Eating Disorders in Children
This is part 1 of a 3-part series featuring information for parents about Eating Disorders in Children.
I am sure you have heard discussions about diets and resolutions of weight loss–they’re hard to miss! Unfortunately, your child is probably hearing these conversations too, and may be thinking about going on a diet or losing weight.
While going on the latest diet trend might seem appealing to you, dieting is linked to disordered eating in children and teens. Studies have found that young girls who go on a diet are seven to eight times more likely to develop an eating disorder than girls who do not diet.
Because dieting talk is everywhere, and the pressure to be fit and trim is real, I thought it was time to launch a series on eating disorders in children, particularly focused on what parents need to know, how to recognize the early signs of an eating disorder, and what you can do to prevent them.
What is an eating disorder?
Eating disorders are a serious disturbance in thinking about food and eating behavior. Eating disorders are not diet strategies or trends, rather, they are serious psychological disorders that have the highest mortality rate of any mental illness. There are many types of eating disorders and they are not limited to gender, age, socio-economic status or ethnicity.
Eating disorders are affecting kids at younger ages than ever before, and diagnosis in boys is on the upswing. According to the National Association of Anorexia Nervosa and Associated Disorders Ten Year Study, 10% of those affected with an eating disorder report the onset occurring before the age of 10 years.
Not a surprise, considering one study found 81% of 10 year old girls were afraid of becoming fat. Sadly, kids’ exposure to thin idealism and dieting from TV, movies, magazines, and the Internet are not fading away anytime soon.
Furthermore, national surveys suggest a significant number of women (20 million) and men (10 million) will have an eating disorder at some point in their lives. For these reasons and more, as a parent, I believe you need to know about the different types of eating disorders.
Types of Eating Disorders in Children
1. Anorexia nervosa (AN)
Anorexia nervosa is characterized by significant weight loss, and in children, a lack of weight gain, and/or height growth. This is often accompanied be a distorted body image (ie, thinking of oneself heavier or larger) and/or an intense fear of gaining weight or becoming fat (even though the individual is underweight). Eating is restrictive and may be progressively limited in food types and amounts.
According to the National Eating Disorders Association (NEDA), 25% of all individuals with anorexia are male; and anorexia is the third most common chronic disease (after asthma and Type 1 diabetes) among young people.
2. Bulimia nervosa (BN)
Bulimia is characterized by uncontrolled or binge eating accompanied by behaviors to prevent weight gain, such as self-induced vomiting, laxative use, fasting, excessive exercise, and other measures to keep from gaining weight. Some people with bulimia also struggle with self-harm, drug abuse, and other risky behaviors.
According to research by Stice and Bohon, about 1 to 5% of females and up to 0.5% of males will develop bulimia.
3. Binge Eating Disorder (BED)
Binge eating disorder (BED) is the most common eating disorder in the United States. It is characterized by recurrent occurrences of eating large amounts of food (very quickly and to the point of discomfort) along with a feeling of a being out of control while eating. Individuals with binge eating disorder do not typically use unhealthy measures (e.g., vomiting or excessive exercise) to counter the binge eating.
BED often begins in the late teens or early adulthood. It has been reported in young children and approximately 40% of those with binge eating disorder are male. Most people with BED are overweight or obese.
4. Other Specified Feeding and Eating Disorders (OSFED)
OSFED was previously known as Eating Disorder- Not Otherwise Specified (EDNOS), and has historically been a “catch-all” diagnosis for those disordered eating patterns that meet some, but not all, of the criteria for anorexia or bulimia, but who still have a significant eating disorder. OSFED includes more uncommon eating disorders, such as Night-Eating Syndrome and purging disorder. Complications of OSFED can create countless health consequences that can be lethal.
5. Avoidant Restrictive Food Intake Disorder (ARFID)
Previously recognized as selective eating disorder, ARFID is a relatively new name for a disorder characterized by extreme picky eating without concern for body weight, shape or size. Individuals with ARFID have a limited number of foods they will eat, may have anxiety around eating, and demonstrate sensory sensitivities to the characteristics of food such as texture of smell. To learn whether your child may have ARFID, read: Does My Child Have ARFID? or listen to my podcast interview on extreme picky eating with Melanie Potock.
One study showed that one-third of children with ARFID have a mood disorder, three-quarters have an anxiety disorder, and nearly 20 percent have an autism spectrum condition.
In my experience, all eating disorders are complicated and may occur alongside other challenges.
Eating disorders in children are both a medical and psychological concern. Genetic factors play a strong role in the development of an eating, but so does the environment in which a child grows up.
Even if your child has a genetic “history,” you aren’t powerless. You can do quite a bit to prevent an eating disorder from developing. I’ll cover that in Part 3.
Meanwhile, there’s more you need to know, like the red flags that warn you of an eating disorder.
Read that next, in Part 2 of this series: Eating Disorders in Children: Warning Signs to Keep an Eye On
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Written by: Jill Castle, MS, RDN
Published on: February 22, 2018
Updated on: March 1, 2018