
“Eating disorders” is an umbrella term that includes anorexia, bulimia, binge eating disorder, and OSFED (other specified feeding and eating disorders)—the most common category in real life.
Teens can move between patterns over time; it’s the rigidity, distress, and impairment that matter most.
Body dysmorphia is not the same as an eating disorder:
Body dysmorphia centres on perceived flaws in specific body parts (e.g., skin, nose, symmetry) and drives checking and/or concealing behaviours
Self-harm, suicide risk, and what to do
Self-harm is often an expression of how much distress they are feeling inside. It can temporarily distract from intense internal pain or “punish” self-loathing. It is not an attempt to seek attention but connection.
Self-harm isn’t automatically a suicide attempt, but risk can escalate.
Act now if you notice: plans, farewell letters, giving possessions away, or statements like “It would be better if I weren’t here.” Seek urgent medical help.
How to talk to your teen; scripts you can borrow
Open gently:
“I’ve noticed meals feel stressful lately and I’m worried about how anxious you seem—how are things feeling inside for you?”
Name feelings, not weight:
“It looks like this is really hard and scary. I’m here with you. Let’s figure it out together.”
Curious, not controlling:
“Can you walk me through what feels safest to eat right now? What makes it harder? What might make it 10% easier?”
Validate and anchor:
“Your feelings make sense. You don’t have to carry them alone.”
Set the team tone:
“This is a health issue. We’ll involve the GP, and if needed a psychologist and dietitian. We’ll build your support bubble.”
Avoid: commenting on weight/appearance, policing every bite, or using shame/lectures. These amplify anxiety and secrecy.
What actually helps at home:
1. Be the calm presence
Your instinct may be to fix. First, steady yourself. Teens in chaos need your quiet, consistent safety. Trade “on-duty” time with a partner/friend so you can regulate too.
2. Create a buffered environment
Regular meals & snacks—predictable rhythms lower anxiety.
Neutral food language—drop “good/bad,” “clean/cheat.”
Model flexibility—show balance with food, movement, rest.
Repair beats perfection—if you’ve rushed, snapped, or diet-talked in the past, name it and repair: “I’m sorry. I’m learning and changing with you.”
3. Social media: contain and educate
Curate feeds (follow friends/positive creators, avoid pro-eating-disorder content).
Teach literacy (filters, algorithms, permanence, future employers).
Boundaries: devices out of bedrooms at night; time-limited use; graduated independence as they approach leaving home.
When to seek professional help (sooner is better):
Rapid weight change; fainting/dizziness; missed periods; chest pain/heart palpitations.
Persistent food rules, compensatory behaviours, or social withdrawal.
Self-harm or any suicidal thoughts.
Start with your GP for medical safety checks and referrals. A psychologist can map out the biopsychosocial picture (biology, temperament, perfectionism, stress tolerance, family/school context) and build a plan. A dietitian can support renourishment. Early intervention improves recovery odds because the teen brain is still plastic and can heal.
Hope, recovery and relapse
Recovery is common with early, steady support—many teens do get back to friends, school, and joy.
Relapse can happen during stress; it’s not failure, just a cue to re-engage supports.
The biggest risk factor for sliding back? Dieting. Letting go of dieting culture—at home and online—protects long-term wellbeing.
Quick reference: Red flags & next steps:
Call urgently / same-day review if:
Fainting, chest pain, cold/blue hands, severely reduced intake, rapid weight loss, confusion, or signs of suicide planning.
Book GP within days if:
Escalating rules around food/exercise, missed periods, frequent bathroom trips after meals, or significant mood/anxiety changes.
At home, today:
Offer three meals + two–three snacks, sit with them, keep talk neutral, and plan one simple pleasure for connection (walk, film, art).
Final thought:
“It’s never too late to reconnect. You don’t need perfect history to build a healthier future—just today’s willingness to show up, repair, and learn together.” Dr Anneliese Lai
Resources & follow-ups
Listen to the full episode with Anneliese Lai for deeper context here
School pastoral team and trusted teachers can extend the “bubble” around your teen.
Consider family sessions if food/body talk at home has been diet-centred—repair is powerful.
