An eating disorder is a serious health condition that can impact anyone regardless of gender, race, background, and even age. Although it’s often thought that eating disorders occur mostly in young adults, it is possible and increasingly common for children and teens to experience eating disorders as well. This article will help you better understand eating disorders among children and help you get the care your child may need. 

Can Children Experience Eating Disorders?

Despite commonly held ideas about eating disorders occurring mainly among young adults, it is true that children can also experience eating disorders. In fact, one in five children show signs of disordered eating. Researchers found that thirty percent of girls and seventeen percent of boys experienced disordered eating in adolescence. Another study found that 1.4% of nine- and ten-year old children had eating disorders with no notable differences in gender. These unsettling statistics emphasize how important it is for parents, caretakers, teachers, and healthcare professionals to understand the signs of eating disorders in children and how to pursue help. 

Because childhood is a pivotal time in life for physical growth and cognitive development, children experiencing eating disorders risk severe negative impacts to growth and development that can have lasting effects well into adulthood. All people, including children and teens, can experience an eating disorder regardless of their body size or weight, so it is important to take note of your child’s behaviors regarding food and body image during key developmental phases. It may feel overwhelming to recognize signs that your child may have an eating disorder, but remember that help is available and recovery is always possible. Noticing symptoms early and finding help immediately can make all the difference in creating a healthy future for your child. 

Eating Disorders Experienced by Children

You might be wondering what eating disorders your child or teen could experience. There are several different eating disorders defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), each with a unique diagnostic criteria. Eating disorders are diagnosed with diagnostic examinations utilized by medical professionals to screen, assess, and diagnose patients. These diagnostic assessments may be used differently when assessing children based on the child’s developmental and cognitive abilities. This section will walk you through common eating disorders that can be found in children and teens as well as adults.

Avoidant/Restrictive Food Intake Disorder (ARFID)

Avoidant Restrictive Food Intake Disorder is an eating disorder distinguished by a refusal or lack of interest in eating or food. Those who suffer from ARFID may avoid foods based on smell, texture, or other sensory characteristics, and hold obsessive concerns about consuming particular foods or food categories. Extreme pickiness or anxiety around certain foods may be signs of ARFID. Children and teens experiencing ARFID often are unable to obtain sufficient nutritional or energy needs due to their tendency to avoid particular foods. This can have significant negative impacts on growth and development. Behaviors of food avoidance often start in early childhood and can continue into adulthood if not diagnosed and treated. 

Pica

Pica is an eating disorder where individuals eat non-nutritive, non-food substances such as paper, glass, clay, paint, hair, chalk, dirt, or other nutrient-deficient non-food items. Pica is a relatively rare condition seen most commonly in young children. Though rare, pica can cause a myriad of medical complications due to lack of nutrients in the substances they eat and the risks of the substances themselves. Risks include anemia, nutritional deficiencies, intestinal blockage, dental erosion, and toxicity of eating non-food substances such as lead paint. 

Rumination Disorder

Rumination disorder is a condition characterized by the act of regurgitation, re-chewing, and re-swallowing or spitting out of previously eaten food. Rumination generally happens within a half hour after eating a meal. Individuals with rumination disorder often develop these behaviors in infancy or childhood and the condition tends to disappear on its own. However, when rumination disorder persists it can lead to nutritional deficiencies and malnutrition. 

Anorexia nervosa

Anorexia nervosa is an eating disorder characterized by an intense fear of gaining weight. The fear of weight gain leads to distorted body image and disturbances in eating behaviors. There are two subtypes: restricting subtype and binge-eating and purging subtype. It is less common for children to show purging behaviors than it is for them to restrict their food intake. Children experiencing anorexia nervosa may significantly limit food intake, leading to low body weight. Though it is less common in children,  the binge-eating and purging subtype also may restrict food intake as well as engage in binging behaviors, like excessive eating, and purging behaviors, like induced vomiting, using laxatives, or excessive exercise. Anorexia nervosa poses a significant risk to children because restricting nutrients and energy during a period of significant growth can have permanent effects on a child’s development. 

Other Specified Feeding and Eating Disorders (OSFED)

Other Specified Feeding and Eating Disorders (OSFED) is a classification of eating disorders for those with conditions that do not meet diagnostic criteria of other eating disorders despite similar symptoms. A person with OSFED may show signs of disordered eating similar to conditions such as anorexia nervosa or bulimia nervosa, but will not meet the entire criteria necessary to be diagnosed with these conditions. Those diagnosed with OSFED generally show symptoms present in other eating disorders, but to a lesser degree or lower frequency. Low frequency and limited duration of these symptoms can nevertheless be clinically significant and cause health problems and impairment, especially when found during childhood and teen years when important physical and cognitive development are occurring. 

Binge Eating Disorder (BED)

Binge eating disorder is a condition where people experience recurring episodes of overeating. These episodes generally take place in a rapid manner and in a short amount of time. Binge eating episodes tend to occur when a child is not hungry, consist of eating large amounts of food, and often lead well past the point of extreme fullness. Children and teens experiencing binge eating disorder often feel a lack of control over eating habits, an inability to sense fullness, and an indecision of what to eat. 

Causes and Risk Factors

There are many factors that may cause a child or teen to experience an eating disorder. These causes vary based on personal medical history, family history,  and environment. One of the highest predictors of developing an eating disorder is if a family member also has had an eating disorder. In fact, a child is seven to twelve times more likely to experience an eating disorder if a parent or sibling has struggled with an eating disorder. Along with family medical history, social and cultural factors have been found to contribute to eating disorders. Social pressures around body shape and image, often exacerbated by the influence of social media, may have a role in the development of eating disorders. As children have increasing access to social media, these pressures can have negative effects at a younger age. Furthermore, if a child has struggled with mental illness such as depression and anxiety or has experienced childhood trauma, they may be more at risk of developing an eating disorder.

Signs and Symptoms

Recognizing the warning signs and symptoms of eating disorders in children can help make a difference in early detection and eating disorder treatment. Because body size and weight are not necessarily predictors of an eating disorder, it’s important to keep an eye on the behavioral signs your child might be showing. Early signs of eating disorders among children may include:

• Extreme pickiness when eating 
• Anxiety around certain food sensory factors like texture or smell
• Concerns about body image
• Spending excessive time in the bathroom

Other signs of of eating disorder for children and teens include:

• Avoidance of food and eating
• Extreme weight gain or weight loss
• Delayed puberty
• Gastrointestinal issues
• Secretive eating or ritualized mealtime habits
• Mental health issues

If you notice these symptoms in your child or teen, it is important to seek professional care as soon as possible. Eating disorders are complex conditions involving both mental and physical health and professional medical support is necessary for recovery. 

How to Support Your Child

If your child or teen is experiencing an eating disorder, you may feel overwhelmed with concern. Remember that connecting your child to pediatric help immediately is the best thing you can do for your child’s health and wellbeing. Because eating disorders are both a medical concern as well as a mental health problem, it can be extremely challenging to overcome on their own. A dedicated care team, consisting of dietitians, psychiatrists, and primary care physicians, as well as a supportive network of family will be critical for their diagnosis and recovery. 

Parents should appropriately monitor their child’s eating habits and make sure that their child is eating a variety of foods that support their nutritional needs. Your job as a parent is to help your child’s progress toward recovery. This path may be difficult for both you and your child, but remember that an eating disorder is a condition, not a choice made by your child or teen. Creating a homespace and network of support that is non-judgemental and empathetic will encourage your child to trust in your support and care. 

Seek Help

If you believe your child may be experiencing an eating disorder, it’s important to seek help now. Find professionals that are experts in treating eating disorders, even among children and teens. Recovery is always possible and help is available with the National Alliance for Eating Disorders.