Many kids — particularly teens — are concerned about how they look and feel self-conscious about their bodies. During puberty, they undergo dramatic physical changes and face new social pressures.
Unfortunately, for a growing proportion of kids and teens, that concern grows into an obsession that can become an eating disorder. Eating disorders such as anorexia nervosa or bulimia nervosa cause dramatic weight fluctuation, interfere with normal daily life, and damage vital body functions.
Parents can help prevent kids from developing an eating disorder by nurturing their self-esteem, and encouraging healthy attitudes about nutrition and appearance. If you fear that your child has an eating disorder, it's important to intervene and seek proper medical care.
About Eating Disorders 
Generally, eating disorders involve self-critical, negative thoughts and feelings about body weight and food, and eating habits that disrupt normal body function and daily activities.
While more common among girls, eating disorders can affect boys too. They're so common in America that 1 or 2 out of every 100 kids will struggle with one, most commonly anorexia or bulimia. Unfortunately, many kids and teens successfully hide the disorders from their families for months or even years.
People with anorexia have an extreme fear of weight gain and a distorted view of their body size and shape. As a result, they can't maintain a normal body weight. Some restrict their food intake by dieting, fasting, or excessive exercise. They hardly eat at all, and the small amount of food they do eat becomes an obsession.
Bulimia is characterized by habitual binge eating and purging. Someone with bulimia may undergo weight fluctuations, but rarely experiences the low weight associated with anorexia. Both disorders tend to involve compulsive exercise.
Although anorexia and bulimia are very similar, people with anorexia are usually very thin and underweight but those with bulimia may be a normal weight or even overweight.
It's important to remember that an eating disorder is not just a behavior that someone can control. It is a medical condition that requires professional medical attention and treatment.
Causes of Eating Disorders
The causes of eating disorders aren't entirely clear, though a combination of psychological, genetic, social, and family factors are thought to be involved.
For kids with eating disorders, there is a large gap between the way they see themselves and how they actually look. People with anorexia or bulimia frequently have an intense fear of being fat or think that they're fat when they aren't. And certain sports, such as ballet, gymnastics and wrestling are thought to be risk factors for eating disorders because of their emphasis on leanness.
There is also an increased incidence of psychiatric disorders, such as anxiety disorder and obsessive-compulsive disorder, among kids and teens with eating disorders. Sometimes, problems at home, such as drug or alcohol abuse, can put kids at higher risk of disordered eating behaviors.
Some research suggests that media images contribute to the rise in the incidence of eating disorders. Most women in advertising, movies, TV, and sports programs are very thin, and this may lead girls to think that the ideal of beauty is thinness. Boys, too, may try to emulate a media ideal by drastically restricting their eating and compulsively exercising.
And this concern can begin at an alarmingly young age. Research shows that 42% of first- to third-grade girls want to be thinner, and 81% of 10-year-olds are afraid of being fat. In fact, most kids with eating disorders began their disordered eating between the ages of 11 and 13.
Many kids who develop an eating disorder have low self-esteem and their focus on weight is an attempt to gain a sense of control.
The Effects of Eating Disorders
While eating disorders result from
a serious mental and behavioral health condition, they can lead to other physical health problems. Anorexia or bulimia may cause dehydration and other medical complications such as heart problems or kidney failure. In extreme cases, eating disorders can lead to severe malnutrition and even death.
With anorexia, the body goes into starvation mode, and the lack of nutrition can affect the body in many ways:
- a drop in blood pressure, pulse, and breathing rate
- hair loss and fingernail breakage
- lanugo hair, a soft hair that can grow all over the skin
- lightheadedness and inability to concentrate
With bulimia, constant vomiting and lack of nutrients can cause:
- damage to the stomach and kidneys
- tooth decay (from exposure to stomach acids)
- "chipmunk cheeks," when the salivary glands permanently expand from throwing up so often
- loss of the mineral potassium (this can contribute to heart problems and even death)
Warning Signs
It can be a challenge for parents to tell the difference between kids' normal self-image concerns and warning signs of an eating disorder.
While many kids and teens — girls in particular — are self-conscious, compare themselves with others, talk about dieting, this doesn't necessarily mean that they have eating disorders. In kids with eating disorders, there are glaring abnormal behaviors and physical signs.
Someone with anorexia might:
- become very thin, frail, or emaciated
- be obsessed with eating, food, and weight control
- weigh herself or himself repeatedly
- count or portion food carefully
- only eat certain foods, avoid foods like dairy, meat, wheat, etc. (of course, lots of people who are allergic to a particular food or are vegetarians avoid certain foods)
- withdraw from social activities, especially meals and celebrations involving food
- be depressed, lethargic (lacking in energy), and feel cold a lot
Someone with bulimia might:
- be intensely unhappy with body size, shape, and weight
- make excuses to go to the bathroom immediately after meals
- only eat diet or low-fat foods (except during binges)
- regularly buy laxatives, diuretics, or enemas
- spend most of his or her time working out or trying to work off calories
- withdraw from social activities, especially meals and celebrations involving food
If You Suspect an Eating Disorder
If you suspect your child has an eating disorder, it's important to intervene and make sure the disorder is diagnosed and treated. Kids with eating disorders often react defensively and angrily when confronted for the first time. Many have trouble admitting, even to themselves, that they have a problem.
Trying to help when someone doesn't think he or she needs it can be hard. Remember, it's not your job to diagnose your child — only a doctor can do that. Your job is to express your concerns and get your child to a medical professional for an objective and accurate assessment.
Approach your child in a loving, supportive, and non-threatening way. Try to bring up your concerns when your child feels comfortable and relaxed, and there are no distractions.
Your child may be
more receptive to a conversation if you focus on your own concerns, and
use "I" statements, rather than "you" statements. For example, steer clear of statements like "you have an eating disorder" or "you're obsessed with food," which may only prompt anger and denial. Instead, try "I imagine that it's very stressful to count calories of everything you eat" or "I'm worried that you have lost so much weight so quickly." Cite specific things your child has said or done that have made you worry, and explain that you want your child to see a doctor to put your own mind at ease.
If you still encounter resistance, talk with your doctor or a mental health care professional about other approaches.
Treating Eating Disorders 
Treatment focuses on helping kids cope with their disordered eating behaviors and establish new patterns of thinking about and approaching food. This can involve medical supervision, nutritional counseling, and therapy. The professionals will address a child's perception about his or her body size, shape, eating, and food.
Kids who are severely malnourished may require hospitalization and ongoing care after their medical condition stabilizes.
Generally, the earlier the intervention (ideally, before malnutrition or a continual binge-purge cycle starts), the shorter the treatment required.
Preventing Eating Disorders
You can play a powerful role in your child's development of healthy attitudes about food and nutrition.
Your own body image can influence your kids. If you constantly say "I'm fat," complain about exercise, and practice "yo-yo" dieting, your kids might feel that a distorted body image is normal and acceptable.
At a time of great societal concern about obesity, it can be tricky for parents to talk with their kids about their eating habits. It's best to emphasize health, rather than weight. Make sure your kids know that you love them for who they are, not how they look.
Finally, take an active role in creating a healthy lifestyle for your family. Involve your kids in the preparation of healthy, nutritious meals. Let them know that it's OK to eat when hungry and refuse food when they're not. Also, make exercise a fun, rewarding, and regular family activity.
Developing your own healthy attitudes about food and exercise will set an excellent example for your kids.
[From kidshealth.org
Reviewed by: Barbara P. Homeier, MD
Date reviewed: June 2005]
Eating Disorder
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