Eating Disorders in Children

When considering eating disorders, the general perception often revolves around teenagers and young adults. However, it is important to acknowledge that eating disorders in children can happen.

In recent years, there has been a noticeable increase in eating disorders among girls and boys under the age of 12. This highlights the importance for parents and all adults who interact with young children to be able to identify the warning signs. The physical growth stage plays a vital role in a child’s development, and eating disorders can have severe detrimental effects on their bodies.

Causes of Eating Disorders in Children

Parents often find themselves questioning why their child is experiencing difficulties with eating, such as a lack of appetite or abnormal eating behaviors. It is important to understand that the reasons eating disorders in children are unique to each child, and parents are not to blame. However, parents can play a significant role in finding solutions.

Here are several factors that may contribute to a child’s susceptibility to developing an eating disorder: 

• A family history of eating disorders, indicating a genetic predisposition.
• Past struggles with feeding, which may have impacted their relationship with food.
• Traumatic experiences related to eating, such as instances of choking.
• Instances of bullying or harassment at school.
• Sensory issues, particularly for those with Avoidant/Restrictive Food Intake Disorder (ARFID).
• Co-occurring mental health conditions like anxiety or depression, which can contribute to the development of eating disorders.

Early Signs of Eating Disorders in Children

Eating disorders in children typically manifest with symptoms that differ from those commonly observed in older patients. The presentations tend to be complex, and patterns of food restriction deviate from the norm. Children often refuse food for various reasons, including: 

• Fear of being perceived as “fat” due to witnessing peers being teased at school.
• Apprehension about experiencing stomach aches, vomiting, or choking.
• Aversion to specific tastes, smells, and textures.

Moreover, many children exhibit anxiety symptoms prior to developing disordered eating habits, which further exacerbate their fears and unhealthy relationship with food. Some may also develop behaviors resembling obsessive-compulsive disorder (OCD), which coincide with their restrictive eating and resulting malnutrition. As a result of these challenges, children often display behavioral regression, characterized by:

• Frequent and intense tantrums.
• Physical aggression towards others.
• Persistent screaming.
• Excessive restlessness or hyperactivity.

Common Types of Eating Disorders in Children

Children can experience various types of eating disorders, each characterized by unique symptoms and behaviors. By familiarizing yourself with the different types of eating disorders that can affect children, you can develop a better understanding of the complexities involved and the specific signs to look out for. 

Anorexia Nervosa

Anorexia nervosa can impact both young girls and boys, leading them to perceive themselves as overweight despite appearing significantly underweight to others. Children with anorexia often develop an obsession with monitoring their food intake and exerting control over their weight. This may involve engaging in excessive exercise or experiencing cycles of binge eating followed by purging behaviors. 

Bulimia Nervosa

Bulimia nervosa is a disorder characterized by recurring episodes of binge eating, which are typically kept hidden, and subsequent efforts to compensate for these episodes through excessive exercise, self-induced vomiting, or strict dieting. 

Binge Eating Disorder

Binge eating disorder is marked by repetitive episodes of excessive eating. Individuals consume significantly more food than usual, resulting in discomfort from feeling overly full, even when not physically hungry. Unlike other eating disorders, binge eating disorders do not involve compensatory behaviors such as excessive exercise or purging.

Avoidant/Restrictive Food Intake Disorder (ARFID) 

Those with ARFID have a reduced interest in food or a sensory aversion to specific types of food. For instance, a child may develop an aversion to swallowing or dislike the texture of foods they used to enjoy. They may also harbor fears of experiencing stomachaches if they consume certain foods. These aversions and restrictions can result in weight loss and nutritional deficiencies among young children.

Pica

Pica is a condition in which a child regularly consumes non-food or non-nutritional items. For a diagnosis of pica, the behavior must go beyond what is considered typical for the child’s developmental stage; for example, an infant who chews on objects would not be classified as having pica. Common objects ingested by individuals with pica include dirt, soap, sand, ice, and hair.

Treatments

Eating disorders in children can be managed and treated. Given that children have limited cognitive abstraction abilities during their development, the treatment approach for addressing difficulties related to nutrition primarily focuses on behavioral interventions. These interventions revolve around implementing rewards and consequences to ensure adequate nutritional intake and address maladaptive behaviors.

During the treatment process, it is common for periods of behavioral regression to occur before observing improvement. These regressions can manifest in various ways, including:

• Refusal to consume solid foods, necessitating the need for a liquid supplement diet.
• Complete rejection of both food and supplements, leading to the requirement of NG tube feeding.
• An increase in aggressive tantrums or outbursts.
• Heightened levels of anxiety.

In the case of younger children, family-centered interventions have proven to be highly effective. This type of therapy is particularly suitable, as it empowers parents to take charge of nutrition-related decisions and acquire skills in meal support, supervision, and the management of food avoidant behaviors and anxiety.

The involvement of a pediatrician for medical monitoring is crucial. In cases of severe eating disorders or medical instability, higher levels of care might be necessary. Consulting with dieticians can also provide valuable support, especially if parents have uncertainties about how to provide meals that are sufficient for weight restoration.

If your child has signs and symptoms of an eating disorder, it is highly advisable to seek professional help right away. You can visit Mindshift Psychological Services to help you find the right solution and treatment for your child’s condition. You can contact them at (714) 584-9700 to schedule an appointment.