Recognizing Eating Disorders in Children

Parents may notice their teenager picking at his or her food or that their child has begun to exercise more frequently and intensely. Parents may also notice their child talking constantly and almost obsessively about body size of their peers or slender people they idolize on television. Although parents may want to pass these occurrences off as a normal stage of adolescence, some parents are right to be concerned.

The signs of an eating disorder

According to the American Academy of Child and Adolescent Psychiatry, all of the activities mentioned above may be signs of an eating disorder. Anorexia nervosa and bulimia nervosa are eating disorders that are increasing among teens and children, especially young women but not excluding young men.

"Generally, eating disorders involve self-critical, negative thoughts and feelings about personal appearance and food," says Becky Burnett, Clinical Dietitian at East Tennessee Children's Hospital. "Eating disorders are thought to be caused by underlying psychological problems, with the visible symptom being disordered eating and thinking about food."

A person with anorexia nervosa is hungry, but he or she denies the hunger because of an irrational fear of becoming fat. It is often characterized by self-starvation, food preoccupation and rituals, compulsive exercising, and in women, the absence of menstrual cycles.

Bulimia nervosa is characterized by reoccurring periods of binge eating, during which large amounts of food are consumed in a short period of time. Frequently, the binges are followed by purging, through self-induced vomiting, abuse of laxatives and/or diuretics, or periods of fasting. The bulimic's weight is usually normal or somewhat above normal range; it may fluctuate more than 10 pounds due to alternating binges and fasts.

The National Association of Anorexia Nervosa and Associated Disorders estimates that there are 8 million people in this country suffering from eating disorders, and there are more cases being reported in the eight-to- eleven-year-old bracket every day. The American Anorexia/Bulimia Association estimates that 1 percent of teenage girls in the United States develop anorexia nervosa, and approximately 5 percent of college women in the United States have bulimia.

The staff at East Tennessee Children's Hospital offers the following warning signs for helping to detect both anorexia nervosa and bulimia nervosa.

Anorexia danger signs include significant weight loss; continual dieting (even though the child is already thin); feelings of fatness by the child even after weight loss; fear of weight gain; lack of menstrual periods; preoccupation with food, calories, nutrition, and/or cooking; a preference to eat in isolation; compulsive exercise; insomnia; brittle hair or nails; and social withdrawal.

Bulimia nervosa danger signs include uncontrollable eating (binge eating), purging by self-induced vomiting; vigorous exercise; abuse of laxatives or diuretics (water pills) to lose weight; frequent use of the bathroom after meals; reddened fingers (from inducing vomiting); swollen cheeks or glands (from induced vomiting); preoccupation with body weight; depression or mood swings; irregular menstrual periods; dental problems, such as tooth decay caused by induced vomiting; and heartburn and/or bloating.

It won't go away on its own

Eating disorders are not associated with an "adolescent stage" in life or something that will merely fade away. Once a parent suspects a child or adolescent has an eating disorder, they should talk with the child about visiting a doctor or a dietitian. A medical professional can help the child with an eating disorder to take steps toward healthier eating and nutrition.

The focus of treatment is helping children and teens cope with emotional problems which are the cause of their disordered eating behaviors.

Treatment includes medical supervision, nutritional restoration and behavioral therapy, which addresses beliefs about body size, shape, eating, and foods. "Whatever the reason for the eating disorder, if parents and children can work together to understand the problem, the results will be much more favorable," says Burnett.

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