Eating Disorders in Children

Children and Eating DisordersThe thought of having a young child develop an eating disorder is difficult and painful. Unfortunately, in more recent years, the number of children diagnosed with eating disorders has been on the rise. Although the onset of eating disorders is most typically documented in adolescents, prepubescent children can and do develop them. Children as young as 7 are being diagnosed and treated for eating disorders.

Children are increasingly becoming affected by diet culture and body shame. Studies show 40%-60% of girls 6-12 years old are worried about their body shape or weight. 80% of girls have been on a diet by the 4th grade. Of elementary school-aged kids, 69% of those who read magazines say they have influenced their body image, and 47% say the pictures make them want to lose weight.

Diagnosis

It is unclear why more young children are being diagnosed with eating disorders now. It is possible that diagnostic techniques have improved over the years as well as clinicians being better educated on the signs and symptoms, but there are studies that are looking into this concerning trend. Young children may have always struggled with eating disorders but they may have gone undiagnosed until they were older.

Identifying eating disorders in the very young is difficult because prepubescent children differ in body weight and nourishment as growth spurts come and go. If a child loses weight this is very indicative that something is amiss. It does not always mean they have an eating disorder but it should be taken seriously no matter what size the child is. In fact, many children who later develop anorexia start out with bigger bodies. These children often become praised for weight loss and their eating disorder can get reinforced.

It can be complicated for parents to try and distinguish an eating disorder from more common food behaviors in young children such as picky eating and fussiness. There are forms of eating disorders such as:

Avoidant/Restrictive Food Intake Disorder (ARFID) which is characterized as eating a limited list of foods either due to lack of interest or rapid fullness, sensory avoidance (due to texture, temperature, taste, or smell), or fear of negative consequences (choking, illness, or nausea).

Pica is seen in adults and children who have cravings to eat non-foods such as hair, paper, soil, coal, and gravel to name a few. These are different forms of eating disorders which call for a different treatment focus than anorexia nervosa, bulimia nervosa, and binge eating disorder.

Symptoms to watch out for:

  • Refusal to eat
  • Reduction in portion size
  • Actively dieting
  • Changes to diet
  • Body image concerns
  • Social withdrawal
  • Fine hair growing on body
  • Hiding or hoarding food
  • Eating alone
  • Weight loss or failure to gain weight in a growing child
  • Lack of growth
  • Hyperactivity or excessive movement such as leg jiggling, running around, or standing and refusing to sit still
  • Thinning hair on head
  • Going to the bathroom during or after eating
  • Menstrual cycle abnormalities in girls
  • Personality changes, usually irritability or depression
  • Anger when offered food

Be sure to read A Mom’s Perspective: Having a Child with an Eating Disorder

Eating disorders present uniquely in different individuals and these are just a few of the most common symptoms. As a parent, you know your child better than anyone else so if you have any doubts about their behavior, contact an eating disorder specialist and ask for advice.

eating disorders in children

If you suspect that your child has an eating disorder:

  • Trust your instincts as a parent. You know if something is not right.
  • Find a family-based therapy trained treatment provider. More information on finding a therapist is here.
  • Do not blame yourself. Eating disorders are complex and develop from a variety of causes.
  • Educate yourself – online blogs, books, podcasts, forums and reviews of clinical trials will help you understand eating disorders, how to support someone with them, and therefore the role that it is playing in your household dynamics.
  • Do not underestimate the potential you have to help your child recover. Eating disorders are difficult and will have detrimental effects on your family’s functionality. Make sure you surround yourself with resources and support so you can stay strong, optimistic and positive.

Complications

Eating disorders are serious conditions that can create significant physical complications to every organ in the body, so it’s important to seek medical treatment as soon as possible. There could be damage to the heart, bones, blood, digestive tract, and kidneys to name a few. Eating disorders place a great deal of physical stress on the body no matter what age that person is. In a growing body, it is even more vital that weight is restored quickly so that the child’s height, bone strength or fertility is not permanently compromised. If a child is not eating enough when they are in a growing stage their height could be compromised.

Understand that an eating disorder will change your child’s personality somewhat, due to the large amount of stress their body is under. Your child may become irritable and moodier than before. This is something that is a natural response in a body and brain that is undernourished and most parents find that after their child’s body has returned to a more normal weight for them the child they once knew comes back also.

What Can Parents DoAnorexia in Children

It is important you understand that your child’s eating disorder is not your fault and find a supportive community to help you and your family return to wellness. Many parents find it helpful to work with an individual therapist to navigate this process and go through their own healing.

While parents are not to blame for eating disorders, they can be a very positive force when helping their young children recover from them. In very young children it will most likely be the parents who are relied on to deliver a constant and structured recovery plan. This can be done with the help of a treatment team and peers. Find a licensed therapist and registered dietitian in your area who specializes in children with eating disorders.

While a parents attitude to food cannot cause an eating disorder, a good relationship with food and your body can help a child who is healing from an eating disorder.

  • Demonstrating that no food should be feared and that all nutrients, fat, carbohydrates and protein are important for a body to thrive is a beneficial message for any family to adopt.
  • Keeping diet foods, talking about dieting, weight, body dissatisfaction, other people’s bodies, or actively dieting out of the home is another important protocol for the whole family to adopt.
  • Planned family meals give children a good structure and can help them understand the importance of sitting down, connecting, and eating adequately.
  • Health at Every Size is an approach to wellness that focuses on health-promoting behaviors (eating a variety of foods, engaging in enjoyable activities, getting adequate rest, stress management, etc) without concentrating on body weight. There is a book of the same name that can be a helpful resource, listed below.

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Further Reading:

Secrets of Feeding a Healthy Family: How to Eat, How to Raise Good Eaters, How To Cook – By Ellyn Satter

Health at Every Size: The Surprising Truth About Your Weight, by Linda Bacon.

Getting Your Child With an Eating Disorder to Eat

A Mom’s Perspective: Having a Child with an Eating Disorder

Binge Eating Disorder in Children

Help Your Teenager Beat An Eating Disorder, by James Lock and Daniel LeGrange.

Early Intervention: What, Why and How?” Katharine Loeb, PhD, Maudsley Parents Conference, February 2012- Slides only

Eating With Your Anorexic: How My Child Recovered Through Family-Based Treatment and Yours Can Too, by Laura Collins.

References:

Kartini Clinic – The Very Young Child With Anorexia

Smolak, L. (2011). Body image development in childhood. In T. Cash & L. Smolak (Eds.), Body Image: A Handbook of Science, Practice, and Prevention (2nd ed.). New York: Guilford.

Martin, J. B. (2010). The Development of Ideal Body Image Perceptions in the United States. Nutrition Today, 45(3), 98-100.

Updated by Molly Bahr – 2020
Written by Tabitha Farrar – 2014