Anxiety, Eating Disorders, and the Early Signs We Often Miss
Why Middle School Is Where Prevention Starts
There’s a growing awareness around teen mental health, and for good reason. Anxiety, body image struggles, and disordered eating patterns are all on the rise—and for many, these issues become deeply embedded before high school even begins.
As a registered dietitian, I’ve spent years supporting teens navigating disordered eating and self-worth challenges. What I’ve seen again and again is this: by the time students are 16 or 17, the roots of these issues have already taken hold—often long before anyone realized.
So when do the seeds get planted?
Middle school.
What the Research (and Real Life) Tell Us
Middle school marks a developmental crossroads. Students are:
Becoming more aware of their bodies
Immersed in peer dynamics and comparison
Taking in constant messages from social media
Learning how to cope—often without support or vocabulary
And that’s exactly where anxiety and disordered eating find fertile ground.
According to current research:
50% of teenage girls and a third of boys use restrictive dieting behaviors by age 15
Anxiety is the most common mental health disorder among adolescents
Early-onset anxiety increases the risk for disordered eating and depression later in life
Social media use in middle school is linked to body dissatisfaction, low self-esteem, and increased worry
The overlap between these issues is clear—and they’re showing up earlier and earlier.
What We Often Miss as Adults
In middle school, kids may not yet have the language to say “I’m anxious” or “I feel out of control with food.” Instead, we see:
Mood swings and withdrawal
Increased focus on appearance or clothing
Quiet restriction of meals or “clean eating” behaviors
Fixation on social comparison or how others perceive them
Seemingly small shifts in how they talk about their bodies or friendships
These signs are easy to miss or misread—especially in a culture that normalizes anxiety and idolizes self-discipline.
Why Prevention Must Start Earlier
By the time students show up in high school health class or counseling appointments, they’ve already internalized damaging messages:
That their worth is tied to appearance
That stress is something to push through silently
That fitting in is more important than feeling safe
What they haven’t often learned are tools for managing thoughts, recognizing comparison, or asking for support.
The truth is, prevention doesn't mean perfection—it means giving students language and tools before silence turns into suffering.
A Better Way Forward
It’s possible to shift this.
When we meet students in middle school with real, honest, and developmentally appropriate emotional tools, we build protection around their mental health. We show them they’re not alone. We help them recognize when something feels off—and what to do next.
Whether you’re a teacher, counselor, coach, parent, or mentor: your support in these formative years makes a lasting difference.
Let’s stop thinking of anxiety and eating disorders as inevitable outcomes.
Let’s start seeing them as interceptable patterns.
And let’s reach students before the spiral begins.
