Eating disorders are very complex. They not only affect how children eat, they also impact their mental health. Eating disorders can affect many parts of a child’s life, including how they feel physically and emotionally, as well as their friendships.
An eating disorder is characterized by disordered (or abnormal) eating habits. In children, these habits interfere with their growth, development and quality of life. Recognizing the signs and symptoms early is critical for recovery and improving outcomes.
Understanding Eating Disorders
While many eating disorders share common characteristics, each disorder is unique. And they can affect anyone regardless of age, gender or background.
Below are the eating disorders most often seen in children.
1. Anorexia Nervosa
Anorexia occurs when a person eats very little food. They may also over-exercise or engage in extreme dieting. They often have a distorted body image. And an intense fear of gaining weight. People with anorexia can have rapid weight and muscle loss, stunted growth and weak bones. It can also cause a dangerous drop in heart rate.
Anorexia is especially prevalent among children and adolescents. It carries the highest death rate of any mental illness, with suicide being the second leading cause of death among those affected.
2. Bulimia Nervosa
Bulimia involves uncontrolled eating of large volumes of food followed by vomiting, laxative use or excessive exercise. The goal is to reduce calories and lose weight or prevent weight gain. Bulimia may have lasting consequences, including damage to the stomach and intestines. It can also lead to acid reflux, heartburn, ulcers and severe malnourishment.
3. Other Specified Feeding or Eating Disorder
Other Specified Feeding or Eating Disorder (OSFED) is a general diagnosis for people with significant symptoms of one or more eating disorders. But they don’t meet all the criteria for those disorders. One condition that falls into this category is atypical anorexia. This can occur when a previously higher-weight person loses substantial weight. They have all the other characteristics of anorexia, such as an obsession with getting thinner and exercising excessively, but they’re not underweight.
4. Binge Eating Disorder
Binge eating disorder is the most common eating disorder worldwide. But it’s often overlooked. It consists of eating large quantities of food in a short time. This behavior often comes with feelings of loss of control and guilt. Unlike bulimia, binge eating does not involve purging. Yet, it can significantly impact a person’s life and their self-esteem. Complications can include obesity as well as kidney, liver and heart disease.
5. Avoidant Restrictive Food Intake Disorder
Avoidant restrictive food intake disorder (ARFID) is characterized by constant, limited food intake. Children with ARFID may have little interest in eating and have strong fears about food. They may worry about certain tastes or textures or believe specific foods will cause pain.
ARFID can lead to vitamin deficiencies and inadequate weight gain. Kids with ARFID can also be overweight. This is because their food choices may be higher in calories or more processed. However, they may still have nutritional deficiencies due to lacking essential vitamins. Read more about ARFID.
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The Mental Health Connection
Eating disorders are deeply connected with mental health disorders. These include anxiety, depression and obsessive-compulsive disorder (OCD). This is especially true in younger people.
For instance, children with ARFID may experience anxiety about food textures. Or they may fear what may happen when they eat, such as stomach pain. They avoid food as a result. Individuals with anorexia, on the other hand, may show perfectionist tendencies. They may use control over food to cope with life feeling out of their control.
The pressure to look a certain way plays a big role in the development of eating disorders. This is especially true in adolescent females. They naturally start comparing themselves to others. One 13-year-old girl might be 5'10” and beginning to look like a woman. Another may be 4'10” and not yet hit puberty. The pace at which they develop differs. This leads to comparisons that can trigger insecurities. And the constant comparison — intensified by social media use — can be too much to handle. This can give rise to their insecurities.
During the COVID-19 pandemic, when isolation was at an all-time high, eating disorders escalated — particularly among young people who used social media to stay connected. The stress of the pandemic and concerns about health risks drove some to unhealthy behaviors, causing these disorders to rise.
Just a decade ago, the average age of eating disorder onset was 16. Now, it’s around 14-15 years old. And children ages 10-12 are the fastest-growing group affected.
Eating disorders now have the second highest mortality rate of any mental illness. These individuals also have the highest risk of suicide. Being aware of the signs and symptoms and getting help can save lives.
Signs and Symptoms of Eating Disorders
Adolescents may do everything possible to hide their eating behaviors. So, recognizing the signs can be challenging. But knowing what to look for can help with early diagnosis.
Here are some possible warning signs that may indicate your child has an eating disorder:
- A sudden or dramatic change in eating habits, such as:
- When or how much they eat
- Being very selective in what they eat
- Unusual or sudden changes in weight (gain or loss)
- An obsession with food, including clean eating
- Exercising much more than normal
- Making comments about their bodies or food, such as:
- Feeling or looking fat
- That something isn’t healthy for them to eat
- Anxiety over food, eating or mealtimes
- Sudden, very sensitive teeth or tooth decay
- Complaining about acid reflux or heartburn
- Menstrual cycle stops or becomes infrequent
- Frequent trips to the bathroom immediately after meals
- Eating in secret or hiding food
Eating disorders that are not treated can lead to serious complications. If your child is showing any of these signs or symptoms, it’s time to seek help. Early intervention is essential. And getting the proper support can improve outcomes.
When and Where To Seek Help
If you notice any of these behaviors in your child, ask for help from their pediatrician, behavioral health consultant or other mental health professional. This can be a crucial step toward recovery. These professionals can provide the appropriate guidance and support. Parents can also self-refer to the Adolescent Health and Medicine Program at Children's Wisconsin. Resources such as the National Eating Disorders Association also offer valuable information and tools for assessing risk.
Having open conversations with your children about body image, food and mental health can also help promote a supportive environment. Positive communication can help them feel safe. And encourage them to talk about their feelings and experiences. It’s also important for parents to model positive behaviors regarding food and body image. Avoiding comments about your own weight or restrictive diets in front of your children can help create a healthier environment. Encouraging a focus on health rather than appearances can help prevent unhealthy comparisons. Parents can also help by monitoring their children's use of technology, social media and apps. Apps that promote weight loss, for instance, can be harmful.
It’s important to remember that there’s hope for adolescents with eating disorders. They can develop a healthier relationship with food. And with the proper support and patience, they can overcome these challenges and lead healthy lives.
