While eating disorders are commonly diagnosed in teens and young adults, the rate at which children are developing these disorders has increased exponentially. According to the Agency for Healthcare Research and Quality, hospitalizations for children with eating disorders under the age of 12 increased by 119% between 1999 and 2006. Due to the potential impact on a child’s physical, cognitive and emotional development, it is crucial that parents understand what these disorders look like in children in order to intervene as soon as possible.
The Four Most Common Eating Disorders in Children
1. Avoidant/Restrictive Food Intake Disorder (ARFID): Children with this disorder exhibit a lack of interest in food, refuse to eat due to sensory issues (smell, taste, texture, or colour of the food) or fear aversive experiences (choking, vomiting). ARFID is not associated with a fear of weight gain or issues with body image.
2. Anorexia Nervosa (AN): Characterized by significantly low body weight, behaviour that interferes with weight gain (ex. restricting food intake, excessive exercise), distorted self-image, and a fear of gaining weight.
3. Eating Disorder Not Otherwise Specified (EDNOS): This encompasses a wide range of symptoms specifically related to disordered eating that does not fit criteria for another eating disorder. Example: if a child exhibits multiple symptoms of AN but does not have a fear of gaining weight then they may be diagnosed with EDNOS.
4. Pica: Children with this disorder will consume inedible objects such as chalk, nails, buttons, paint, etc. This is often associated with a nutrient deficiency, as well as co-existing psychological disorders (ex. obsessive-compulsive disorder and schizophrenia) and developmental disabilities.
What To Look For: Warning Signs in Children
Most children with eating disorders show signs that they are struggling, though some may be subtle or unexpected. Examples of some common warning signs include:
- Fear of stomach aches, choking or throwing up
- Refusal to eat foods that they previously enjoyed
- Aversion to certain tastes or textures
- Extreme tantrums
- Negative comments about body shape
- Hyperactivity or excessive exercise
- Failure to make expected gains in weight or height (specifically in still growing children)
- Restricting the amount of food or how often they eat
- Constipation or digestion problems
- Hiding or hoarding food
- Mood swings
Depending on the severity of your child’s eating disorder, they may need to be placed into inpatient therapy to have their treatment overseen by numerous health care professionals. Currently, the most effective psychological treatment for children is family-based therapy (FBT). In this form of therapy, parents are charged with helping their child establish normal eating and exercise patterns. Part of this step involves creating a plan for when and what your child will eat, as well as a steadfast routine for mealtimes. As children have not yet developed the cognitive abilities to undergo intensive cognitive therapy, much of their treatment revolves around behavioural modifications. This kind of therapy focuses on changing eating habits and unhealthy behaviours through rewards and consequences to create more positive associations with food and eating. In addition to this, a paediatrician can monitor your child and assist with any weight restoration if needed. It may be helpful to consult with a dietician as well to ensure your child is getting the proper nutrients in their diet.
The best approach you can do for your child is recognize the signs and speak up. Talk to them about your concerns and about how they’re doing and feeling – and remember, shaming language and consequences are detrimental and counterproductive to your child’s healthy recovery. It is crucial that you get help as soon as possible, as this will ensure a better chance of recovery. Above all, be patient and supportive. It is important to let your child know that you are there with them every step of the way without judgement.