It’s estimated that 22 percent of children and adolescents worldwide have some form of disordered eating.* Could your child be one of those affected?

Learning about eating disorders and the associated behaviors – which many affected children strive to hide – may help families recognize these disorders early on and get children the help they need before their health is adversely impacted.

What are Eating Disorders and Who is Affected?

According to the National Alliance for Eating Disorders, “Eating disorders are psychological conditions that affect an individual’s relationship with food. Each one involves serious changes in your normal eating behavior. These changes can be actions like eating much less than normal, compulsively overeating, engaging in harmful compensatory behaviors, or having extreme obsessions about body shape or weight.”

Eating disorders can disrupt quality of life for the affected child and family. If left untreated, they can affect growth and development and harm organ systems, including the cardiovascular, neurological, kidney, hematologic, gastrointestinal, and endocrine systems, as well as the teeth and bones.

Children of all ethnic, racial, and socioeconomic backgrounds experience eating disorders. While more commonly associated with girls, eating disorders also affect boys.

Types of Eating Disorders

Below are common types of eating disorders and general descriptions of each.

• Anorexia Nervosa: This disorder is characterized by fear of weight gain, low body weight with caloric restriction and distorted body image.
• Bulimia Nervosa: Individuals with bulimia are known to overeat (binge), followed by purging behaviors, including vomiting and use of diuretics and laxatives.
• Binge Eating Disorder: Common features of this disorder include overeating, eating when not hungry or past the point of feeling sick, feelings of guilt about eating and weight gain.
• Avoidant Restrictive Food Intake Disorder: Individuals with this disorder avoid certain foods, lose weight, or have poor weight gain. They are not affected by body images issues and do not fear weight gain.

Causes of Eating Disorders

Mental health issues, such as anxiety, mood disorders and obsessive-compulsive disorder and more, contribute to development of eating disorders. Also, studies have shown that eating disorders may have a genetic component, as they frequently occur within families. Environmental influences are also a factor. Social media can focus children on unrealistic body goals; while participating in sports (e.g., dance, gymnastics, running, swimming/diving and wrestling) in which performance, appearance, diet, and weight requirements are a factor, can promote disordered eating.

Signs of an Eating Disorder

Children with eating disorders can be very clever at concealing the associated behavior. They may pretend to eat or mislead about the amounts they have eaten or hide their eating binges. Here are behaviors to watch for:

• Preoccupation with dieting and food
• Obsession with weight loss
• Refusing to eat certain foods
• Avoidance of mealtimes, leaving the table early
• Food rituals
• Disappearing into the bathroom after meals
• Withdrawal from friends, mood swings
• Fixation on body size and shape
• Excessive exercise

Physical signs of eating disorders can also include:

• Weight changes
• Stomach and gastrointestinal issues including constipation
• Menstrual problems
• Lab test abnormalities
• Dizziness and fainting
• Cold intolerance
• Skin changes (yellow or pale skin or dry skin
• Dental problems
• Dry hair and brittle nails
• Fine hair on body
• Muscle weakness
• Poor wound healing
• Frequent illness
• Sleep problems

Eating Disorders in Males

Boys can have all types of eating disorders and experience many of the same medical complications as girls. They may also present differently than girls. A 2019 U.S. survey published by the Journal of Adolescent Health indicated that 30 percent of adolescent boys are trying to gain weight, even if their weight is within a normal range.

What to do if You Suspect an Eating Disorder

If you believe your child may have an eating disorder, let them know you are concerned about them and their well-being. Schedule time for them to talk to their pediatrician about eating disorders. You may also wish to schedule the child with an eating disorders specialist. Nicklaus Children’s Division of Adolescent Medicine offers eating disorders consultations. The team includes an adolescent medicine physician, mental health provider, and dietitian.

For more information, please call 305-668-5525.

*National Eating Disorders Association and Journal of the American Medical Association (JAMA) Pediatrics, 2023)